Skilled Nursing Occupancy Hit Record Low in March, ‘Mainly’ Due to Post-Acute Admission Decline

New data reveals significant skilled nursing occupancy declines in amid the ongoing COVID-19 crisis, primarily driven by a drop in admissions to the post-acute setting, according to the National Investment Center for Seniors Housing & Care (NIC).

Skilled nursing occupancy dropped 132 basis points from February to 83.4% in March, pushing the national census to the lowest level since NIC started gathering the numbers in 2012, according to the update, published late last week.

Medicaid patient day mix stayed “relatively steady” in the first quarter, increasing slightly from December of last year to 67.1% at the end of March. But when comparing March to the month before it, the numbers for Medicaid patient mix rose significantly, NIC senior principal Bill Kauffman wrote in the update.


“Compared with February, Medicaid patient mix increased 66 basis points as less of the patient population was likely associated with post-acute care, i.e., Medicare and managed Medicare stays were likely down due to the numerous measures implemented to contain COVID-19,” he wrote. “This is notable and suggests that the occupancy decrease from February to March was mainly, if not all, due to the decreases in post-acute admissions.”

Both Medicare and managed Medicare mix fell from February to March, with Medicare dropping 18 basis points and managed Medicare falling 46 basis points over the course of those 30 days. Overall skilled mix dropped 59 basis points during that time, Kauffman wrote, due to the pressure on Medicare and managed Medicare.

“These declines suggest the pressure on new post-acute admissions began in the month of March as COVID-19 started to impact skilled nursing properties,” Kauffman wrote.


Managed Medicare revenue mix was at 10.8% in February, but it fell 76 basis points in March — likely from the suspension of elective surgeries due to COVID-19 and other factors affecting admission.

The data presented in the update from NIC are different from the numbers cited in the snapshot released May 19, which examined senior housing and nursing care trends. The numbers in the May 28 update come from NIC’s Skilled Nursing Data Initiative.

NIC also will be releasing data from the Skilled Nursing Data Initiative on a monthly basis; it was not clear how many operators had contributed to the data set.

Several publicly traded skilled nursing stakeholders reported that skilled nursing occupancy took a beating due to the fallout from COVID-19 during the most recent round of earnings calls.

Genesis Healthcare (NYSE: GEN) reported an occupancy drop of almost 7%, while Sabra Health Care REIT reported that its skilled nursing occupancy was down 460 basis points from February through the last week of April. Another real estate investment trust (REIT), Omega Healthcare Investors (NYSE: OHI) observed a decline in skilled nursing occupancy of between 3% to 6% across its portfolio.

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