In SNFRadar’s system: occupancy, staffing and rating, plus its Medicare cost report and a calculator to run its numbers.
Every Florida 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 Florida 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.
694
facilities
84,537
licensed beds
89%
avg occupancy
48%
showing distress
What the Cost Reports Say · FY2024 to FY2026
The beds are full. The margin is the question.
Every full-year Medicare cost report Florida's skilled nursing facilities filed in FY2024 to FY2026, read as one set of bands: 677 reports across 64 counties. This is the table an owner puts their own filing against.
677
cost reports read across 64 counties
91.0%
median occupancy
60.1%
of the days reported by payer were Medicaid
3.5%
median net margin, 33.3% filed a loss
Six of every ten patient days Florida's skilled nursing facilities billed in FY2024 to FY2026 were Medicaid days: 60.1% of the 26,375,881 patient days on the 664 reports that break days out by payer. The median building ran 91.0% occupancy, with the middle half between 85.0% and 94.0%, on 671 reports that carry it. Patient revenue ran $376 a patient day at the median against $362 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 3.5% at the median. 224 of the 672 reports that carry a bottom line filed a loss, which is 33.3% 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.
85.0%
91.0%
94.0%
671
84.2%
Medicare share of days
Traditional Medicare days as a share of all patient days, off Worksheet S-3 Part I.
9.0%
13.8%
20.8%
676
7.7%
Medicaid share of days
Medicaid days as a share of all patient days, off Worksheet S-3 Part I.
49.6%
62.4%
71.0%
665
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.
16.5%
22.9%
30.9%
664
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.
$342
$376
$413
673
$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.
$337
$362
$407
672
$372
Net income per patient day
Net income off Worksheet G-3, divided by patient days.
-$9
$13
$34
675
$14
Margin and liquidity
Net margin
Net income off Worksheet G-3 over net patient revenue off the same worksheet.
-2.5%
3.5%
8.7%
672
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 26,375,881 days on the 664 reports that break days out by payer
Median facility
Medicaid
60.1%
62.4%
Traditional Medicare
15.2%
13.8%
Everyone else, including managed care
24.7%
22.9%
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 377 of the state’s reports; on those 15,273,455 days Medicare Advantage is 8.4% and managed Medicaid 53.9%, and both sit inside the row above.
Urban against rural, at the median
Urban (643)
Rural (34)
Occupancy
91.3%
84.6%
Medicaid share of days
62.4%
69.8%
Patient revenue per patient day
$377
$342
Operating expense per patient day
$364
$336
Net margin
3.5%
3.9%
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.
Census is not the constraint
85% of Florida buildings closed the year at 80% occupancy or better, on the 671 reports that carry occupancy, and 33% of the 672 that carry a bottom line still filed a loss.
A $70 gap per patient day
Operating cost runs $337 a patient day at the 25th percentile against $407 at the 75th, on 672 Florida reports. At the median building's own year of 39,608 patient days, that gap is $2.8 million a year between a lean cost structure and a heavy one.
Margin without liquidity
The median Florida filing closed on a current ratio of 0.91, on the 626 reports that carry both sides of the balance sheet, and 55% of them closed under 1.00, which means owing more inside a year than they hold to pay it with. Only 33% 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 2024-06-30 to 2026-03-31, one full-year report per facility: 677 reports covering 26,561,270 patient days, of which 26,375,881 sit on the 664 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
$303
Florida average daily rate
$303
statewide median
Florida carries a median Medicaid daily rate of $303 across 631 rated facilities, 91 percent of the buildings we track in the state, with the middle half of the market between $293 and $315 a day. The distribution is tight, which usually means a cost-capped methodology holding most buildings in a band. For-profit buildings run $2 a day above non-profit ones ($303 against $301 at the median), a gap that reflects the class each sits in rather than the quality of the building. Rates are effective October 2026.
Percentile
Medicaid daily rate
10th
$280
25th
$293
Median (50th)
$303
75th
$315
90th
$325
Range $241 to $354 across 631 rated facilities; rates effective October 2026.
