Medicare cost reports · fiscal years ending August 2024 to August 2025
Missouri skilled nursing benchmarks
The median Missouri skilled nursing facility filed a cost report showing 71.0% occupancy, $252 of net patient revenue per patient day and $254 of total operating expense per patient day, across 440 full-year reports. Revenue per day is below the US median of $351. Medicaid paid for 65.3% of days at the median facility, against 62.1% nationally.
Missouri against the US
| Metric | 25th pct | Median | 75th pct | US median | Range |
|---|---|---|---|---|---|
| Occupancypatient days / bed days available | 56.8% | 71.0% | 83.5% | 82.6% | |
| Net patient revenue per patient day | $216 | $252 | $299 | $351 | |
| Total operating expense per patient day | $225 | $254 | $303 | $355 | |
| Operating margin as reportednet patient revenue less total operating expense | -10.0% | -1.1% | 5.0% | -0.3% | |
| Medicare share of days | 2.7% | 5.1% | 8.0% | 7.5% | |
| Medicaid share of days | 49.7% | 65.3% | 78.2% | 62.1% | |
| Other payers share of daysprivate pay, managed care, VA and others | 16.4% | 28.6% | 43.5% | 27.7% | |
| Medicare PPS payment per Medicare day | $545 | $568 | $618 | $627 | |
| Contract labor share of labor cost | 8.1% | 12.6% | 19.2% | 11.5% | |
| Beds | 79 | 100 | 120 | 106 |
middle half of Missouri facilities Missouri median US median
A 100-bed building at Missouri medians
At 71.0% occupancy, 100 beds produce about 25,922 patient days a year. At the median revenue and expense per day, that is about $6,535,530 of net patient revenue against $6,589,967 of total operating expense, an operating result of $-54,437 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 Missouri
Change from the prior year's reports
| Median | Prior reports | Latest reports | Change (points for occupancy and margin) |
|---|---|---|---|
| Occupancy | 68.5% | 71.0% | +2.6 pts |
| Net patient revenue per day | $229 | $252 | +10.1% |
| Operating expense per day | $247 | $254 | +3.0% |
| Operating margin as reported | -5.7% | -1.1% | +4.5 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
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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.