Occupancy rates at nursing homes across the country continued to be depressed in October, according to data from the latest Skilled Nursing Monthly Report, published by the National Investment Center for Seniors Housing & Care’s NIC MAP Data Service.

The occupancy rate edged up to 74.7%, an increase of 40 basis points over September’s level of 74.3%, but it was still down 9.1 percentage points since the pandemic began in March (83.8%), 10.5 percentage points since February (85.2%), and 9.9 percentage points from year-earlier levels (84.7%), according to NIC.

The occupancy trend also varied across geographies as urban areas saw a 70-basis point increase from September to October, but rural areas experienced a 23-basis point decline. Both rural and urban areas, however, are experiencing unprecedented low occupancy levels due to COVID-19, noted Bill Kaufman, senior principal at NIC.

“Achieving stabilized occupancy will be a challenge as the pandemic enters a third wave and as the vaccine begins to be distributed,” Kaufman wrote in a blog post Thursday examining the data.

The report also showed that Medicare patient day mix decreased 21 basis points from 12.4% in September to 12.2% in October. It is up 79 basis points since March (11.4%), however. In addition, Medicare revenue mix decreased from September to October, falling 51 basis points. Further, managed Medicare revenue mix increased slightly from September to October (16 basis points) to 9.1% but has declined 174 basis points since February and 75 basis points from year-earlier levels. 

“As skilled nursing occupancy continues to remain depressed and many insurance plan enrollees are being cared for at home after surgeries, the October data suggests that managed Medicare admissions remain far below the levels seen prior to the pandemic, even after elective surgeries were resumed,” Kaufman said. “Expectations are that admissions will take some time to rebound due to competition from home health as well as other factors.”

Latest wave of NIC Executive Survey show increased PPE costs, continued move-in slow-downs

Adding insult to injury, personal protective equipment cost increases continue to challenge SNFs’ operating budgets, noted Lana Peck, senior principal at NIC, during a NIC Community Connector virtual meetup on Thursday. In the 18th wave of NIC’s Executive Survey, in which responses were collected Dec. 14 to 27, more than a quarter (28%) of operators with skilled nursing units reported that their estimated PPE budget had increased by more than 300%. That’s compared with approximately 15% reporting a 300% PPE budget increase earlier in the previous wave.

Data such as these have been invaluable in terms of its ability to provide directional insight into some of the near, real-time experiences of operators amidst the pandemic, Peck noted. 

“When we started this executive survey back in March, we did it to provide timely, transparent information to the sector,” she noted, adding that the result has been a time-series of data encompassing not only the market fundamentals but also many of the other aspects of what’s going. 

“It’s really helped to provide color and context to what’s going on in the sector during the pandemic,” she said.

Peck noted that this latest wave, which included responses from 76 senior living and skilled nursing operators across the country, appears to reflect the true effect of the pandemic’s surge in the fall. Although the survey waves collected in November (Waves 15 and 16) certainly showed downward trends in the pace of move-ins, move-outs and occupancy rates across the continuum of care that operators were experiencing starting in October, Peck noted that the trends continued into the holiday season. 

More survey respondents reported drops in occupancy in the past 30 days than increases,” she said. “In light of COVID-19 infection positivity rates rising across the country, more organizations in Wave 18 cited self-imposed or government-imposed move-in restrictions as a reason for slowing the pace of settling residents into their communities.”