New on SNFRadar
- October state editions
Every state edition is out for October: occupancy, staffing, survey record and Medicaid rates, building by building.
- The Rented Shift, corrected
Two published staffing quarters the first edition missed are restored and every affected comparison recalculated. The original edition stays up beside it.
Watch it, then try it
Thirty seconds of SNFRadar on screen: a search, a building’s full read, the what-if calculator and the portfolio tracker. Free to link with a story.
Four doors to try, no sign-in for a first read
Story starters
Each one opens on the record behind it. We will pull a state or a building for you, free.
- Any building, line by line
Each building's Medicare cost report, ranked against its state. The what-if calculator shows what occupancy or the Medicaid rate does to it.
- What a bedside hour costs
In the median state, one hour of care at the bedside carries $46 of a building's payroll.
- Agency nurses and new owners
Buildings leaning hardest on agency nurses changed Medicare ownership at 11.79 percent over two years, against 7.46 percent for the lightest users. An association, not proof of cause.
- Any state or county, on one page
A report for every state and the nation, and every building in a county side by side: occupancy, staffing, inspections and rates.
What we publish
Free to run with a story, with attribution.
The reports
Free to read, free to quote with attribution. National, plus a few state editions, all fifty are one tap from the reader's own footer.
- 14,690 facilities
- 1.57M licensed beds nationwide
- 80% average occupancy
- 356 facilities
- 39,462 licensed beds
- 81% occupancy
- 507 facilities
- 48,825 licensed beds
- 75% occupancy
- 656 facilities
- 83,064 licensed beds
- 82% occupancy
- 922 facilities
- 81,115 licensed beds
- 84% occupancy
Two buildings, worked end to end
The same sources every report is built from, read down to one building at a time.
The studies
Independent studies built from the federal record. Free to read, free to quote with attribution, and the state tables are free to reproduce whole.
The Rented Shift
Agency nursing hours and subsequent Medicare ownership changes
- Higher agency use was associated with more subsequent Medicare ownership changes. The recorded two-year rate was 7.46% below 2% agency and 11.79% at 15% or more: 1.6 times the unadjusted rate. These are facility-year observations, not counts of properties sold.
- The comparison varies by year. Giving both groups the same observation-year weights reduces the ratio to 1.35. That adjusts for year composition only; it does not establish causation or an individual facility’s sale probability.
- Across eight pooled agency bands, the recorded rate ranges from 6.98% in the rounded-zero band to 14.87% at 40% or more. The pooled pattern does not demonstrate a threshold or a uniform relationship within every year.
- Heavy agency use appears across nursing roles. The recorded ownership-change rates were 10.96% for heavy registered-nurse agency use, 11.29% for practical nurses and 11.58% for aides. Those groups overlap.
- Rating and occupancy comparisons are descriptive. We show both agency groups within broad bands, including separate unknown categories. Those cuts do not hold all other facility or market characteristics constant.
- In the latest observed trailing year, ending March 2026, 1,580 of 14,095 qualifying facilities, 11.2%, averaged at least 15% agency. This is the latest published staffing window, not a September headcount.
- Agency use fell in both descriptive before-and-after groups. Heavy users with a recorded change went from 28.43% to 17.07%; heavy users without a change in the held record went from 26.44% to 20.46%. The comparison cannot tell us how much a new owner caused.
The Rented Shift asks whether facilities using more contract nursing hours have more subsequent Medicare enrollment ownership changes. It joins public staffing and enrollment records; the current measured findings above come directly from the study. A September 14, 2026 correction restored two published staffing quarters missed in our original analysis and recalculated every affected comparison. The study preserves its original edition and explains the changes. These are retrospective associations: an enrollment change is not necessarily a property sale, and the before-and-after comparison does not identify what new ownership caused.
3G Healthcare Real Estate / SNFRadar Intelligence, “The Rented Shift: agency nursing hours and subsequent Medicare ownership changes,” September 2026; corrected September 14, 2026.
The staffing and agency figures here are refreshed each quarter, against the next Payroll-Based Journal release CMS publishes. Ask us and we will send the update when it lands.
Stan Klos III (Interviews and comment): [email protected] · Christian Patrick (Data requests and methodology): [email protected]
The Bedside Hour
What nine years of federal payroll and staffing records say about the cost of caring for one resident for one day
- Skilled nursing is running on 13,459 fewer workers than in 2019 while paying 36.7% more per week. The workforce never came back; the wage bill did.
- Care intensity has not moved in seven years. Nursing time per resident sits at 3.86 hours a day, within a rounding error of 2019, while occupancy has fully recovered to 81%.
- A resident-day of care costs the median state $185 in facility payroll, and every nursing hour delivered carries $46 of that payroll, from $31 in Wyoming to $65 in Oregon.
- Agency staffing more than tripled in the crisis and never went home. It was 3.0% of nursing hours in 2019Q1, peaked at 10.5% in 2022Q4, and was 5.3% in 2026Q1, still 77% above the baseline. The latest quarter rose slightly from the previous quarter.
- Thin staffing barely predicts hospital readmissions: 20.5% at the worst-staffed fifth of buildings against 20.3% at the best. The link the sector assumes is not in the data.
- Medicare pays as though it were, and it now prices staffing directly. 78.6% of all facilities are being penalized, and the gap between the best and worst staffed is worth about $147,000 a year.
The Bedside Hour started as a question sellers ask us before any other: what is staffing doing to my building’s value? We advise sellers, so we hear it weekly, and we got tired of answering it with anecdotes. The federal government already collects the answer, every facility’s daily payroll journal, every quarter’s unemployment-insurance filings, every Medicare payment decision. It just publishes the pieces in places nobody joins together. We joined them: 1.3 million facility-months, nine years, every certified building in the country. The name is the unit everything in this industry is secretly priced in: one hour of care, delivered at a bedside. In the median state that hour carries $46 of the building’s payroll. Nobody had published that number. Now everyone can cite it.
3G Healthcare Real Estate / SNFRadar Intelligence, “The Bedside Hour: an independent study of skilled nursing staffing, cost and Medicare payment,” August 2026; corrected September 14, 2026.
The staffing and agency figures here are refreshed each quarter, against the next Payroll-Based Journal release CMS publishes. Ask us and we will send the update when it lands.
Stan Klos III (Interviews and comment): [email protected] · Christian Patrick (Data requests and methodology): [email protected]
More from the same build
Press credential
A press account, in your name.
Every report and study on this site opens in full for a signed-in press account: invited directly, or requested below and approved by hand. It follows you to the newsroom machine at seven on a Tuesday, and it is how we know who to call if a figure needs correcting before you file.
- Every reportThe national edition and all fifty states, in full.
- Free to quoteFigures and cards run alongside your story, with attribution.
- Any deviceYour laptop, your phone, the newsroom machine.
- A number on requestAsk for a cut we do not publish and we build it.
We approve press accounts by hand, usually the same day. If we sent you a link directly, open that one instead: it is a single tap with nothing to fill in.
Spokespeople
Working on a story?
We will pull the numbers for whatever you are writing about, and we will tell you plainly when the data does not support it. No charge and no conditions.
Ask us for a numberOr reach us directly: [email protected] · 317.493.7767