13,092 full-year Medicare cost reports · fiscal years ending August 2024 to August 2025
Skilled nursing benchmarks by state
The median US skilled nursing facility ran at 82.6% occupancy with $351 of net patient revenue and $355 of operating expense per patient day. Medicaid covered 62.1% of its days and Medicare 7.5%.
United States
| Metric | 25th pct | Median | 75th pct | US median | Range |
|---|---|---|---|---|---|
| Occupancypatient days / bed days available | 69.3% | 82.6% | 90.8% | 82.6% | |
| Net patient revenue per patient day | $301 | $351 | $418 | $351 | |
| Total operating expense per patient day | $304 | $355 | $432 | $355 | |
| Operating margin as reportednet patient revenue less total operating expense | -8.8% | -0.3% | 6.1% | -0.3% | |
| Medicare share of days | 4.3% | 7.5% | 12.6% | 7.5% | |
| Medicaid share of days | 39.4% | 62.1% | 74.5% | 62.1% | |
| Other payers share of daysprivate pay, managed care, VA and others | 17.4% | 27.7% | 47.3% | 27.7% | |
| Medicare PPS payment per Medicare day | $579 | $627 | $694 | $627 | |
| Contract labor share of labor cost | 5.8% | 11.5% | 18.5% | 11.5% | |
| Beds | 76 | 106 | 135 | 106 |
middle half of US facilities US median US median
By state
| State | Reports | Occupancy | Revenue per day | Expense per day | Margin as reported | Medicare days | Medicaid days |
|---|---|---|---|---|---|---|---|
| Alabama | 205 | 86.6% | $310 | $308 | 0.6% | 5.0% | 68.0% |
| Arizona | 126 | 80.7% | $401 | $396 | 2.3% | 7.9% | 57.7% |
| Arkansas | 202 | 72.3% | $314 | $308 | 3.1% | 7.0% | 66.7% |
| California | 999 | 90.4% | $480 | $465 | 3.5% | 15.0% | 7.0%* |
| Colorado | 170 | 82.3% | $375 | $392 | -3.8% | 4.9% | 66.0% |
| Connecticut | 173 | 89.4% | $379 | $394 | -1.6% | 7.2% | 68.1% |
| Delaware | 34 | 86.8% | $393 | $419 | -0.2% | 11.1% | 63.3% |
| District of Columbia | 12 | 77.8% | $450 | $438 | -16.6% | 8.7% | 80.2% |
| Florida | 655 | 90.9% | $346 | $351 | -1.5% | 12.6% | 60.6% |
| Georgia | 312 | 85.1% | $299 | $305 | -0.8% | 6.1% | 64.1% |
| Hawaii | 33 | 82.1% | $555 | $565 | 1.6% | 6.1% | 61.6% |
| Idaho | 70 | 71.8% | $434 | $414 | 7.6% | 8.4% | 69.5% |
| Illinois | 596 | 73.6% | $305 | $320 | -4.4% | 7.4% | 62.9% |
| Indiana | 494 | 72.8% | $376 | $352 | 4.1% | 5.7% | 65.0% |
| Iowa | 339 | 79.9% | $312 | $313 | -0.7% | 4.8% | 51.2% |
| Kansas | 247 | 83.5% | $322 | $317 | 0.6% | 6.9% | 57.6% |
| Kentucky | 239 | 87.3% | $347 | $329 | 7.3% | 6.9% | 73.6% |
| Louisiana | 253 | 74.9% | $305 | $284 | 5.8% | 6.8% | 73.3% |
| Maine | 66 | 90.7% | $384 | $404 | -2.4% | 5.5% | 59.2% |
| Maryland | 201 | 88.3% | $431 | $414 | 3.3% | 13.7% | 64.2% |
| Massachusetts | 324 | 86.2% | $378 | $389 | -2.7% | 8.6% | 59.5% |
| Michigan | 388 | 81.0% | $369 | $380 | -3.8% | 5.9% | 62.1% |
| Minnesota | 274 | 83.5% | $419 | $450 | -5.2% | 6.1% | 51.8% |
| Mississippi | 172 | 87.2% | $330 | $317 | 5.2% | 9.3% | 77.9% |
