Reality dictates the terms “national” and “SNF industry” should never be used in the same sentence. That said, we're talking alternate reality, so here we go…
In our opinion, NIC's SNF report is inaccurate, unnecessary, and irresponsible. Their sample set was never statistically valid, and it becomes smaller and more geographically biased each quarter. This NIC report is compiled from only 23 contributors whose 919 facilities are clustered in a handful of states; that's down 25% in just six-months. NIC's January benchmark cannot even be compared to its prior releases because its contributor base shrunk so much, so why would anyone measure it against a specific market or, impossibly, the nation? In any event, why is January performance relevant in April when current data is readily available?
Let's start with Occupancy. The NHSN database, while imperfect, provides current occupancy from nearly every facility in the country; it tells a very different story.
NIC's 23 contributors' occupancy hit 81% in January 2023. Good for them. For context, national occupancy averaged 80.5% in 2019 - this is well documented from cost reports. NIC tells us occupancy is stronger today than it was pre-pandemic. In fact, the average provider hasn't seen 81% since 2016! Let that sink in for a minute.
NIC also says SNF occupancy bottomed out at 74.5% in January 2021 (the actual national low was 67.5%). Relative to the real world, January 2023 occupancy was 75.4% (repeat: NIC's all-time low almost equals actual Jan-23 performance).
The NHSN data has flaws. Many operators improperly report operational beds instead of certified beds; this error removes about 55,000 beds from the occupancy calculation's denominator. In other words, reported occupancy for Q1 2023 is 75.5%, but the real figure is closer to 72%. Lastly, remember the nation has shed more than 3% of its SNF beds since 2017 and this distorts comparisons. Here's the reality of SNF occupancy in January 2023 (keep in mind March data is already available):
National (based on reported beds): 75.4%
National (based on certified beds): 72.5%
Relative to 2017's benchmark: 69.9%
NIC's rate data is even worse. Medicare at $592/day? I don't know what county those 23 contributors are in or who's running reimbursement, but I hope that's not right for their sake. The average Medicare rate, if neutralized/qualified, can be a useful facility-specific benchmark, but to aggregate Medicaid & Medicare Advantage data is pointless. NIC will argue the absolute numbers are not the point, that the purpose is to show trends, but that only works with facilities in the same state and only if the same facilities are tracked quarter-to-quarter.
Numbers are not data. Context matters.
Check out z-INTEL for the latest in SNF data.
Zimmet Healthcare Services Group, LLC Reimbursement Reimagined CORE Analytics 
Marc Zimmet responds to NIC's Irrational Quarterly SNF Report
Marc Zimmet
Reality dictates the terms “national” and “SNF industry” should never be used in the same sentence. That said, we're talking alternate reality, so here we go…
In our opinion, NIC's SNF report is inaccurate, unnecessary, and irresponsible. Their sample set was never statistically valid, and it becomes smaller and more geographically biased each quarter. This NIC report is compiled from only 23 contributors whose 919 facilities are clustered in a handful of states; that's down 25% in just six-months. NIC's January benchmark cannot even be compared to its prior releases because its contributor base shrunk so much, so why would anyone measure it against a specific market or, impossibly, the nation? In any event, why is January performance relevant in April when current data is readily available?
Let's start with Occupancy. The NHSN database, while imperfect, provides current occupancy from nearly every facility in the country; it tells a very different story.
NIC's 23 contributors' occupancy hit 81% in January 2023. Good for them. For context, national occupancy averaged 80.5% in 2019 - this is well documented from cost reports. NIC tells us occupancy is stronger today than it was pre-pandemic. In fact, the average provider hasn't seen 81% since 2016! Let that sink in for a minute.
NIC also says SNF occupancy bottomed out at 74.5% in January 2021 (the actual national low was 67.5%). Relative to the real world, January 2023 occupancy was 75.4% (repeat: NIC's all-time low almost equals actual Jan-23 performance).
The NHSN data has flaws. Many operators improperly report operational beds instead of certified beds; this error removes about 55,000 beds from the occupancy calculation's denominator. In other words, reported occupancy for Q1 2023 is 75.5%, but the real figure is closer to 72%. Lastly, remember the nation has shed more than 3% of its SNF beds since 2017 and this distorts comparisons. Here's the reality of SNF occupancy in January 2023 (keep in mind March data is already available):
National (based on reported beds): 75.4%
National (based on certified beds): 72.5%
Relative to 2017's benchmark: 69.9%
NIC's rate data is even worse. Medicare at $592/day? I don't know what county those 23 contributors are in or who's running reimbursement, but I hope that's not right for their sake. The average Medicare rate, if neutralized/qualified, can be a useful facility-specific benchmark, but to aggregate Medicaid & Medicare Advantage data is pointless. NIC will argue the absolute numbers are not the point, that the purpose is to show trends, but that only works with facilities in the same state and only if the same facilities are tracked quarter-to-quarter.
Numbers are not data. Context matters.
Check out z-INTEL for the latest in SNF data.
Zimmet Healthcare Services Group, LLC Reimbursement Reimagined CORE Analytics