In SNFRadar’s system: occupancy, staffing and rating, plus its Medicare cost report and a calculator to run its numbers.
Every Colorado building in this report has its own page.
This report is the state. The full read is one building: its occupancy month by month, its cost reports, its Medicaid rate files and its surveys. Free with an account.
October 27, 2026 · Exclusively SNF Sell-Side Advisors · Since 2014
3G Healthcare Real Estate is a sell-side advisory firm working only in skilled nursing facility real estate. This report is the Colorado ownership and operating picture as we track it, drawn from CMS Provider Information, federal ownership filings, county property records, published Medicaid rate files, and our own resolution work.
Every figure below describes the market in aggregate; nothing here is specific to any single owner or property.
210
facilities
19,749
licensed beds
80%
avg occupancy
67%
showing distress
What the Cost Reports Say · FY2024 to FY2026
Seven days in ten are Medicaid.
Every full-year Medicare cost report Colorado's skilled nursing facilities filed in FY2024 to FY2026, read as one set of bands: 202 reports across 39 counties. This is the table an owner puts their own filing against.
202
cost reports read across 39 counties
82.2%
median occupancy
66.7%
of the days reported by payer were Medicaid
1.9%
median net margin, 41.8% filed a loss
Seven of every ten patient days Colorado's skilled nursing facilities billed in FY2024 to FY2026 were Medicaid days: 66.7% of the 5,223,211 patient days on the 193 reports that break days out by payer. The median building ran 82.2% occupancy, with the middle half between 70.3% and 89.1%, on 196 reports that carry it. Patient revenue ran $378 a patient day at the median against $385 of reported operating expense, the cost report's own operating line rather than every cost a building carries. Net margin on the filings themselves was 1.9% at the median. 82 of the 196 reports that carry a bottom line filed a loss, which is 41.8% of them.
Statistic
25th
Median
75th
Reports
National median
Census and payer mix
Occupancy
Patient days as a share of available bed days, both off Worksheet S-3 Part I.
70.3%
82.2%
89.1%
196
84.2%
Medicare share of days
Traditional Medicare days as a share of all patient days, off Worksheet S-3 Part I.
2.3%
4.7%
10.6%
201
7.7%
Medicaid share of days
Medicaid days as a share of all patient days, off Worksheet S-3 Part I.
52.5%
69.9%
83.0%
194
66.3%
Everyone else as a share of days
Patient days that are neither traditional Medicare nor Medicaid, as a share of all patient days on the same filing. Managed care sits in here.
14.6%
22.5%
36.3%
193
23.4%
Per-resident-day economics
Patient revenue per patient day
Net patient revenue off Worksheet G-3, divided by patient days off Worksheet S-3 Part I. Blended across every payer.
$349
$378
$443
200
$373
Operating expense per patient day
Total operating expense off Worksheet G-3, divided by patient days. Net income also counts income and expense outside patient care, such as investment income, rentals and donations, which is why it is not patient revenue minus this line.
$347
$385
$481
199
$372
Net income per patient day
Net income off Worksheet G-3, divided by patient days.
-$20
$7
$32
202
$14
Margin and liquidity
Net margin
Net income off Worksheet G-3 over net patient revenue off the same worksheet.
-5.2%
1.9%
7.1%
196
3.7%
Current ratio
Current assets over current liabilities on the same filing. Under 1.00 means the building owes more inside a year than it holds to pay it with.
Statewide pool, of the 5,223,211 days on the 193 reports that break days out by payer
Median facility
Medicaid
66.7%
69.9%
Traditional Medicare
6.4%
4.7%
Everyone else, including managed care
26.9%
22.5%
The statewide pool adds to 100 because it divides one set of days three ways. The median facility column does not, and is not meant to: every building’s own mix sums to 100, but the median Medicaid building is not the median Medicare building. Managed care is broken out separately on 44 of the state’s reports; on those 1,568,831 days Medicare Advantage is 5.4% and managed Medicaid 12.8%, and both sit inside the row above.