| Missouri | 440 | 71.0% | $252 | $254 | -1.1% | 5.1% | 65.3% |
| Montana | 38 | 71.8% | $339 | $367 | -4.6% | 9.7% | 56.2% |
| Nebraska | 154 | 72.6% | $334 | $347 | -3.6% | 6.0% | 50.1% |
| Nevada | 50 | 87.4% | $453 | $447 | 6.7% | 12.6% | 64.7% |
| New Hampshire | 66 | 81.0% | $382 | $417 | -6.1% | 9.2% | 66.6% |
| New Jersey | 327 | 82.9% | $390 | $394 | -1.4% | 13.5% | 64.1% |
| New Mexico | 60 | 85.3% | $400 | $412 | -0.4% | 7.2% | 71.0% |
| New York | 523 | 92.5% | $417 | $433 | -2.4% | 10.8% | 64.3% |
| North Carolina | 371 | 81.6% | $362 | $350 | 3.1% | 7.5% | 62.7% |
| North Dakota | 49 | 94.6% | $431 | $425 | 1.9% | 5.1% | 52.6% |
| Ohio | 887 | 85.1% | $322 | $332 | -1.6% | 5.1% | 46.5% |
| Oklahoma | 258 | 61.7% | $264 | $262 | 2.1% | 6.3% | 77.3% |
| Oregon | 94 | 63.6% | $597 | $570 | 4.3% | 10.3% | 56.1% |
| Pennsylvania | 567 | 85.0% | $336 | $365 | -6.9% | 5.3% | 67.4% |
| Rhode Island | 69 | 87.1% | $354 | $369 | -2.9% | 5.1% | 63.4% |
| South Carolina | 165 | 89.8% | $317 | $314 | 1.2% | 8.9% | 63.7% |
| South Dakota | 67 | 84.4% | $330 | $325 | -0.0% | 7.9% | 55.6% |
| Tennessee | 275 | 73.6% | $337 | $353 | -2.9% | 8.6% | 63.6% |
| Texas | 1079 | 66.8% | $259 | $271 | -2.7% | 6.5% | 66.3% |
| Utah | 89 | 73.7% | $400 | $401 | -0.0% | 7.3% | 59.5% |
| Vermont | 33 | 86.0% | $429 | $436 | 2.4% | 10.1% | 0.0%* |
| Virginia | 254 | 90.6% | $361 | $339 | 7.2% | 7.7% | 63.3% |
| Washington | 176 | 75.4% | $465 | $474 | -1.2% | 10.2% | 62.0% |
| West Virginia | 102 | 93.8% | $433 | $395 | 9.3% | 5.3% | 82.9% |
| Wisconsin | 289 | 72.2% | $401 | $401 | 0.5% | 7.6% | 60.5% |
| Wyoming | 20 | 69.0% | $381 | $388 | 0.6% | 11.6% | 59.3% |
Medians. States with fewer than 8 usable reports are left out. * Most of that state's reports leave the Medicaid (Title XIX) day column nearly empty, so its Medicaid share is not comparable.
By ownership
| Type of control | Reports | Occupancy | Revenue per day | Expense per day | Margin as reported | Medicare days | Medicaid days |
|---|---|---|---|---|---|---|---|
| For-profit | 9,384 | 84.1% | $350 | $350 | 1.1% | 7.9% | 64.6% |
| Nonprofit | 2,289 | 83.5% | $376 | $429 | -8.6% | 7.4% | 42.9% |
| Government | 1,419 | 70.5% | $320 | $322 | -1.1% | 5.5% | 65.4% |
By size
| Beds | Reports | Occupancy | Revenue per day | Expense per day | Margin as reported | Medicare days | Medicaid days |
|---|---|---|---|---|---|---|---|
| Under 60 beds | 1,694 | 84.4% | $380 | $397 | -2.5% | 7.7% | 49.5% |
| 60 to 99 beds | 4,080 | 84.2% | $353 | $356 | 0.1% | 7.7% | 59.8% |
| 100 to 149 beds | 4,764 | 81.7% | $345 | $345 | 0.4% | 7.6% | 64.7% |
| 150 beds or more | 2,554 | 80.5% | $349 | $356 | -1.1% | 6.6% | 65.1% |
Source: CMS Skilled Nursing Facility Cost Report (Skilled Nursing Facility Cost Report, posted October 2026). Ownership is the cost report's type of control. Per Patient Day is not affiliated with CMS. Methodology.