How the benchmarks are built
One public file, read carefully: CMS's Skilled Nursing Facility Cost Report data, which summarizes the Medicare cost reports every certified facility files each year.
The source
The current benchmarks use Skilled Nursing Facility Cost Report as posted October 2026 (CSV): 14,587 reports for fiscal years ending August 2024 to August 2025. Year-over-year changes compare with the prior file, which covers fiscal years ending 2023-08 to 2024-09.
A script (scripts/refresh_data.py) finds the two newest cost report files in the data.cms.gov catalog, downloads them and recomputes everything, so the dates on each page move with the data.
Which reports count
A report is used when it covers at least 330 days, has patient days, bed days available, beds, net patient revenue and total operating expense, and does not report more patient days than bed days available. 13,092 of 14,587 reports pass. Short-period reports (a facility that changed hands mid-year, for example) are the largest group left out. States with fewer than 8 usable reports get no state page.
How each measure is calculated
| Measure | Calculation (cost report fields) |
|---|---|
| Occupancy | Total days ÷ total bed days available |
| Revenue per patient day | Net patient revenue (Worksheet G-3 line 3) ÷ total days |
| Expense per patient day | Total operating expense (G-3 line 4) ÷ total days |
| Operating margin as reported | (Net patient revenue − total operating expense) ÷ net patient revenue |
| Medicare and Medicaid share | Title XVIII days and Title XIX days ÷ total days |
| Medicare PPS per Medicare day | Inpatient PPS amount ÷ Title XVIII days, for facilities with at least 365 Medicare days |
| Contract labor share | Contract labor ÷ (Worksheet A salaries + contract labor) |
Each measure is shown as the 25th percentile, the median and the 75th percentile across facilities, never as an average. Ownership groups use the cost report's type of control: codes 1 and 2 nonprofit, 3 to 6 proprietary, 7 to 13 governmental, per the CMS data dictionary.
What the numbers cannot tell you
- The reported margin is after rent, depreciation and capital interest, because those are inside total operating expense. It is not EBITDAR. Why.
- Some states' reports leave the Medicaid day column nearly empty. Those states' payer mix is flagged on their pages.
- Cost reports are filed months after the year ends and published later still, so the newest benchmarks describe a year that has already passed.
- Hospital-based and distinct-part units are mixed in with freestanding facilities.
Corrections and questions: hello@fhaskillednursing.loan.