SNF characteristics by ACO participation status

Table 1. Facility characteristics; Table 2. Patient characteristics (LTC Focus); Table 3. Financial and employed staffing characteristics (cost reports); Table 4. Medicare utilization (PAC-PUF); Table 5. Mean star ratings. All tables compare never-participating, exited, and currently participating SNFs.

Generated 2026-10-28 10:46. Cost report rules: 360-370 day reports; FY-to-CY attribution OFF; gov't/territory exclusion ON; other income NA-to-zero ON; G-3 winsorized by year ON.

**Table.** SNF Facility Characteristics by ACO Participation Status
Characteristic	Overall N = 13,542¹	Never participated N = 12,765¹	Exited before 2026 N = 285¹	Participating as of 2026 N = 492¹	p-value
Table 1. SNF Facility Characteristics by ACO Participation Status
Facility Characteristics
Certified beds	108.4 (55.9)	108.4 (56.0)	116.0 (58.0)	104.4 (53.3)	0.015
Occupancy rate, % (LTC Focus)	77.1 (16.4)	76.8 (16.5)	81.0 (13.3)	79.6 (14.6)	<0.001
Urban location					<0.001
Rural	3,296 (25.3%)	3,170 (25.8%)	40 (14.0%)	86 (17.5%)
Urban	9,749 (74.7%)	9,098 (74.2%)	245 (86.0%)	406 (82.5%)
Hospital-based SNF	77 (0.6%)	76 (0.6%)	0 (0.0%)	1 (0.2%)	0.239
Continuing care retirement community	1,518 (11.6%)	1,361 (11.1%)	36 (12.6%)	121 (24.6%)	<0.001
Facilities in chain	57.7 (76.0)	58.7 (77.2)	38.1 (50.2)	36.8 (40.4)	<0.001
¹ Mean (SD); n (%)
Source: CMS Nursing Home Compare (April 2026); HCRIS multi-year mean 2021-2026 (nhcr_2021_2024_07). Continuous: mean (SD). Categorical: n (%). Star ratings: mean (SD), scale 1-5. Financial variables in dollars. p-values: Kruskal-Wallis (continuous), chi-square with simulation (categorical). Bold p < 0.05.

