The U.S. post-acute market is expected to reach $243.4 billion in 2024, a 3% increase from 2023 when the market was valued at $241.5 billion. Labor challenges, growing demand for at-home care, and fluctuating government reimbursements drive market performance. In 2024, occupancy rates for skilled nursing facilities (SNFs), continuing care retirement communities (CCRCs), assisted living facilities, and memory care facilities continue to inch toward pre-pandemic levels while SNFs could see full occupancy recovery in 2024.
Labor Shortages and New Federal Staffing Mandate Strain Nursing Homes
Despite raising wages, nursing homes continue to see slow employment recovery. Nearly half of nursing homes turned to staffing agencies in 2022 to fill labor gaps. Forty-six percent of nursing homes had to limit new admissions due to labor shortages in 2023. The first-ever nursing home staffing mandate was finalized in April 2024 with requirements on the number of nursing care hours. More than 75% of nursing homes in the U.S. will need to increase staff to meet the mandate requirements or face financial penalties. The mandate went into effect on June 21, 2024, and the requirements must be incrementally implemented through May 2027.
SNFs Expand Services as the Older U.S. Population Grows
The post-acute market is facing a growing demand for services, as older Americans are projected to represent more than a quarter of the U.S. population by 2065. Nearly all Americans aged 60 years and older now have at least one chronic condition, which places higher burdens on SNF staff while creating opportunities to offer new specialty services to patients. More than a third of skilled nursing administrators indicated that in 2024, their organizations will likely become more involved with specialty services such as dialysis, memory care, and ventilator care.
Skilled Nursing Facilities Experience Negative Operating Margins and Fewer Mergers and Acquisitions
Forty-five percent of SNFs reported operating at a loss or negative total margin in March 2024, down from 54% in May 2023. Key factors impacting operating margins in 2024 include labor costs, interest rates, and inflation. Similar factors contributed to a decline in SNF mergers and acquisitions from 2022 to 2023, although merger and acquisition activity is expected to rise in 2024.
Medicare Changes Benefit Inpatient Rehabilitation and Skilled Nursing Facilities
Medicare spending on inpatient rehabilitation facility (IRF) stays rose from $8.5 billion in 2021 to $8.8 billion in 2022. For SNFs, Medicare revenue per patient day (RPPD) climbed 2.9% from $575 to $592 between 2022 and 2023. The Centers for Medicare & Medicaid Services (CMS) released the final fiscal year 2024 payment rule, increasing Medicare Part A payments to SNFs by an aggregated 4%, or $1.4 billion, compared to FY 2023.
Key factors influencing market performance:
- Growth in demand for at-home care
- Government reimbursement rates fluctuating
- Workforce challenges
Table of Contents
- Executive Summary
- Post-Acute Market Overview
- Nearly Half Of Skilled Nursing Facilities Operating At A Financial Loss
- Nursing Homes Experience Rise In Occupancy Rates Despite Limiting Admissions
- Fewer Certified Nursing Homes Operated In 2023$
- New Federal Staffing Mandate Is Finalized For Nursing Homes
- Financial Incentives And Staffing Agencies Help To Fill Gaps In Nursing Home Staffing
- Nursing Home Residents Receive Fewer Hours Of Care Than Pre-Pandemic
- Share Of Skilled Nursing Medicaid And Managed Medicare Payments Increased In 2023
- CMS Increases 2024 Skilled Nursing Payments 4%
- More Than 25% Of Nursing Facilities Cited With Serious Deficiencies In 2023
- Post-Acute Executives Prioritize Artificial Intelligence For Workforce Management
- Referral Volumes Surpass Pre-Pandemic Baseline
- Sepsis Remains Top Condition Leading To SNF Admissions
- Skilled Nursing Merger And Acquisition Volume Declines In 2023 But Could Increase In 2024
- Medicare Spending On Inpatient Rehabilitation Increases 3.5%
- Assisted Living Occupancy Approaches Pre-Pandemic Levels
- Cost Of Assisted Living Continues To Rise Steadily
- Memory Care Market To Grow Alongside Aging Population And Prevalence Of Dementia-Related Diseases
- CCRC Occupancy Rates Inch Closer To Pre-Pandemic Levels
- Clarivate Lists Top Post-Acute Products Sold Through Distribution
