The delta variant and staffing challenges have slowed occupancy gains over the summer, yet skilled nursing still saw an increase in occupancy for the sixth month in a row as of July.
NIC MAP® Data, released by NIC MAP Vision, found occupancy increased 58 basis points from June to July to land at 75%. It’s still a far cry from pre-pandemic occupancy levels of 85.5% in February 2020, but up from January’s pandemic low of 71.4% this year.
Hospital capacity in delta ravaged parts of the country led to less elective surgeries, and in turn less referrals for nursing homes, NIC MAP data authors noted.
On the SNF side, continued staffing shortages have forced some facilities to limit new residents coming in, according to NIC MAP data.
Medicare revenue per patient day (RPPD) remained at $560 between June and July — the figure dropped 1.5% since January, however, when COVID-19 cases were higher at skilled nursing properties.
“During the pandemic there has been support from the federal government to increase Medicare fee-for-service reimbursements for COVID-19 positive patients requiring isolation,” added NIC MAP data authors; RPPD decreased 2.2% since June 2020. “RPPD has now declined and one possible reason is lower property-level case counts.”
Medicare revenue mix increased from June to July, but the statistic has been trending downward — 431 basis points to 20.3% — due to less use of the three-day inpatient hospital stay waiver instituted during the pandemic.
Pre-pandemic, a patient would need to stay in a hospital for at least three days before Medicare would cover a move to a skilled nursing facility.
Medicaid RPPD increased from June to July to end at $241; NIC MAP data found Medicaid RPPD had an overall increase of 3.7% from February 2020 despite a downward trend from February of this year.
“Medicaid reimbursement has increased more than usual as many states embraced measures to increase reimbursement related to COVID-19,” according to NIC MAP data authors. Still, Medicaid reimbursement rates remain a “major concern” as coverage doesn’t match cost of care in some states.
Managed Medicare RPPD declined further month-to-month, down 4.5% compared to a year ago, NIC MAP data say, ending at $447 for July. That’s a difference of $113 between Managed Medicare and Medicare fee-for-service, which was $560. Pre-pandemic, the difference was $95.
“As Medicare Advantage enrollment now represents 46% of all eligible Medicare beneficiaries, and continues to grow, operators must find ways to adjust, such as opening their own insurance plans,” NIC MAP data authors added.
NIC MAP data was collected from 26 contributors across 47 states for the month of July, a change from 27 contributors in June. This changed the total SNF property number from 1,314 in June to 1,289 in July.
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