Insights from the 2025 Zimmet Reimbursement Conference
SNF Metrics (www.snfmetrics.com) was again a proud sponsor of the Zimmet Reimbursement Conference (https://www.zimmetconference.com/). SNF Metric’s Saas-based data analytics and workspace applications exclusively serve data-driven operators just like those that participated in this year’s event. Your data holds the clues to informed decision making. Bringing those millions of data points forward in simple insights is SNF Metrics.
Zimmet must have analyzed billions of data points for us this year. Their insights and predictions continue to be a driving force in SNF operator’s future successes:
- Technology fatigue is real. This was a top topic this year with AI adoption and intra and inter-operability taking center stage.
- On Artificial Intelligence in the nursing home: This technology is not yet led by Responsible Artificial Intelligence. AI in Reimbursement beware!
What do the Recent National Numbers Show Us?
Occupancy has recovered to post-Covid care levels.
The National Average Nursing CMI is 1.49 with lots of variances across all states
SNF Occupancy is recovering to around 80% where North Dakota is 95.1%, CA is 88.6%, FL is 88.1%
*Direct Care Differential is the ratio of PBJ hours to Cost Report hours paid
*Relative Occupancy adjusts for number of lost beds. Occupancy alone does not speak to demand
Medicare covered SNF days are down from 65 million in 2016 to around 50 in 2024. This shows a significant reduction trend
Hours Per Resident Day are 3.66
Average Medicare rates are $666 with CT at $669, MA at $670, NJ at $715, TX at $676 and OR at $649. This compares apples to apples with everyone using the same 1.0 wage index
Average bad debt write-off is $6.66 where IL is 11.52, SD is $0.00, NC is $11.33 and PA is $6.19
*This is due to Medicaid paying or not paying coinsurance
On Medicare:
Other Presentations focused on the future of nursing homes and Medicare Advantage, ISNP, ACO and value-based care took center stage. Even Gov. Mark Parkinson shared his insights on our future and suggested we all start to build our strategies now, because the “Crimson Tsunami” is coming if we like it or not. Other presentations suggest that Medicare Advantage is coming, but the revenue is not. In 2024, $13.8 Billion was pulled from the nursing home operators. Zimmet created a live “Bad Debt” clock. Check it out here: https://debt-clock.z-pax.com/
Medicare Advantage’s penetration in 2019 was 36.2%. Today it is 51.3%
On Medicaid:
Medicaid reimbursement is going through a “Great Transition” today where they are transitioning mainly to CMI, but each state has a different methodology, mostly on nursing however. Understanding your state’s CMI and how it impacts your facility’s Medicaid reimbursement is even more critical today.
About SNF Metrics
SNF Metrics is a Saas-based platform that integrates with nursing home time and attendance, financial, EMR and even hospital EHR data. Your data is integrated through industry standard APIs, then our data-driven operators share with us what they demand from their data to drive better outcomes. All in one platform. Intra and inter -operability issues are greatly minimized. Now that Zimmet has shared the national trends, patterns and opportunities that lie ahead, take the next step and challenge SNF Metrics to provide you the answers you need to clinical and reimbursement successes in 2026 and beyond. Click here to schedule your 30 minute demo.
To learn more about How Zimmet can support your SNF operation, contact Vincent Fedele at vincent@zhealthcare.com
