Medicare cost reports · fiscal years ending August 2024 to August 2025
California skilled nursing benchmarks
The median California skilled nursing facility filed a cost report showing 90.4% occupancy, $480 of net patient revenue per patient day and $465 of total operating expense per patient day, across 999 full-year reports. Revenue per day is above the US median of $351. Medicare covered 15.0% of days at the median facility against 7.5% nationally.
California against the US
| Metric | 25th pct | Median | 75th pct | US median | Range |
|---|---|---|---|---|---|
| Occupancypatient days / bed days available | 85.1% | 90.4% | 93.5% | 82.6% | |
| Net patient revenue per patient day | $413 | $480 | $550 | $351 | |
| Total operating expense per patient day | $418 | $465 | $525 | $355 | |
| Operating margin as reportednet patient revenue less total operating expense | -4.9% | 3.5% | 9.8% | -0.3% | |
| Medicare share of days | 9.0% | 15.0% | 24.6% | 7.5% | |
| Medicaid share of days | 3.9% | 7.0% | 44.8% | 62.1% | |
| Other payers share of daysprivate pay, managed care, VA and others | 29.1% | 70.0% | 82.1% | 27.7% | |
| Medicare PPS payment per Medicare day | $824 | $893 | $1,007 | $627 | |
| Contract labor share of labor cost | 2.9% | 8.3% | 12.7% | 11.5% | |
| Beds | 70 | 99 | 130 | 106 |
middle half of California facilities California median US median
Most California cost reports put few or no days in the Medicaid (Title XIX) column, so the Medicaid share above is not comparable with other states, and Medicaid days are likely counted under other payers. Read California's payer mix from your own census instead.
A 100-bed building at California medians
At 90.4% occupancy, 100 beds produce about 33,007 patient days a year. At the median revenue and expense per day, that is about $15,835,084 of net patient revenue against $15,364,075 of total operating expense, an operating result of $471,009 as the cost report counts it. The two medians come from different facilities, so this shows scale only.
Lenders do not underwrite that line. The cost report's total operating expense includes items a lender adds back or replaces with its own assumptions, such as rent, interest, depreciation and related-party management fees. Why reported margin is not EBITDAR.
Run your building against California
Change from the prior year's reports
| Median | Prior reports | Latest reports | Change (points for occupancy and margin) |
|---|---|---|---|
| Occupancy | 88.1% | 90.4% | +2.3 pts |
| Net patient revenue per day | $445 | $480 | +7.7% |
| Operating expense per day | $444 | $465 | +4.8% |
| Operating margin as reported | 0.6% | 3.5% | +2.9 pts |
Prior reports: Skilled Nursing Facility Cost Report, fiscal years ending 2023-08 to 2024-09. Medians are of different sets of facilities in each year.
Other states
Alabama · Arizona · Arkansas · Colorado · Connecticut · Delaware · District of Columbia · Florida · Georgia · Hawaii · Idaho · Illinois · Indiana · Iowa · Kansas · Kentucky · Louisiana · Maine · Maryland · Massachusetts · Michigan · Minnesota · Mississippi · Missouri · Montana · Nebraska · Nevada · New Hampshire · New Jersey · New Mexico · New York · North Carolina · North Dakota · Ohio · Oklahoma · Oregon · Pennsylvania · Rhode Island · South Carolina · South Dakota · Tennessee · Texas · Utah · Vermont · Virginia · Washington · West Virginia · Wisconsin · Wyoming
Source: CMS Skilled Nursing Facility Cost Report data (Skilled Nursing Facility Cost Report, posted October 2026), full-year reports with usable days and revenue. Per Patient Day is not affiliated with CMS. Methodology.