Occupancy among skilled nursing facilities held steady in July overall, after increasing in June, according to the latest Skilled Nursing Monthly Report, released Thursday by NIC MAP Vision.

SNF occupancy has hovered around 81% since January and ended July at 81.5%, NIC Senior Principal Bill Kauffman wrote Thursday in a blog post. This rate is an 82 basis point increase since December.

Both Medicare revenue mix and the revenue per patient day decreased in July, Kauffman said. Medicare revenue mix ended July at 17.2%, whereas Medicare RPPD was $598 at the end of the month, a 1% decrease from its recent high of $595 in December.

Managed Medicare revenue mix decreased 38 basis points from June to end July at 11.6%, up 243 basis points from the pandemic low of 9.2% set in May 2020. Kauffman reminded that mid-2020 “was a time when elective surgeries were suspended and created less referrals from hospital to skilled nursing properties.”

Managed Medicare RPPD increased from $491 to $492 (0.1%) in July, but it remains down $120 (19.6%) from a high in January 2012, he said. This,  Kauffman said, puts pressure on operators’ revenue as enrollment in managed Medicare programs continues to expand across the country. “However, some operators see an opportunity to capture patient volume with the growth of managed care,” he said.

Medicaid revenue mix increased 143 basis points, ending July at 54.3%, he said. It is up 218 basis points from July 2022, when it was 52.2%. 

Medicaid RPPD was up 1.1% from June and is up 2.6% since last year in July 2022, Kauffman said, noting that it now is $278.

The effects of Medicaid reimbursement rates, inflation-related growth and elevated interest rates “have created expense pressure for many operators around the country,” he said.

Read the full blog post here.