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Every Louisiana 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 Louisiana 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.
265
facilities
32,239
licensed beds
74%
avg occupancy
64%
showing distress
What the Cost Reports Say · FY2024 to FY2026
Seven days in ten are Medicaid.
Every full-year Medicare cost report Louisiana's skilled nursing facilities filed in FY2024 to FY2026, read as one set of bands: 256 reports across 61 counties. This is the table an owner puts their own filing against.
256
cost reports read across 61 counties
76.0%
median occupancy
73.3%
of the days reported by payer were Medicaid
8.4%
median net margin, 16.3% filed a loss
Seven of every ten patient days Louisiana's skilled nursing facilities billed in FY2024 to FY2026 were Medicaid days: 73.3% of the 8,395,785 patient days on the 254 reports that break days out by payer. The median building ran 76.0% occupancy, with the middle half between 63.6% and 87.1%, on 248 reports that carry it. Patient revenue ran $317 a patient day at the median against $293 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 8.4% at the median. 41 of the 251 reports that carry a bottom line filed a loss, which is 16.3% 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.
63.6%
76.0%
87.1%
248
84.2%
Medicare share of days
Traditional Medicare days as a share of all patient days, off Worksheet S-3 Part I.
4.3%
6.7%
10.2%
255
7.7%
Medicaid share of days
Medicaid days as a share of all patient days, off Worksheet S-3 Part I.
66.2%
74.4%
80.9%
255
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.
11.9%
17.5%
24.0%
254
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.
$293
$317
$335
252
$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.
$267
$293
$320
250
$372
Net income per patient day
Net income off Worksheet G-3, divided by patient days.
$10
$28
$47
253
$14
Margin and liquidity
Net margin
Net income off Worksheet G-3 over net patient revenue off the same worksheet.
3.2%
8.4%
14.2%
251
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 8,395,785 days on the 254 reports that break days out by payer
Median facility
Medicaid
73.3%
74.4%
Traditional Medicare
7.4%
6.7%
Everyone else, including managed care
19.3%
17.5%
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 58 of the state’s reports; on those 1,992,698 days Medicare Advantage is 5.6% and managed Medicaid 1.1%, and both sit inside the row above.
Urban against rural, at the median
Urban (182)
Rural (74)
Occupancy
76.6%
72.8%
Medicaid share of days
74.5%
75.2%
Patient revenue per patient day
$320
$307
Operating expense per patient day
$298
$281
Net margin
8.4%
8.4%
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
40% of Louisiana buildings closed the year at 80% occupancy or better, on the 248 reports that carry occupancy, and 16% of the 251 that carry a bottom line still filed a loss.
A $53 gap per patient day
Operating cost runs $267 a patient day at the 25th percentile against $320 at the 75th, on 250 Louisiana reports. At the median building's own year of 32,591 patient days, that gap is $1.7 million a year between a lean cost structure and a heavy one.
The balance sheet holds
The median Louisiana filing closed on a current ratio of 2.99, on the 229 reports that carry both sides of the balance sheet, and 16% of them closed under 1.00, which means owing more inside a year than they hold to pay it with. Only 16% 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 2026-04-30, one full-year report per facility: 256 reports covering 8,422,097 patient days, of which 8,395,785 sit on the 254 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 Context
Louisiana does not publish facility-level Medicaid daily rates in a form we have been able to obtain, so there is no per-building rate picture published for this market. That absence is itself the point: without published rates most owners have no reliable way to benchmark their own building, and we maintain the comparison independently.
CMS Ownership Analytics · 265 LA SNFs
Ownership
Facilities
Avg ★
Staffing ★
Nurse turnover
1★ / 5★
CMS fines
For-Profit
216
2.34
2.24
48%
81 / 11
$10.4M
Non-Profit
39
3.51
3.03
44%
5 / 11
$1.3M
Government
10
3.40
3.14
36%
3 / 4
$776K
Louisiana skilled nursing is 82 percent for-profit by facility count: 216 of 265 buildings, averaging 2.34 stars overall and 2.24 on staffing. The balance is 39 non-profit, 10 government. Non-Profit buildings rate highest at 3.51 stars and for-profit lowest at 2.34. 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
51%
rated one or two stars
6
special focus / candidate
Louisiana averages 2.55 stars overall across 265 facilities and 32,239 licensed beds. Average occupancy runs 74 percent, which is the number that decides whether a building services its debt. Quality splits at the bottom: 134 facilities (51 percent) rate one or two stars overall, 89 of them one star. Special Focus status or candidacy covers 6 of them. CMS fines on the current record total $12.4M across 129 facilities. Total nurse turnover averages 47.6 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, 170 of 265 buildings show a distress signal, 64 percent of the total.