Urban against rural, at the median
Urban (154)
Rural (48)
Occupancy
85.2%
72.6%
Medicaid share of days
73.4%
70.4%
Patient revenue per patient day
$385
$358
Operating expense per patient day
$387
$376
Net margin
2.2%
1.3%
Each side is ranked over its own filings, so the two columns are two medians and not a split of one. A filing CMS left unclassified is in neither column, which is why the two counts need not add to the state total.
Full buildings, thin years
57% of Colorado buildings closed the year at 80% occupancy or better, on the 196 reports that carry occupancy, and 42% of the 196 that carry a bottom line still filed a loss.
A $134 gap per patient day
Operating cost runs $347 a patient day at the 25th percentile against $481 at the 75th, on 199 Colorado reports. At the median building's own year of 25,422 patient days, that gap is $3.4 million a year between a lean cost structure and a heavy one.
Margin without liquidity
The median Colorado filing closed on a current ratio of 1.49, on the 182 reports that carry both sides of the balance sheet, and 36% of them closed under 1.00, which means owing more inside a year than they hold to pay it with. Only 42% of the state's filings lost money on patient care, so this is a working-capital reading rather than an earnings one.
Medicare cost reports as filed, fiscal years ending 2024-12-31 to 2026-03-31, one full-year report per facility: 202 reports covering 5,351,639 patient days, of which 5,223,211 sit on the 193 reports that break days out by payer, which is what the payer table below divides by. Every line carries the number of reports behind it, and a line standing on fewer than 20 reports is not ranked. Operating expense is the cost report’s own operating line. Net income also counts income and expense outside patient care, such as investment income, rentals and donations, which is why it is not patient revenue minus that line.
Medicaid Rate Snapshot
$283
Colorado average daily rate
$282
statewide median
Colorado carries a median Medicaid daily rate of $282 across 186 rated facilities, 89 percent of the buildings we track in the state, with the middle half of the market between $264 and $300 a day. The distribution is tight, which usually means a cost-capped methodology holding most buildings in a band. Government buildings run $36 a day above for-profit ones ($314 against $278 at the median), a gap that reflects the class each sits in rather than the quality of the building. Rates are effective July 2026.
Percentile
Medicaid daily rate
10th
$248
25th
$264
Median (50th)
$282
75th
$300
90th
$321
Range $205 to $356 across 186 rated facilities; rates effective July 2026.
CMS Ownership Analytics · 210 CO SNFs
Ownership
Facilities
Avg ★
Staffing ★
Nurse turnover
1★ / 5★
CMS fines
For-Profit
175
3.06
2.95
48%
24 / 35
$4.3M
Non-Profit
22
3.86
4.41
42%
0 / 10
$308K
Government
13
3.42
3.83
45%
2 / 5
$155K
Colorado skilled nursing is 83 percent for-profit by facility count: 175 of 210 buildings, averaging 3.06 stars overall and 2.95 on staffing. The balance is 22 non-profit, 13 government. Non-Profit buildings rate highest at 3.86 stars and for-profit lowest at 3.06. Ownership type as CMS records it describes the license holder. The real estate behind it is frequently a different party, and that is the layer we resolve.
Quality, Staffing & Distress Signals
37%
rated one or two stars
6
special focus / candidate
Colorado averages 3.17 stars overall across 210 facilities and 19,749 licensed beds. Average occupancy runs 80 percent, which is the number that decides whether a building services its debt. Quality splits at the bottom: 78 facilities (37 percent) rate one or two stars overall, 26 of them one star. Special Focus status or candidacy covers 6 of them. CMS fines on the current record total $4.8M across 120 facilities. Total nurse turnover averages 47.1 percent. Counting any facility that carries at least one of a one- or two-star overall rating, Special Focus status or candidacy, CMS fines on the current record, or a distressed-title flag from county records, 140 of 210 buildings show a distress signal, 67 percent of the total.
