senior holding hand of healthcare worker

After two months of increases, skilled nursing occupancy declined 40 basis points to 78.4% from August to September, according to the latest Skilled Nursing Monthly Report released by the National Investment Center for Seniors Housing & Care.

Despite the drop, occupancy is still up 188 basis points from the same time period last year. A pandemic low was 73% set in January 2021.

“Some challenges do persist as staffing shortages continue to create difficulties within skilled nursing properties limiting the ability to admit new patients in some markets,” NIC Senior Principal Bill Kauffman wrote in a blog post. “However, the current occupancy trend does suggest that demand for skilled nursing properties is recovering, given the 172-basis point increase from January to September this year.”

Medicare revenue per patient day decreased slightly from August to end September at $572. It has declined 3.1% since January, when cases of COVID-19 were increasing in skilled nursing facilities. One reason RPPD might have been higher at the beginning of the year, according to Kauffman, is that the federal government had implemented initiatives to aid Medicare fee-for-service reimbursements to help care for COVID-19-positive patients requiring isolation. 

The Medicare revenue mix continues to decline, according to the current data. It fell 50 basis points from August to the end of September, to 21.2%. In January, the Medicare revenue mix was 24.4%.

Managed Medicare revenue mix declined 19 basis points to 10.2% from August to September, according to NIC. That’s 130 basis points lower than its recent high of 11.5% in February. Managed Medicare revenue mix is up by 211 basis points from the pandemic low of 8.4% set in May 2020.

“Expectations are that it will continue to increase over time with the growth of managed Medicare,” Kauffman said. Managed Medicare revenue per patient day decreased from $461 to $460 in September and is down 1.7% from last year in September 2021, he noted.

“It has decreased $117 (20.2%) from January 2012 and continues to pressure some operators’ revenue as managed Medicare enrollment grows around the country,” Kauffman said. “However, some operators see managed Medicare as an opportunity for growth in patient volume.”

Medicaid patient day mix increased to 65.1 % in September, which is up 210 basis points from the pandemic low of 63% set in January 2021. Medicaid revenue mix also increased in September, “representing over half of property revenue,” according to Kauffman.

Medicaid revenue mix has increased 345 basis points from the pandemic low of 48.3% set in February 2022. Meanwhile, Medicaid RPPD held steady at $257 in September, increasing slightly from $254 in September 2021.