Skilled nursing occupancy is up 142 basis points year over year as of the end of August. Occupancy reached 82.3% in August, topping 82% for the first time since April 2020, according to the latest Skilled Nursing Monthly Report, released last week by NIC MAP Vision.

“However, challenges do persist with staffing shortages that continue to create difficulties within skilled nursing properties limiting the ability to admit new residents in some markets,” Bill Kauffman, senior principal at the National Investment Center for Seniors Housing & Care, wrote in a blog post.

Although the sector is showing signs of recovery, SNF occupancy still is 6.9 percentage points below the February 2020 pre-pandemic level of 89.1%, according to the data.

Managed Medicare revenue mix increased 19 basis points month-over-month, ending August at 11.8%. This level is below the high of 12.5% seen in February 2022. Kauffman, however, noted that it is still well above the pandemic low of 9.2% reached in May 2020.

“Expectations are that it will continue to increase over time with the continued growth of managed Medicare,” he said.

According to the report, managed Medicare revenue per patient day, or RPPD, declined 0.6%, ending August at $487. That amount is a decrease of 0.1% from the previous August.  

“It has decreased $122 (20.1%) since 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 RPPD decreased to $277 in August. That’s a 2.6% year-over-year increase from $270 in August 2022.

Medicaid patient day mix ended August at 67%, a 13 basis point increase month over month. That’s an increase of 397 basis points from the pandemic low of 63.1% reached in February 2022.

“In addition, Medicaid revenue mix decreased in August, but still represented over half of property revenue at 53.8%,” Kauffman noted. “It has increased 472 basis points from the pandemic low of 49.1% set in February 2022.”

Medicare RPPD increased month over month, ending August at $592. Since September 2022, Medicare RPPD has increased 2.9%. 

“Most of this increase in reimbursement is likely a result of the increase in Medicare rates to skilled nursing properties for fiscal year 2023 and potentially higher acuity patients, which also increases RPPD to care for more complex patients,” according to Kauffman.

Medicare revenue increased slightly month over month, ending August at 17.3%. That is a 419 basis points decline from August 2022.