Skilled Nursing Occupancy Continued Slow Recovery in December

March 3, 2022

“The Omicron variant has challenged the skilled nursing recovery given the staffing shortages around the country as skilled nursing properties are unable to hire enough staff to admit more residents.”

NIC MAP® data, powered by NIC MAP Vision, released its latest Skilled Nursing Monthly Report on March 3, 2022. The report includes key monthly data points from January 2012 through December 2021.

Here are some key takeaways from the report:


Skilled nursing property occupancy increased 24 basis points in the month of December, ending the month at 76.0%. This was the highest occupancy level since May 2020. After not changing from October to November, occupancy continued its slow recovery, which was challenged by the Delta variant and, more recently, the Omicron COVID-19 variant. Occupancy has increased 411 basis points from the low of 71.8% set in January 2021. The fact that occupancy held steady through the Delta variant and the early stage of Omicron suggests that the demand for skilled nursing properties remains, but a significant challenge for many skilled nursing operators around the country has been the staffing shortages that limit the ability to admit new residents. The already difficult labor shortage has grown increasingly worse as staff infected with Omicron have been forced to quarantine.

Managed Medicare

Managed Medicare revenue mix increased 20 basis points from November to end December at 9.9%, reversing the 20-basis point decline that occurred from October to November. It remains well below its 2021 high of 10.8% seen in February 2021 but was up by 204 basis points from the pandemic low set in May 2020 of 7.9%. The increase from the pandemic low is likely due to growth in elective surgeries from 2020, which typically creates additional referrals to skilled nursing properties. Meanwhile, Managed Medicare revenue per patient day (RPPD) decreased again, albeit slightly, ending December at $451. In addition, it is down 3.4% from December 2020. It has decreased $107 (19.2%) from January 2012 when the data series began to be reported as managed Medicare enrollment continues to grow across the country.

Medicare revenue per patient day (RPPD) increased slightly from November to end December 2021 at $580. It has decreased 1.0% from $585 in June 2020 when severe cases in skilled nursing properties were increasing significantly during the early stages of the pandemic. The federal government implemented many initiatives to aid properties for cases of COVID-19, including increases in Medicare fee-for-service reimbursements to help care for COVID-19 positive patients requiring isolation. Meanwhile, Medicare revenue mix also trended higher in December, increasing 57 basis points ending December at 20.7%. However, it has been falling since January 2021 when it was 24.5%.

Medicaid revenue per patient day (RPPD) was relatively flat from November to end December 2021 at $248. Medicaid RPPD declined 1.1% from February of 2021 to September 2021 but has since increased 1.6% from September to December. This increase is likely due to some states adjusting their Medicaid budgets and increasing reimbursement for the 2022-2023 fiscal year. Medicaid RPPD increased 0.90% from a year ago in December 2020 and has increased 5.0% from pre-pandemic levels of February 2020 ($236).

Medicaid reimbursement has increased more than usual as many states embraced measures to increase reimbursement related to the number of COVID-19 cases to support skilled nursing properties.

To get more trends from the latest data you can download the Skilled Nursing Monthly Report. There is no charge for this report.

The report provides aggregate data at the national level from a sampling of skilled nursing operators with multiple properties in the United States. NIC continues to grow its database of participating operators to provide data at localized levels in the future. Operators who are interested in participating can complete a participation form. NIC maintains strict confidentiality of all data it receives.

This blog was originally published on NIC Notes.

About NIC
The National Investment Center for Seniors Housing & Care (NIC), a 501(c)(3) organization, works to enable access and choice by providing data, analytics, and connections that bring together investors and providers. The organization delivers the most trusted, objective, and timely insights and implications derived from its analytics, which benefit from NIC’s affiliation with NIC MAP Vision, the leading provider of comprehensive market data for senior housing and skilled nursing properties. NIC events, which include the industry’s premiere conferences, provide sector stakeholders with opportunities to convene, network, and drive thought-leadership through high-quality educational programming. To see all that NIC offers, visit

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