CLA Releases 38th SNF Cost Comparison Report with State-Level Data

  • Regulations
  • 10/24/2023
Doctor and nurse discussing patient case at hospital

Navigating heightened volatility across economic, operational, and regulatory fronts is pivotal for stability in the SNF sector.

Today, CLA (CliftonLarsonAllen LLP), the eighth largest accounting firm in the United States, announced it has issued its 38th edition of the Skilled Nursing Facility (SNF) Cost Comparison and Industry Trends Report and its complementary state-level data. Combined, the report and supplemental state specific data include national and state-specific benchmarks and ratios. The report analyzed operating margins and the factors influencing them, labor, occupancy, reimbursement rates, expenses, and other financial metrics, providing operators a data-resource to understand their performance and plan for the future.

SNF’s are navigating a complex and challenging environment with economic, operational, and regulatory volatility including a new proposed minimum staffing mandate. State-specific conditions have emerged as one of the most important forces impacting workforce availability, financial sustainability, and costs, alongside shifts in payer mix, reimbursements, and patient preferences.

Key trends include:

  • Operating margin — Operating margins have witnessed a national regression, with a wide disparity between states. Nationally in 2022, SNFs faced a -0.6% operating margin, further emphasizing the need for sustainable operating models. While occupancy increased, expenses surged and revenue growth fell short, intensifying margin pressure.
  • Labor and workforce — Labor availability and costs continue to heavily shape SNF operations and financial performance. In 2022, contract labor utilization surged by approximately 56%, driving a 12.6% increase in direct care nursing costs. Labor shortages and economic pressures are accelerating nursing wages, outpacing facility level revenue rate increases. The average overall nursing hourly wages increased 10.6% in 2022; while wage rates increased in every state, there is significant variation state-to-state.
  • Occupancy — Occupancy rates saw a national increase to 76.3% in 2022, rebounding from pandemic-related declines. Thus far 2023 data indicates a promising rise to 80%, the highest since pre-pandemic levels, albeit with varying state-by-state levels.

“The SNF industry has historically managed regulatory pressures, but with recent economic, operational, and regulatory reforms at federal and state levels, budgeting for revenue and expenses has grown more complex,” said Stephen Taylor, leader of CLA’s senior living and care practice. “Looking ahead, strategic investments in workforce, technology, and infrastructure as well as an agile problem-solving mindset will remain essential for SNFs to thrive.”

He added, “While national trends provide valuable insights, our report underscores the significance of understanding local markets and state-specific challenges and opportunities for SNF’s to succeed in this dynamic industry.”

For more in-depth insights and state-specific data, please refer to the complete 38th SNF Cost Comparison and Industry Trends Report and supplemental state-specific data.


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