Skilled nursing facilities across the United States have experienced increases in both Medicaid and Medicare payer mix while other payer mixes have decreased in recent years, according to a three-year Nursing Home Statistical Review released Monday by public accounting and advisory services firm Marcum.
“These trends certainly make running a nursing facility a far more difficult task. Struggling to keep buildings full of residents and relying more heavily on governmental payor sources rather than private ones (which pay higher rates) makes turning a profit a challenge,” stated Thomas Moore, supervisor in advisory services at Marcum. “However, with the pandemic winding down and recovery ensuing, we are optimistic that these trends will rapidly reverse course to pre-pandemic levels.”
From 2018 through 2020, the Medicare payer mix percentage increased by 1.3% nationally. The Medicaid payer mix percentage increased by 1.07% nationally. Payer mix for others decreased by 3.09% nationally.
It’s taking longer for skilled nursing facilities to get paid, also. The national average of days in accounts receivable has increased one day for each year presented in Marcum’s analysis. The Pacific region — Alaska, California, Hawaii, Oregon and Washington state — is hardest hit in this area. It is taking 44 days, or almost a month, for operators to receive payment. Providers in the Rocky Mountain region — Colorado, Idaho, Montana, Nevada, Utah and Wyoming — are receiving payment at approximately one month, on average.
Occupancy declined during this time, too, and varied greatly by region. In the Northeast region — Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania and Vermont — overall occupancy decreased by 12.04%. The Rocky Mountain region saw the lowest decrease in occupancy, with a decline of 7.88%.
According to the report, all regions hit their lows for occupancy at the end of 2020, with the
Southwest region — Alabama, Arkansas, Delaware, the District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia — having the lowest occupancy in the nation, at 56.5% on Dec. 31, 2020, and the Northeast having the highest percentage, at 72.5% on Dec. 31, 2020.
