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3G Healthcare Real Estate is a sell-side advisory firm working only in skilled nursing facility real estate. This report is the Oregon 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.
128 facilities | 10,600 licensed beds | 70% avg occupancy | 59% showing distress |
Medicaid Rate Context Oregon 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 in the public record 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 · 128 OR SNFs | Ownership | Facilities | Avg ★ | Staffing ★ | Nurse turnover | 1★ / 5★ | CMS fines |
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| For-Profit | 111 | 3.03 | 3.82 | 47% | 18 / 23 | $2.9M | | Non-Profit | 13 | 3.92 | 4.18 | 52% | 2 / 6 | $344K | | Government | 4 | 3.00 | 3.50 | 57% | 1 / 0 | $167K |
Oregon skilled nursing is 87 percent for-profit by facility count: 111 of 128 buildings, averaging 3.03 stars overall and 3.82 on staffing. The balance is 13 non-profit, 4 government. Non-Profit buildings rate highest at 3.92 stars and government lowest at 3.00. 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 38% rated one or two stars | 6 special focus / candidate |
Oregon averages 3.12 stars overall across 128 facilities and 10,600 licensed beds. Average occupancy runs 70 percent, which is the number that decides whether a building services its debt. Quality splits at the bottom: 49 facilities (38 percent) rate one or two stars overall, 21 of them one star. Special Focus status or candidacy covers 6 of them. CMS fines on the current record total $3.4M across 63 facilities. Total nurse turnover averages 47.4 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, 76 of 128 buildings show a distress signal, 59 percent of the total.
Where the Beds Are | County | Facilities | Licensed beds |
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| Multnomah | 33 | 2,776 | | Lane | 13 | 1,171 | | Clackamas | 13 | 862 | | Washington | 9 | 910 | | Marion | 8 | 635 | | Yamhill | 6 | 415 | | Linn | 5 | 474 | | Jackson | 5 | 450 |
Market Structure 70% run by the eight largest groups | 30% run by everyone else |
The eight largest operating groups run 89 of Oregon's 128 skilled nursing facilities, 70 percent of the state and 71 percent of its licensed beds. The remaining 39 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 14,938 SNF-relevant discharges (minimum) | 31 reporting hospitals |
Oregon's 31 reporting hospitals discharged at least 14,938 traditional-Medicare inpatients in the diagnosis groups that most often need skilled care afterward, in federal fiscal 2024. Sepsis leads at 5,474 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) |
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| Sepsis | 5,474 | | Heart failure | 2,478 | | Stroke | 1,308 | | Respiratory infection | 1,226 | | Kidney failure | 1,067 | | Pneumonia | 1,051 | | Urinary tract infection | 828 | | Hip & femur surgery | 805 | | Hip & knee replacement | 389 | | COPD | 312 |
| Hospital | SNF-relevant discharges | 30-day HF readmissions |
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| SALEM HOSPITAL · SALEM | 1,490 | 20.5% | | PROVIDENCE ST VINCENT MEDICAL CENTER · PORTLAND | 1,349 | 21.7% | | ST CHARLES MEDICAL CENTER - BEND · BEND | 1,213 | 19.3% | | SACRED HEART MEDICAL CENTER - RIVERBEND · SPRINGFIELD | 1,178 | 17.3% | | ASANTE ROGUE REGIONAL MEDICAL CENTER · MEDFORD | 922 | 17.4% | | BAY AREA HOSPITAL · COOS BAY | 914 | 22.1% | | PROVIDENCE PORTLAND MEDICAL CENTER · PORTLAND | 849 | 22.0% | | OHSU HOSPITAL AND CLINICS · PORTLAND | 605 | 20.3% | | ASANTE THREE RIVERS MEDICAL CENTER · GRANTS PASS | 571 | 18.7% | | PROVIDENCE MEDFORD MEDICAL CENTER · MEDFORD | 559 | 22.0% |
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 43% of graded facilities are cut this year | 0.3% average raise across the graded set |
48 of Oregon's 111 graded skilled nursing facilities (43%) 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 0.3% raise 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 54.0% of the state's Medicare population is in MA plans |
Medicare Advantage now covers 54.0% of Oregon's Medicare population, as of April 2026. That is up 0.8 points in three years. Clackamas County runs highest in the state at 66.3%. 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 |
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| Clackamas County | 66.3% | | Multnomah County | 65.7% | | Marion County | 65.1% | | Polk County | 64.7% | | Washington County | 64.0% | | Lane County | 63.0% | | Linn County | 61.1% | | Columbia County | 61.1% |
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: Multnomah County with 33 facilities and 2,776 beds, Lane County with 13 facilities and 1,171 beds, Clackamas County with 13 facilities and 862 beds.
Legislative & Regulatory Watch In effect Oregon: Medicaid Rates (effective July 1, 2026) Oregon's published Medicaid schedule raises 5 statewide rates by 4.0%, effective July 1, 2026. The largest move takes the basic to $568.23 a day from $546.36. On the state's own site by July 10, 2026. 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. This one moves in the operator's favour. Federal: Staffing Mandate (Aug 2026) Operator implication: Staffing floors bind hardest on buildings already below the state average on hours per resident, which is where distressed sales start. Federal: Reimbursement (Aug 2026) Operator implication: Payment policy changes reach every building in the state, and the effect on a thin-margin operator arrives within a quarter. Federal: Reimbursement (Jul 2026) Two recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned, particularly for skilled nursing facility stays. This may cause delays for Medicare beneficiaries who are particularly Operator implication: Payment policy changes reach every building in the state, and the effect on a thin-margin operator arrives within a quarter. Federal: Reimbursement (Sep 2026) 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. Rescinded Federal: Staffing Mandate (Jul 2026) Amid changes to federal oversight of nursing homes during the Trump administration -- including rescinding the nursing home staffing rule issued by the Biden administration, prioritizing inspections that are triggered by complaints over routine inspections, and suspending the deadline to report detailed ownership information -- this issue brief provides an overview of the nursing home inspection process and the types If a county-level Oregon 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.
Christian Patrick
President
Exclusively SNF Sell-Side Advisors
Sources - CMS Provider Information / Care Compare: facility counts, licensed beds, occupancy, Five-Star ratings, staffing, nurse turnover, fines and Special Focus status, processed 2026-07-01.
- 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.
- Oregon 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.
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