Where the Beds Are
County
Facilities
Licensed beds
Denver
23
2,352
Jefferson
23
2,304
El Paso
20
1,849
Arapahoe
19
2,067
Adams
14
1,764
Larimer
13
1,257
Boulder
10
1,010
Pueblo
9
1,119
Market Structure
56%
run by the eight largest groups
44%
run by everyone else
The eight largest operating groups run 118 of Colorado's 210 skilled nursing facilities, 56 percent of the state and 62 percent of its licensed beds. The remaining 92 buildings are spread across a long tail of smaller operators and independents.
Operating scale is not the same as real-estate ownership, and in most markets the two are separate. The property behind these portfolios is held across a far larger and more fragmented set of owners, many of them holding a single building outright. That is the layer we resolve, and it is why a market that looks consolidated from the operating side is usually anything but from the ownership side.
Hospital Discharge Demand
18,911
SNF-relevant discharges (minimum)
47
reporting hospitals
Colorado's 47 reporting hospitals discharged at least 18,911 traditional-Medicare inpatients in the diagnosis groups that most often need skilled care afterward, in federal fiscal 2024. Sepsis leads at 7,648 discharges. Every one of these patients needed a next setting, and the facilities positioned closest to the highest-volume hospitals see that demand first.
Condition
Discharges (at least)
Sepsis
7,648
Heart failure
2,559
Pneumonia
1,616
Respiratory infection
1,585
Stroke
1,361
Kidney failure
1,260
Hip & femur surgery
1,037
Urinary tract infection
965
Hip & knee replacement
562
COPD
318
Hospital
SNF-relevant discharges
30-day HF readmissions
CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES · COLORADO SPRINGS
1,552
20.5%
UCH-MEMORIAL HEALTH SYSTEM · COLORADO SPRINGS
1,536
17.9%
UNIVERSITY OF COLORADO HOSPITAL AUTHORITY · AURORA
1,171
17.1%
HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER · ENGLEWOOD
1,038
21.3%
PARKVIEW MEDICAL CENTER, INC · PUEBLO
801
17.8%
POUDRE VALLEY HOSPITAL · FORT COLLINS
789
19.1%
CENTURA HEALTH-ST ANTHONY HOSPITAL · LAKEWOOD
785
20.7%
THE MEDICAL CENTER OF AURORA & SOUTH HOSPITAL · AURORA
740
17.6%
SKY RIDGE MEDICAL CENTER · LONE TREE
740
20.3%
AdventHealth Littleton · LITTLETON
731
19.0%
Traditional Medicare discharges, federal fiscal 2024, in the diagnosis groups that most often discharge to skilled care. CMS withholds any line under 11 discharges, so every figure is a minimum. Readmission rates: CMS Care Compare, three-year window; n/a means CMS reports too few cases.
Medicare Readmission Penalty
73%
of graded facilities are cut this year
0.6%
average cut across the graded set
139 of Colorado's 190 graded skilled nursing facilities (73%) are taking a live Medicare payment cut this federal fiscal year under CMS's SNF Value-Based Purchasing program, which blends readmissions, infections, staffing and turnover into one multiplier and applies it to every Medicare day a building bills. The graded set averages a 0.6% cut across the whole state. A federal number like that says little read alone, which is why we check it against the fuller financial and operational record we hold on every building before it reaches a report: the buildings already under pressure elsewhere are the ones a payment cut actually threatens.
CMS SNF Value-Based Purchasing, FY2026 determination, published February 2026. The multiplier blends readmissions, infections, staffing and turnover and applies to every Medicare day a facility bills; below 1.0 is a live payment cut, not a one-time fine.
Medicare Advantage Penetration
52.4%
of the state's Medicare population is in Medicare Advantage plans
Medicare Advantage now covers 52.4% of Colorado's Medicare population, as of April 2026. That is up 1.7 points in three years. Adams County runs highest in the state at 64.6%. An MA member typically draws fewer skilled-nursing days per admission than traditional Medicare, so the counties at the top of that list are the ones structurally losing SNF days first, whatever the raw discharge count says.
