Data Trends

Analyses depicting the operations of acute care hospitals are common. However, as the need to more closely integrate services and collaborate with other provider types becomes more prevalent, knowing the playing field for other care settings will be important. This analysis compares a few industry trends of acute care hospitals with those of skilled nursing facilities (SNFs) for the years 1997 through 2009. Unfortunately, complete 2010 data were unavailable for both provider types in time for publication.

Exhibit 1


On considering the percentage of providers operating as a for-profit operation, it is apparent that the dominance of the for-profit model among SNFs is in strong contrast to the largely not-for-profit hospital industry. A rise in the percentage of for-profit hospitals from 1997 through 2009 is also noteworthy. This trend may be attributable in part to the development of specialty- and physician-owned hospitals in recent years.

A look at the ratio of Medicare days to total days among for-profit and not-for-profit hospitals and SNFs discloses that for both industry sectors, for-profit providers have a higher percentage of Medicare days. Clearly both provider types are seeing a shift in the number of days associated with Medicare insured patients, but in opposite directions. However, these trends likely intertwined, as hospitals are increasingly shifting patients into alternate settings such as SNFs for post-acute care services.

Exhibit 2


Medicaid days show very different trends. Although a smaller portion of their business, the percentage of Medicaid days seen in acute care hospitals has remained quite steady over the study period. SNFs, which see nearly half of their business from Medicaid, show a bit of a divergence between for-profit and not-for-profit providers.

Exhibit 3


Last, a simple count of the number of total Medicare participating hospital and SNF providers shows a nearly 30 percent increase in SNF providers. This trend is likely attributable to more SNF providers choosing to participate in Medicare rather than the opening of new facilities. The advent of resource utilization groups (RUGs) in the late 1990s made the prospect of treating Medicare patients more enticing for existing SNFs.

Exhibit 4



About the Data  

Data were obtained from Medicare cost reports made available by the Centers for Medicare & Medicaid Services and processed by Only cost reports covering a 12-month period were included for analysis. Hospital cost reports for psychiatric, rehabilitation, and long-term acute care were excluded. Groupings by year were based on provider fiscal year-end dates occurring during each calendar year. For more information, email


Publication Date: Saturday, October 01, 2011

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