US Revenues for Skilled Nursing Facilities Set to Rise as Population Ages

October 29, 2021

Skilled nursing facility revenues are forecast to grow 3.0% per year in nominal dollars through 2025, according to Skilled Nursing Facilities: United States, a report recently released by Freedonia Focus Reports. Operators of skilled nursing facilities are projected to benefit from the 3.2% annual growth expected for the population aged 80 and older to 2025 – a key demographic for skilled nursing facilities – and the ongoing availability of funds from Medicaid and Medicare. In addition, operators are expected to benefit from the ongoing gains projected in spending per resident due to the following factors:

• an increasing share of skilled nursing facilities operated by for-profit entities, which typically feature higher prices for their services
• a shift toward more individualized care over standardized, task-based plans
• rising availability and use of higher value services, such as private rooms, and physical, occupational, and speech therapy so individuals can maintain an active lifestyle

Faster gains will be restrained by the delivery of medical and custodial care services in different formats and facility types (e.g., assisted living, continuing care retirement communities, and home healthcare). Government-led efforts to match elderly and disabled individuals with appropriate care levels and settings to limit expenditures and improve the quality of life (e.g., giving them the ability to live at home) will represent a particularly salient constraint.

Skilled nursing facilities saw marginal revenue growth in 2020 but are expected to see gains of 3.8% in 2021. While many elderly individuals died in nursing facilities in 2020 and 2021 due to the COVID-19 pandemic and many were reluctant to enter nursing facilities, residents did not leave the facilities during the pandemic for fear of spreading the virus to family members and vice versa. In addition, many elderly individuals continued to get sick and injured, and needed skilled nursing care, and thus had to enter skilled nursing facilities. Going forward, the high rates of vaccinations for elderly individuals are projected to benefit operators, as the risk of contracting COVID-19 in skilled nursing facilities is much lower as of October 2021, and elderly individuals and their families can feel safer about conditions in such facilities.

These and other key insights are featured in Skilled Nursing Facilities: United States. This report forecasts to 2021 and 2025 the revenues of US skilled nursing facilities in nominal US dollars. Total revenues are segmented by operator type in terms of:

• for-profit
• nonprofit

Total revenues are also segmented by funding source as follows:

• Medicaid
• Medicare
• private healthcare insurance
• out-of-pocket
• other sources such as charitable contributions and private grants, long-term care insurance, and the US Department of Veterans Affairs

To illustrate historical trends, total revenues and the various segments are provided in annual series from 2010 to 2020. In addition, the net profit margin and the number of firms, establishments, and employees are provided for the 2010-2019 period.

This report represents the revenues of skilled nursing facilities (i.e., establishments primarily engaged in operating skilled nursing facilities). The skilled nursing care provided by assisted living facilities, continuing care retirement communities, hospitals, and home healthcare agencies is excluded from the scope of this report unless these organizations maintain independent establishments primarily focused on operating skilled nursing facilities. Also excluded from the scope of this report are services provided by caregivers who are directly employed by the patient or family and care that is provided by the family members.

This report includes the results of a proprietary national online consumer survey of US adults (age 18+). This Freedonia Focus Reports National Survey has a sample size of approximately 2,000, screened for response quality, and representative of the US population on the demographic measures of age, gender, geographic region, race/ethnicity, household income, and the presence/absence of children in the household.