Although skilled nursing occupancy increased for seven consecutive quarters, NIC MAP data reported a slowdown in August in its November skilled nursing monthly report.
Occupancy increased at a slower pace in August compared with previous months, rising only 14 basis points (0.14%) from July, to 75.2%. Labor shortages and the delta variant are to blame, according to NIC’s report. Regardless of the slowdown, the occupancy rate is now 378 basis points (3.78%) above the January 2021 low point. Compared with pre-pandemic occupancy levels in February 2020 (85.6%), occupancy is still low.
“The question remains as to how fast the industry can increase occupancy to a sustainable level as staffing shortages are likely to remain challenging,” the authors wrote.
Medicaid patient day mix rose to 66.1% by the end of August from a pandemic low of 63.3% set in January, and it is close to reaching pre-pandemic levels. Medicaid revenue mix increased slightly from July, ending August at 50.4%.
“One element of the Medicaid revenue share of a property’s revenue is revenue per patient day and that has declined 0.8% ($2.08) since the pandemic high of $246.17 set in February 2021. RPPD has likely declined due to less reimbursement support from most states as COVID-19 cases within skilled nursing properties declined,” the authors wrote.
Medicare revenue mix ended August at 20.3% and is down from a pandemic high of 25.0% set in January, according to the data. Medicare revenue per patient day is down $14.03 (2.4%) from its pandemic peak of $576 in June 2020.
“Medicare revenue mix and RPPD continue to decline as fewer COVID-19 cases in properties have resulted in less need for utilizing the 3-Day rule waiver and per day reimbursement for COVD-19 positive patients,” the authors wrote.
Managed Medicare revenue mix decreased slightly ending August at 10.4%. This is still 211 basis points (2.11%) above the May 2020 pandemic low of 8.3%. Managed Medicare revenue per patient day decreased in August to $18.90 (4.1%), which “continues to pose a challenge to skilled nursing operators as the reimbursement differential between Medicare fee-for-service and managed Medicare has accelerated during the pandemic,” according to the authors.
Medicare fee-for-service revenue per patient day ended August at $562 and managed Medicare ended at $445, representing a $117 differential. Back in February 2020, the differential $98.
