Occupancy decreased among skilled nursing facilities in March, after increasing for two months in a row, according to the National Investment Center for Seniors Housing & Care’s most recent skilled nursing monthly report, released Thursday.
SNF occupancy dipped 27 basis points month over month, ending March at 81%. That level is down 7.8 percentage points from the pre-pandemic February 2020 level of 88.9%.
“There has been positive momentum in occupancy throughout 2022 and the first couple months of 2023. It is up 6.3 percentage points since the low (74.7%) point reached in January 2021,” NIC Senior Principal Bill Kauffman wrote in a blog post. “However, staffing in the sector is still a significant burden on skilled nursing operators and is limiting additional admissions in many markets around the country.”
In the short term, skilled nursing remains challenged by economic pressures, “but the long-term demand for skilled nursing services is expected to grow over time,” Kauffman said.
Both Medicare revenue mix and the revenue per patient day increased in March. Kauffman noted, however, that both are down slightly from December.
According to the data, Medicare revenue mix ended March at 22.2%. Medicare RPPD was $591 at the end of March, which is a 0.78% increase from a year ago.
Managed Medicare revenue mix decreased 28 basis points to 11.4% in March. That’s still 220 basis points above the pandemic low of 9.2% set in May 2020.
Managed Medicare RPPD increased slightly in March, but it is down 0.8% from a year ago.
“Depending on an operator’s business model, the continued decline in managed Medicare revenue per patient day can pose a challenge as the reimbursement differential between Medicare fee-for-service and managed Medicare has increased during the past two years. However, some operators see opportunity to capture patient volume with the growth of managed care,” Kauffman said.
Medicare fee-for-service RPPD was $591 at the end of March, and managed Medicare ended the month at $478, a differential of $113.
Medicaid patient day mix was flat month over month, at 64.9%, according to the data. It sits 188 basis points from the pandemic low of 63.1% set in February 2022, Kauffman noted. Medicaid revenue mix declined 45 basis points from the previous month, ending March at 50.1%.
“One element of the Medicaid revenue share of a property’s revenue is RPPD, and that declined 0.23% from February. However, it is up 3.44% since last year in March 2022,” Kauffman said.
