CHIA Publishes First Report on the Massachusetts Nursing Facility Industry

DATE: November 22, 2019

For the first time CHIA is releasing a report and interactive dashboard on the Nursing Facility Industry in Massachusetts.

Nursing facilities serve an important role in the continuum of health care services in Massachusetts, providing over 14 million patient days of service in 2017; an average of over thirty-nine thousand individuals received care from nursing facilities on a daily basis.

To better understand this component of the health care system, this report examines Massachusetts nursing facilities at an industry level, as well as by analytic cohorts, on measures of utilization, financial performance, and quality of care over a five-year period (2013-2017). In addition to this report, CHIA has also developed an analytic dashboard that facilitates a profile view of each of the 393 nursing facilities in Massachusetts.

Key Findings:

• From 2013 to 2017, utilization of nursing facilities in the Commonwealth declined 5.4%.

• In 2017, 92.9% of nursing facility resident days were covered by three payer types: MassHealth (69.0%), Medicare (12.7%), and Self-Pay (11.2%).

• Among these three largest payer categories, Medicare resident days declined the greatest percentage from 2013 to 2017 (-14.8%), compared to Medicaid (-3.4%), and self-pay (-4.8%).

• Across nursing facilities, the median operating margin declined from -0.8% in 2013 to -3.9% in 2017.

• On a per-resident day basis, revenue increased across these three largest payer categories: Medicare (+10.1%), Medicaid (+5.5%), and self-pay (+7.4%).

• In 2017, 67.8% of resident days were provided at facilities with quality rated as average or above, with the remaining 32.2% provided by facilities rated as below or much below average.