**Table.** SNF Patient Characteristics (LTC Focus) by ACO Participation Status
Characteristic	Overall N = 13,542¹	Never participated N = 12,765¹	Exited before 2026 N = 285¹	Participating as of 2026 N = 492¹	p-value
Table 2. SNF Patient Characteristics (LTC Focus) by ACO Participation Status
Patient Demographics
Average age, years (LTC Focus)	77.9 (6.4)	77.7 (6.4)	79.8 (4.9)	81.0 (5.6)	<0.001
Female, % (LTC Focus)	62.4 (11.8)	62.1 (11.9)	65.7 (10.0)	67.7 (9.2)	<0.001
Under age 65, % (LTC Focus)	19.6 (14.8)	19.9 (14.8)	15.2 (11.4)	11.6 (12.9)	<0.001
White, % (LTC Focus)	75.4 (22.7)	75.0 (22.9)	78.2 (20.3)	82.9 (19.4)	<0.001
Black, % (LTC Focus)	16.8 (20.6)	17.1 (20.8)	13.9 (17.7)	12.1 (18.5)	<0.001
Hispanic, % (LTC Focus)	4.6 (11.4)	4.7 (11.5)	4.8 (13.1)	1.9 (7.1)	<0.001
Patient Clinical Conditions
Alzheimer's/dementia, % (LTC Focus)	42.7 (14.5)	42.6 (14.5)	43.5 (14.4)	44.1 (14.0)	0.074
Congestive heart failure, % (LTC Focus)	25.2 (8.3)	25.0 (8.2)	26.1 (7.8)	28.0 (9.2)	<0.001
Hypertension, % (LTC Focus)	78.6 (9.2)	78.5 (9.3)	79.9 (8.4)	80.1 (8.9)	<0.001
Schizophrenia or bipolar disorder, % (LTC Focus)	16.3 (13.9)	16.7 (14.0)	12.1 (10.2)	9.2 (11.3)	<0.001
Obesity, % (LTC Focus)	29.4 (8.7)	29.5 (8.7)	28.1 (7.2)	29.1 (7.8)	0.090
Patient Functional & Cognitive Status
Average ADL score (LTC Focus)	16.5 (2.4)	16.5 (2.4)	16.8 (2.0)	17.0 (1.9)	<0.001
Able to walk, % (LTC Focus)	4.8 (9.5)	5.0 (9.7)	2.8 (6.5)	3.0 (6.9)	<0.001
Bed-fast, % (LTC Focus)	20.6 (12.2)	20.7 (12.3)	19.4 (10.1)	18.8 (11.2)	0.104
Bladder incontinence, % (LTC Focus)	82.6 (12.4)	82.5 (12.5)	84.4 (10.7)	84.3 (11.7)	0.002
Bowel incontinence, % (LTC Focus)	71.2 (14.7)	71.2 (14.7)	71.8 (14.3)	70.9 (14.7)	0.664
Indwelling catheter, % (LTC Focus)	7.7 (7.3)	7.7 (7.4)	9.0 (6.4)	8.5 (7.3)	0.056
Ventilator-dependent, % (LTC Focus)	0.5 (3.7)	0.5 (3.8)	0.3 (2.1)	0.1 (1.3)	0.058
Cognitive Function Scale: intact/mild, % (LTC Focus)	41.0 (13.0)	41.0 (13.0)	41.3 (13.2)	42.5 (13.0)	0.165
Cognitive Function Scale: moderate, % (LTC Focus)	52.9 (12.8)	52.9 (12.8)	53.4 (12.4)	52.0 (12.7)	0.416
Cognitive Function Scale: severe, % (LTC Focus)	9.8 (10.2)	9.9 (10.2)	8.6 (8.7)	8.4 (9.0)	0.071
Patient Care & Risk Indicators
Urinary tract infection, % (LTC Focus)	2.8 (5.8)	2.7 (5.7)	3.3 (5.7)	5.8 (8.1)	<0.001
Fall in past 30 days, % (LTC Focus)	18.9 (8.5)	18.8 (8.5)	19.6 (8.2)	19.9 (9.2)	0.034
Influenza vaccination, in-facility offer % (LTC Focus)	57.2 (16.7)	57.4 (16.6)	54.7 (16.8)	55.1 (18.8)	0.042
Influenza vaccination, outside offer % (LTC Focus)	71.9 (15.5)	71.7 (15.5)	73.4 (15.0)	76.2 (14.6)	<0.001
Patient Payer Mix
HMO enrollment, % (LTC Focus)	41.6 (21.0)	41.4 (21.0)	44.4 (19.7)	44.4 (20.0)	0.003
Medicaid-paid days, % (LTC Focus)	58.0 (24.4)	58.6 (24.2)	52.3 (23.0)	45.9 (25.1)	<0.001
Medicare-paid days, % (LTC Focus)	14.8 (15.2)	14.6 (15.0)	18.0 (15.7)	19.2 (18.1)	<0.001
¹ Mean (SD)
Source: CMS Nursing Home Compare (April 2026); HCRIS multi-year mean 2021-2026 (nhcr_2021_2024_07). Continuous: mean (SD). Categorical: n (%). Star ratings: mean (SD), scale 1-5. Financial variables in dollars. p-values: Kruskal-Wallis (continuous), chi-square with simulation (categorical). Bold p < 0.05.

**Table.** SNF Financial and Employed Staffing Characteristics (Cost Reports) by ACO Participation Status
Characteristic	Overall N = 13,542¹	Never participated N = 12,765¹	Exited before 2026 N = 285¹	Participating as of 2026 N = 492¹	p-value
Table 3. SNF Financial and Employed Staffing Characteristics (Cost Reports) by ACO Participation Status
Financial Characteristics (multi-year mean, $)
Total patient revenue (GROSS), $	13,322,560.8 (8,871,684.5)	13,179,766.0 (8,816,243.7)	15,096,757.4 (9,055,803.9)	15,861,167.5 (9,634,468.8)	<0.001
Net patient service revenue, $	10,869,450.0 (6,995,324.8)	10,754,978.8 (6,957,951.0)	12,108,182.7 (6,748,157.4)	13,009,350.1 (7,633,987.5)	<0.001
Total other income, $	1,011,912.5 (2,571,405.0)	973,468.9 (2,507,614.0)	1,220,351.4 (2,874,948.5)	1,849,119.4 (3,606,628.3)	<0.001
Net income from patient services, $	-936,200.3 (2,818,406.1)	-901,878.1 (2,764,036.3)	-1,171,197.7 (3,072,365.3)	-1,656,006.6 (3,756,352.7)	<0.001
Total operating expenses, $	11,854,334.7 (7,950,062.0)	11,705,338.0 (7,867,961.0)	13,330,537.1 (7,752,797.7)	14,718,324.6 (9,358,776.1)	<0.001
Employed Staffing Hours (per resident-day)
RN hours per resident-day (employed)	14,679.7 (12,710.8)	14,353.5 (12,478.8)	19,481.5 (16,282.5)	20,309.8 (14,334.9)	<0.001
LPN hours per resident-day (employed)	24,760.3 (17,500.3)	24,602.9 (17,524.8)	28,178.6 (18,522.5)	26,835.6 (15,881.1)	<0.001
CNA hours per resident-day (employed)	66,172.9 (40,536.7)	65,617.2 (40,363.4)	77,119.2 (44,266.5)	74,175.5 (41,077.5)	<0.001
¹ Mean (SD)
Source: CMS Nursing Home Compare (April 2026); HCRIS multi-year mean 2021-2026 (nhcr_2021_2024_07). Continuous: mean (SD). Categorical: n (%). Star ratings: mean (SD), scale 1-5. Financial variables in dollars. p-values: Kruskal-Wallis (continuous), chi-square with simulation (categorical). Bold p < 0.05.

