Nursing home use may be finally stabilizing after years of precipitous declines, according to new data from the National Investment Center for Seniors Housing & Care.
NIC reports that occupancy at U.S. facilities stood at about 82.4% in the fourth quarter of last year. That’s virtually the same tally as the previous quarter and down less than half a percentage point compared to 2017’s fourth quarter.
Overall, 2018 shook out as a positive year for the skilled nursing industry, with the numbers holding steady since April, said Bill Kauffman, senior principal at NIC.
“There were some bright spots, certainly, because of what we’ve seen in the stabilization of occupancy for most of that year,” he told McKnight’s. “Going into 2018, I think there was a lot of anxiety. I think there still is, depending on where you’re operating, for sure.”
Rural providers, in particular, have been more challenged in recent years by pressures including inadequate reimbursement rates and labor shortages. NIC’s analysis found that occupancy declined to 80.4% in rural areas, a decrease of 330 basis points, compared to urban counterparts, which reached 83.7%.
Kauffman noted that rural providers have faced a significant strain on the amount of managed Medicare dollars they receive per day. That figure has dropped 21% since the beginning of 2012, from $527 down to $415 at the end of last year.
“When you’re starting off at much lower occupancy levels, from a rural perspective, any additional pressure, even small movements from payer sources, can really move the needle,” Kauffman said.
Across the industry, managed Medicare revenue per patient day rose slightly, up to $430. NIC labeled that swing as a positive after a steady decrease in such revenues since 2012, down 13% from then to the end of 2018. There has not be a quarterly increase in managed Medicare revenue per day since the end of 2016.
NIC’s experts also highlighted the growing popularity of Medicare Advantage plans which now account for 13% of skilled nursing facilities’ revenues, up five percentage points since the beginning of 2012.
“Managed Medicare and Medicare Advantage are the future, we’re pretty comfortable in saying,” Beth Mace, chief economist for NIC, told McKnight’s. “As low Medicaid reimbursement challenges skilled nursing, federal policymakers are making Medicare Advantage even more accessible, and we’ve seen that it’s been gaining popularity for years.”
The report was compiled using data from 27 contributors, representing 1,431 facilities in 47 states. Data is not meant as a census survey for all SNF across the U.S., authors noted.