After a brief shot of optimism last month, skilled nursing occupancy rates dropped slightly in the second quarter, falling to 86.7%. The fade comes as managed care and declining  lengths of stay continue to erode SNF operators’ influence.

“There’s definitely downward pressure due to shorter lengths of stay, due to the push to move people out of skilled nursing into less costly settings,” said Beth Burnham Mace, the chief economist for the National Investment Centers for Seniors Housing & Care, which released new figures Thursday.

“Those pressures are definitely affecting the occupancy rates, and the hope is that demographic trends will start to offset that. But that can vary by market, and that’s more of a long-term aspiration,” she told McKnight’s.

She added that a slightly different survey that NIC will soon release is “showing the same trends” for skilled nursing. Occupancies in rural areas will register lower than urban, she added. The upcoming report also factors payer mix into the equation. 

“Medicaid is becoming a more significant portion of the overall payer mix because of pressures that we’re seeing from Medicare Advantage,” Mace noted.

In June, while reflecting on separate data, NIC hailed skilled nursing’s first year-over-year occupancy rise in four years.

Tough times persist, however, and Mace said that skilled nursing providers should follow a basic recipe: “Serve your residents or your patients as best you can and provide them a really good experience. You could say that same statement for any business, really — produce a good product, and you’ll benefit from that.”

Assisted living and independent living occupancy rates fell in the second quarter, to 85.1% and 90.2%, respectively, compared to the previous quarter, according to NIC. Seniors housing occupancy overall hit an eight-year low, averaging 87.8%, down 20 basis points from the previous quarter.