Skilled Nursing Facilities (SNFs) provide short-term skilled nursing care and rehabilitation services. As a critical sector of post-acute care (PAC), SNF spending accounted for 8% of all Medicare fee for service (FFS) spending in 2015, and over 20% of hospitalized FFS beneficiaries were discharged to SNFs. In this study, we estimated SNF occupancy using SNF cost reports, and we examined SNF beds and availability of other PAC providers using Provider of Service (POS) files and cost reports. We characterized Medicare FFS beneficiaries in SNFs using inpatient standard analytic files. We projected 2018-2022 Medicare SNF days at the county and MSA level using proprietary county-level population projections, projection of growth in Medicare Advantage (MA) penetration, and estimates of SNF utilization for Medicare FFS and MA. Nationally, the number of SNF days is projected to increase by 10.5% between 2018 and 2022, despite the per capita rate falling by 1.5%, accounting for the impact of projected trends in socio-demographic factors in the Medicare population and projected changes in MA penetration. Our study also an examination of SNF days in five states: Florida, Illinois, Michigan, Ohio, and Pennsylvania. Our estimates vary by state, ranging from a 12.1% increase in total SNF days in Florida to s 9.0% increase in Pennsylvania. Per capita SNF day rates are projected to fall in all selected states.
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