**Table.** SNF Medicare Utilization (PAC-PUF 2020-2023) by ACO Participation Status
Characteristic	Overall N = 13,542¹	Never participated N = 12,765¹	Exited before 2026 N = 285¹	Participating as of 2026 N = 492¹	p-value
Table 4. SNF Medicare Utilization (PAC-PUF 2020-2023) by ACO Participation Status
Medicare Utilization (2020-2023 mean)
Annual Medicare episodes (mean)	133.5 (116.8)	130.5 (113.6)	174.3 (121.0)	186.5 (167.9)	<0.001
Annual Medicare covered days (mean)	3,541.7 (3,196.5)	3,483.9 (3,141.4)	4,485.1 (3,370.7)	4,486.8 (4,138.9)	<0.001
Average length of stay (days)	27.2 (6.6)	27.4 (6.6)	25.8 (5.3)	24.4 (5.4)	<0.001
Annual Medicare payments ($000s)	1,841.8 (1,985.6)	1,812.5 (1,958.2)	2,274.3 (1,826.0)	2,347.6 (2,593.0)	<0.001
Medicare payment per episode ($000s)	13.3 (4.1)	13.4 (4.1)	12.7 (3.3)	12.1 (3.2)	<0.001
Beneficiaries with Alzheimer's/dementia, %	50.6 (10.7)	50.8 (10.7)	49.3 (11.0)	46.2 (10.1)	<0.001
¹ Mean (SD)
Source: CMS Nursing Home Compare (April 2026); HCRIS multi-year mean 2021-2026 (nhcr_2021_2024_07). Continuous: mean (SD). Categorical: n (%). Star ratings: mean (SD), scale 1-5. Financial variables in dollars. p-values: Kruskal-Wallis (continuous), chi-square with simulation (categorical). Bold p < 0.05.

**Table.** SNF Average Star Ratings by ACO Participation Status
Characteristic	Overall N = 13,542²	Never participated N = 12,765²	Exited before 2026 N = 285²	Participating as of 2026 N = 492²	p-value
Table 5. SNF Average Star Ratings by ACO Participation Status¹
Star Ratings
Overall Star Rating	3.0 (1.4)	2.9 (1.4)	2.9 (1.3)	4.0 (1.1)	<0.001
Health Inspection Rating	2.8 (1.3)	2.8 (1.3)	2.6 (1.2)	3.6 (1.0)	<0.001
Staffing Rating	2.8 (1.3)	2.8 (1.3)	3.0 (1.2)	3.5 (1.2)	<0.001
Quality Measure Rating	3.7 (1.2)	3.6 (1.3)	3.8 (1.2)	4.1 (1.0)	<0.001
Long-Stay QM Rating	3.9 (1.3)	3.8 (1.3)	4.0 (1.3)	4.1 (1.1)	<0.001
Short-Stay QM Rating	3.3 (1.4)	3.2 (1.4)	3.4 (1.4)	3.8 (1.2)	<0.001
¹ Star ratings from CMS Nursing Home Compare (April 2026). Scale 1-5; higher = better.
² Mean (SD)
Source: CMS Nursing Home Compare (April 2026); HCRIS multi-year mean 2021-2026 (nhcr_2021_2024_07). Continuous: mean (SD). Categorical: n (%). Star ratings: mean (SD), scale 1-5. Financial variables in dollars. p-values: Kruskal-Wallis (continuous), chi-square with simulation (categorical). Bold p < 0.05.