A new Kaiser study confirms what many skilled care operators already know. Occupancy levels are dipping as residents’ conditions are getting worse.

Investigators found nearly half of the nation’s nursing home residents had a dementia diagnosis, while just under a third had other psychiatric conditions such as schizophrenia or mood disorders. About two-thirds of residents received psychoactive medications, including anti-depressants, anti-anxiety drugs, sedatives, hypnotics and antipsychotics.

Average total nursing hours increased to 4.1 per resident day for 2016, up from 3.9 in 2009, but the report noted wide variations across states.

Other findings included:

• Between 2009 and 2013, the average number of deficiencies per facility declined from 9.33 to 7.28, though there was a slight increase the next three years.

• The proportion of for-profit facilities increased from 67% in 2009 to 69% in 2016.

• Medicaid remains the main payer for most facilities.