Skilled Nursing Medicare Mix Calculator

Payer mix drives skilled nursing facility economics.

Total bed days / yr

Medicare %

Medicaid %

Medicare rate / day

Medicaid rate / day

Private rate / day

Total annual revenue

$11,826,000

Blended rate / day

$324

Medicare revenue

$4,015,000

How the math works

Revenue per segment = days × pct × rate. Blended = total ÷ days.

36,500 × (20% × $550 + 60% × $230 + 20% × $380) = 36,500 × $315 = $11.5M total. $315 blended rate.

How to Use

Enter total bed days.
Enter Medicare % of days.
Enter Medicaid % of days.
Enter private pay % of days.
Enter Medicare rate per day.
Enter Medicaid rate per day.
Enter private rate per day.
Read blended revenue.

Frequently Asked Questions

What's a typical SNF payer mix?

Medicare: 15-25% of days (short-term rehab, 20-100 day stays). Medicaid: 55-70% of days (long-term custodial care). Private pay: 10-25% of days. Medicare rates: $400-750/day (highest). Private pay: $250-500/day (varies by amenities). Medicaid: $180-350/day (lowest, state-dependent). Revenue blend: Medicare drives disproportionately high revenue despite low day share — focus on rehab segment.

Why mix matters?

Medicare margins: 15-25%. Private pay margins: 10-20%. Medicaid margins: -5% to +10% (loss or barely break-even). Higher Medicare + private = higher operator profit. Typical SNF: 20% Medicare + 15% private + 65% Medicaid = reasonable margin. Pure Medicaid SNF: struggles financially. Converting Medicaid beds to Medicare (via rehab capabilities) is primary value-add strategy.

Medicare revenue drivers?

Hospital-short-stay rehab referrals. 20-day average length of stay. Daily rate varies by case-mix (acuity). Resource Utilization Group (RUG) rate adjustments. PDPM (Patient-Driven Payment Model) since 2019 — pays based on patient characteristics, not therapy minutes. Strong rehab team + hospital relationships drive Medicare census. Regional referral patterns matter.

Medicaid reform?

State-specific rates, often below cost of care (subsidized by Medicare/private). Annual 0-3% increases. Some states (NY, CA) higher rates; some (TX, FL) lower. Medicaid mix has grown as private pay depletes savings and Medicare ends (20-100 day limit). Operators lobby aggressively for higher Medicaid rates; political constraint limits. Private-pay-heavy markets (Florida, Arizona, retiree-heavy) more profitable.