Occupancy at the nation’s skilled nursing facilities dropped to a five-year low of 81.6% during the third quarter of 2017, according to the Skilled Nursing Data Report published Thursday by the National Investment Center for Seniors Housing & Care.

That’s down down 29 basis points from the prior quarter and down 167 basis points year-over-year, according to NIC.

“Historically, there has been some variability in the occupancy trend in the third quarter in any given year, so it is difficult to gauge the impact of seasonality,” said Bill Kauffman, senior principal at NIC. “Occupancy did set a new low within this time series in the third quarter as pressure continues on the Medicare mix. However, it did decline at a slower pace from the prior quarter.”

While Medicare patient mix came in at a low of 12.2% percent — down from 15% in 2015 — Medicaid shares continue to increase. It hit its highest point within the last five years at 66.8% last quarter.

“Not only is it important to see how the patient mix is changing over time, but we really need to see how the revenue mix is changing in conjunction with patient days which is why NIC will be expanding this data set to include revenue mix next year,” said Beth Burnham Mace, NIC’s chief economist.

Overall, managed Medicare revenue per patient day showed a total decline of 13.2% from five years ago and it experienced a quarter-over-quarter drop of 1.8%. NIC called that “significant deterioration,” given that the previous decline was just  0.2%.

At 9.1%, private patient-day mix matched its previous lowest point, also recorded in 2017.