Occupancy rates for skilled nursing facilities dropped to 82.2% in the second quarter of 2016 — the lowest level in five years, according to a report released in September by the National Investment Center for Seniors Housing & Care.

The drop was likely due to healthcare payment and delivery reform initiatives, and not just seasonal changes, the report’s authors noted.

The NIC report also found that Medicaid revenue increased slightly during the second quarter, while Medicare managed care revenue appeared to taper off.