CMS Ownership Analytics · 694 FL SNFs
Ownership
Facilities
Avg ★
Staffing ★
Nurse turnover
1★ / 5★
CMS fines
For-Profit
556
3.18
3.14
43%
73 / 119
$13.6M
Non-Profit
125
3.60
4.03
34%
15 / 50
$3.1M
Government
13
4.31
4.85
36%
1 / 9
$274K
Florida skilled nursing is 80 percent for-profit by facility count: 556 of 694 buildings, averaging 3.18 stars overall and 3.14 on staffing. The balance is 125 non-profit, 13 government. Government buildings rate highest at 4.31 stars and for-profit lowest at 3.18. 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
33%
rated one or two stars
18
special focus / candidate
Florida averages 3.28 stars overall across 694 facilities and 84,537 licensed beds. Average occupancy runs 89 percent, which is the number that decides whether a building services its debt. Quality splits at the bottom: 232 facilities (33 percent) rate one or two stars overall, 89 of them one star. Special Focus status or candidacy covers 18 of them. CMS fines on the current record total $16.9M across 265 facilities. Total nurse turnover averages 41.4 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, 335 of 694 buildings show a distress signal, 48 percent of the total.
Where the Beds Are
County
Facilities
Licensed beds
Pinellas
65
7,485
Miami-Dade
54
8,281
Palm Beach
54
6,163
Orange
36
4,559
Duval
34
4,400
Broward
33
4,314
Hillsborough
30
3,943
Sarasota
30
3,086
Market Structure
35%
run by the eight largest groups
65%
run by everyone else
The eight largest operating groups run 245 of Florida's 694 skilled nursing facilities, 35 percent of the state and 37 percent of its licensed beds. The remaining 449 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
170,531
SNF-relevant discharges (minimum)
163
reporting hospitals
Florida's 163 reporting hospitals discharged at least 170,531 traditional-Medicare inpatients in the diagnosis groups that most often need skilled care afterward, in federal fiscal 2024. Sepsis leads at 55,978 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
55,978
Heart failure
23,845
Urinary tract infection
18,082
Pneumonia
15,815
Respiratory infection
15,018
Kidney failure
13,256
Stroke
10,989
Hip & femur surgery
8,132
COPD
5,685
Hip & knee replacement
3,731
Hospital
SNF-relevant discharges
30-day HF readmissions
ADVENTHEALTH ORLANDO · ORLANDO
9,217
22.8%
SARASOTA MEMORIAL HOSPITAL · SARASOTA
4,637
21.2%
BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE · JACKSONVILLE
4,082
20.6%
CLEVELAND CLINIC MARTIN NORTH HOSPITAL · STUART
3,592
22.0%
NAPLES COMMUNITY HOSPITAL · NAPLES
3,374
20.7%
ST JOSEPHS HOSPITAL · TAMPA
3,239
22.3%
ORLANDO HEALTH · ORLANDO
3,202
23.2%
GULF COAST MEDICAL CENTER LEE HEALTH · FORT MYERS
2,811
22.0%
MARION COMMUNTIY HOSPITAL · OCALA
2,691
24.1%
LAKELAND REGIONAL MEDICAL CENTER · LAKELAND
2,667
22.8%
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
84%
of graded facilities are cut this year
0.9%
average cut across the graded set
569 of Florida's 681 graded skilled nursing facilities (84%) 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 0.9% 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
57.2%
of the state's Medicare population is in Medicare Advantage plans
Medicare Advantage now covers 57.2% of Florida's Medicare population, as of April 2026. That is up 2.7 points in three years. Miami-Dade County runs highest in the state at 75.4%. 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
Miami-Dade County
75.4%
Osceola County
71.7%
Gadsden County
71.4%
Liberty County
69.4%
Polk County
68.5%
Hernando County
67.9%
Pasco County
67.3%
Wakulla County
65.5%
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: Pinellas County with 65 facilities and 7,485 beds, Miami-Dade County with 54 facilities and 8,281 beds, Palm Beach County with 54 facilities and 6,163 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.
Operator implication: Staffing floors bind hardest on buildings already below the state average on hours per resident, which is where distressed sales start.
Florida enacted a $114.5B FY2026-27 budget (about $6M below the prior year) in a May 2026 special session; nursing homes received a modest recurring reimbursement increase (House proposed ~$82.4M / Senate ~$68M recurring) even as managed care and hospitals faced reductions. The bulk of the prior year's nursing-home gains were nonrecurring, leaving operators dependent on legislators making the funding permanent.
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. This one moves in the operator's favour.
Florida's 2026 House health package (HB 693, the 'Big Beautiful Healthcare Frontier Act') includes a provision repealing the remaining CON program covering nursing homes; it cleared its first House subcommittee in late January 2026. FHCA is lobbying to strip the CON provision because repeal would remove a key barrier to new SNF beds in an 87%-occupancy market, increasing competitive supply risk for incumbent operator
If a county-level Florida 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.
Florida published Medicaid nursing-facility rate files: 631 rated facilities, effective October 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: 677 filings from 677 Florida 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.
You have read the Florida report.
See a building against these numbers, in SNFRadar’s system:
SNFRadar