Where the Beds Are
County
Facilities
Licensed beds
E. Baton Rouge
24
3,106
Caddo
22
2,687
Jefferson
12
1,807
Orleans
11
1,557
Lafayette
10
1,343
Calcasieu
10
1,294
Ouachita
10
1,100
St. Tammany
9
1,147
Market Structure
50%
run by the eight largest groups
50%
run by everyone else
The eight largest operating groups run 133 of Louisiana's 265 skilled nursing facilities, 50 percent of the state and 54 percent of its licensed beds. The remaining 132 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
28,291
SNF-relevant discharges (minimum)
74
reporting hospitals
Louisiana's 74 reporting hospitals discharged at least 28,291 traditional-Medicare inpatients in the diagnosis groups that most often need skilled care afterward, in federal fiscal 2024. Sepsis leads at 9,059 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
9,059
Heart failure
4,780
Urinary tract infection
3,004
Kidney failure
2,582
Pneumonia
2,558
Stroke
2,018
Respiratory infection
1,892
Hip & femur surgery
1,329
COPD
757
Hip & knee replacement
312
Hospital
SNF-relevant discharges
30-day HF readmissions
WILLIS KNIGHTON MEDICAL CENTER · SHREVEPORT
3,077
20.3%
OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER · BATON ROUGE
1,651
20.4%
OCHSNER MEDICAL CENTER ACUTE · NEW ORLEANS
1,632
21.7%
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC · LAFAYETTE
1,605
21.5%
OCHSNER LAFAYETTE GENERAL MEDICAL CENTER · LAFAYETTE
1,538
22.5%
CHRISTUS ST FRANCES CABRINI HOSPITAL · ALEXANDRIA
1,425
22.4%
FMOL HEALTH ST FRANCIS · MONROE
1,257
22.2%
CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM · SHREVEPORT
1,182
23.3%
RAPIDES REGIONAL MEDICAL CENTER · ALEXANDRIA
1,117
24.5%
EAST JEFFERSON GENERAL HOSPITAL · METAIRIE
1,117
20.7%
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
87%
of graded facilities are cut this year
1.1%
average cut across the graded set
216 of Louisiana's 249 graded skilled nursing facilities (87%) 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 1.1% 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
57.9%
of the state's Medicare population is in Medicare Advantage plans
Medicare Advantage now covers 57.9% of Louisiana's Medicare population, as of April 2026. That is up 4.5 points in three years. St. John The Baptist Parish runs highest in the state at 76.2%. 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
St. John The Baptist Parish
76.2%
St. Charles Parish
75.0%
Iberville Parish
73.0%
Jefferson Parish
71.5%
St. Bernard Parish
71.5%
St. James Parish
70.8%
Plaquemines Parish
70.7%
St. Helena Parish
70.6%
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: E. Baton Rouge County with 24 facilities and 3,106 beds, Caddo County with 22 facilities and 2,687 beds, Jefferson County with 12 facilities and 1,807 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.
Louisiana amended its nursing facility reimbursement methodology to replace the RUG resident classification system with the Patient Driven Payment Model (PDPM). A phase-in runs July 1, 2025 through December 31, 2026 with a direct/care-related rate floor at 90% of those rate components and a +/- $5 corridor that caps how much any facility's rate can move during the transition, making the change largely rate-neutral in
Operator implication: Payment policy changes reach every building in the state, and the effect on a thin-margin operator arrives within a quarter. This one moves in the operator's favour.
Provides for an extension to the moratorium for nursing facilities. (8/1/26) Last action: Introduced in the Senate; read by title. Rules suspended. Read second time and referred to the Committee on Health and Welfare. (2026-03-09)
Operator implication: A licensure freeze makes existing licensed beds harder to replace, which supports the value of buildings already operating.
Louisiana remains one of five states with no state minimum wage, holding at the $7.25 federal floor. HB 353 (proposing $12 rising to $15 by 2029) was rejected by the House Labor Committee on April 9, 2026, and SB 230 (a $10.25 constitutional amendment effective Jan. 1, 2027) remained pending. The absence of a state wage floor keeps SNF entry-level labor costs comparatively low.
Operator implication: Wage floors raise the cost of the largest expense line in the building, and they do not come back down. This one moves in the operator's favour.
If a county-level Louisiana 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.
Louisiana does not publish facility-level Medicaid rates in an obtainable form; no per-facility rate data is presented for this state.
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: 256 filings from 256 Louisiana 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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