Medicare cost reports · fiscal years ending August 2024 to August 2025

Massachusetts skilled nursing benchmarks

The median Massachusetts skilled nursing facility filed a cost report showing 86.2% occupancy, $378 of net patient revenue per patient day and $389 of total operating expense per patient day, across 324 full-year reports. Revenue per day is above the US median of $351. Medicaid paid for 59.5% of days at the median facility, against 62.1% nationally.

Massachusetts against the US

Massachusetts: 25th percentile, median and 75th percentile by metric, with the US median
Metric25th pctMedian75th pctUS medianRange
Occupancypatient days / bed days available77.5%86.2%91.8%82.6%
Net patient revenue per patient day$348$378$414$351
Total operating expense per patient day$359$389$433$355
Operating margin as reportednet patient revenue less total operating expense-10.8%-2.7%3.0%-0.3%
Medicare share of days4.9%8.6%14.3%7.5%
Medicaid share of days49.4%59.5%69.2%62.1%
Other payers share of daysprivate pay, managed care, VA and others18.4%28.1%39.1%27.7%
Medicare PPS payment per Medicare day$670$702$732$627
Contract labor share of labor cost4.1%12.1%19.6%11.5%
Beds88120142106

middle half of Massachusetts facilities Massachusetts median US median

A 100-bed building at Massachusetts medians

At 86.2% occupancy, 100 beds produce about 31,463 patient days a year. At the median revenue and expense per day, that is about $11,907,487 of net patient revenue against $12,229,353 of total operating expense, an operating result of $-321,866 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 Massachusetts

Change from the prior year's reports

MedianPrior reportsLatest reportsChange (points for occupancy and margin)
Occupancy85.0%86.2%+1.2 pts
Net patient revenue per day$359$378+5.4%
Operating expense per day$381$389+2.0%
Operating margin as reported-5.5%-2.7%+2.8 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

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.