County
Medicare Advantage share
Adams County
64.6%
Pueblo County
62.1%
Jefferson County
62.0%
Otero County
61.5%
Denver County
60.1%
Fremont County
59.6%
Broomfield County
58.3%
Arapahoe County
57.6%
CMS Medicare Monthly Enrollment, county grain, April 2026. An MA member typically draws fewer skilled-nursing days per admission than traditional Medicare, so a rising share is a structural headwind on SNF demand, not a one-quarter blip.
Market Observations
Beds concentrate where the population does: Denver County with 23 facilities and 2,352 beds, Jefferson County with 23 facilities and 2,304 beds, El Paso County with 20 facilities and 1,849 beds.
Legislative & Regulatory Watch
In effect
Federal: Staffing Mandate (Oct 2026)
Operator implication: Staffing floors bind hardest on buildings already below the state average on hours per resident, which is where distressed sales start.
Facing post-H.R. 1 budget strain, states moved on SNF Medicaid rates entering FY2026: Idaho enacted a 4% across-the-board provider rate cut and Colorado reversed a 1.6% increase, while some New Hampshire homes report >9% losses in per-resident funding. AHCA survey data warns that 58% of providers would cut staff if federal Medicaid funding falls.
Operator implication: Reimbursement is the single largest line in a nursing facility's revenue, so a rate move of any size resets valuation across the whole state.
With pandemic-era fiscal relief expired and softening state revenues, fewer states reported nursing-facility rate increases for FY2026; Idaho imposed a 4% across-the-board provider cut and Colorado reversed a 1.6% increase. Operators are seeking a clear funding 'roadmap' amid cut concerns, with further FY2027 pressure expected from the 2025 reconciliation law.
Operator implication: Reimbursement is the single largest line in a nursing facility's revenue, so a rate move of any size resets valuation across the whole state.
Long-term Care Services for Nursing Home Residents Last action: House Committee on Appropriations Lay Over Unamended - Amendment(s) Failed (2026-05-14)
Operator implication: Budget language sets the reimbursement envelope for the following rate year, so it is the earliest reliable signal of where rates are heading.
If a county-level Colorado breakdown, or the ownership and capital-structure detail behind any facility in it, would be useful, a short confidential conversation is the fastest way to get it. There is no cost and no obligation, and the buyer you select covers our fee.
CMS Provider Information / Care Compare: facility counts, licensed beds, occupancy, Five-Star ratings, staffing, nurse turnover, fines and Special Focus status, processed 2026-09-01.
CMS Payroll-Based Journal: nurse staffing hours and turnover.
Federal ownership filings: PECOS Form 855A indirect-owner tree and HCRIS cost-report related parties.
County property and mortgage records via the 3G real-estate-ownership resolution layer.
3G Healthcare Real Estate proprietary warehouse, resolved as of the date shown above.
Colorado published Medicaid nursing-facility rate files: 186 rated facilities, effective July 2026.
State and federal legislative and regulatory tracking via the 3G intelligence scan, with the source for each item linked in that section.
CMS Medicare inpatient claims (fiscal 2024): hospital discharge volumes by diagnosis group, traditional Medicare only; CMS withholds lines under 11 discharges, so volumes are minimums. Readmission rates from CMS Care Compare's three-year measure window.
CMS SNF Value-Based Purchasing facility-level file, FY2026 determination (published February 2026): readmission, infection, staffing and turnover measures rolled into one Medicare payment multiplier per facility.
CMS Medicare Monthly Enrollment: Medicare Advantage penetration by county, April 2026.
Medicare cost reports (CMS HCRIS), FY2024 to FY2026: 202 filings from 202 Colorado skilled nursing facilities, one full-year report each, loaded 2026-10-06. Occupancy, patient days by payer, patient revenue, operating expense and net income as each facility filed them.
3G Healthcare Real Estate is a brokerage firm specializing exclusively in skilled
nursing facility real estate. We do not provide legal, financial, or tax advice.
3G Healthcare Real Estate, 456 N. Meridian St #441332, Indianapolis, IN 46204.
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