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Skilled nursing facilities (SNFs) across the country are experiencing the highest occupancy trends in years. According to recent industry data, the occupancy rate for nursing care has risen for fourteen consecutive quarters, demonstrating a sustained recovery from pandemic lows.
This report analyzes occupancy trends from the Centers for Medicare & Medicaid Services, the National Investment Center for Seniors Housing & Care, and state-level health departments to assess skilled nursing facility occupancy trends seen in 2025 and what may occur in 2026.
The COVID-19 pandemic created the steepest decline in nursing home occupancy in modern history, reflecting both the tragic loss of life during the pandemic and families’ decisions to seek alternative care arrangements. This dramatic shift reshaped the financial landscape for skilled nursing facilities nationwide. Here’s how SNF occupancy has changed over a 10-year period:
| SNF Occupancy Rates and Facilities 2015 – 2024 | |||
| Year | Average National Occupancy Rate | Change from Previous Year | Overall Number of Facilities |
| 2015 | 82% | — | 15,648 |
| 2016 | 81% | – 1% | 15,639 |
| 2017 | 81% | — | 15,670 |
| 2018 | 79% | – 2% | 15,609 |
| 2019 | 81% | + 2% | 15,523 |
| 2020 | 81% | — | 15,397 |
| 2021 | 67% | – 14% | 15,291 |
| 2022 | 72% | + 5% | 15,183 |
| 2023 | 75% | + 3% | 15,003 |
| 2024 | 77% | + 2% | 14,827 |
Recovery from COVID-19 numbers has been steady but gradual, with 2024 marking a return toward sustainable occupancy levels. The consistent year-over-year improvements from 2022 through 2024 demonstrate growing confidence in skilled nursing care and the effectiveness of enhanced infection control protocols.
Despite trending upward, national occupancy remains below pre-pandemic levels. This gap represents financial pressure on facilities operating with fixed costs designed for higher occupancy levels. Many facilities continue to adjust their operational models, service offerings, and staffing patterns to accommodate this new normal while maintaining high-quality care standards.
Between 2015 and 2024, the United States lost 813 certified skilled nursing facilities, representing a 5% decline in available facilities. This translates to roughly one in every twenty nursing homes closing during this period.
More than 62,000 beds have been permanently removed from the system. Beyond complete facility closures, many SNFs reduced their licensed capacity by decertifying beds they could no longer adequately staff or maintain. This capacity reduction compounds the access challenges facing aging Americans, particularly in rural areas, where 85% of new “nursing home deserts” are located.
The wave of closures stems from multiple interconnected financial and operational pressures:
While financial pressures affect all SNFs, those already struggling with quality and compliance issues prove least able to weather economic challenges. Some closures eliminate facilities that were providing substandard care, though this still creates access challenges for displaced residents.
Multiple interconnected factors are driving the recent increase in occupancy rates in skilled nursing facilities:
| Factor | Influence on Occupancy | Projected 2026 Effect |
| Hospital discharge rates | +4.2% in 2024 | Higher referrals |
| Workforce availability | RN hours declined 21% since 2015 | Capacity constraints |
| Medicare Advantage growth | 33 million enrollees in 2024 | Volume up, reimbursement pressure |
| Home care expansion | HCBS spending up 18.4% | Care setting competition |
Hospital discharge trends strongly influence skilled nursing admissions. In 2024, hospital discharges rose by 4.2%, creating a bigger pool of patients who might need post-acute care. Facilities that work closely with hospitals and respond quickly to referrals benefited the most.
At the same time, ongoing staffing shortages are holding occupancy back. Even though demand is rising, many facilities cannot accommodate more residents because they lack sufficient nursing staff. Registered nurse hours have dropped 21% since 2015, and turnover continues to be a problem.
The Health Resources and Services Administration expects an RN shortage of more than 63,000 full-time equivalents by 2030, which means many facilities will need to balance taking new admissions with maintaining safe care levels.
The growth of Medicare Advantage (MA) adds both opportunity and challenge. While MA now covers 33 million people, creating a large potential patient base, these plans often require more approvals and have higher denial rates for post-acute care.
Industry forecasts suggest continued but modest occupancy growth for SNFs in 2026:
| Metric | 2024 Actual | 2026 Projection |
| National average occupancy | 77% | 80%–81% |
| Assisted living occupancy | 86% | 88%–89% |
| SNFs at or above 85% occupancy | 34% | 42%–47% |
| SNFs below 70% occupancy | 22% | 15%–18% |
Source 1 | Source 2 | Source 3
Industry forecasts show steady but modest occupancy growth for SNFs through 2026. National SNF occupancy is expected to rise to 80–81%, reflecting ongoing recovery in demand after the COVID-19 pandemic. Assisted living communities show a similar trend, suggesting a broader rebound across senior care settings.
The overall distribution of occupancy is also expected to shift. The share of SNFs operating at 85% occupancy or higher is projected to grow from 34% to 42–47%, while the proportion of low-occupancy facilities (below 70%) is expected to fall from 22% to 15–18%. This points to a market where stronger facilities continue to capture more demand, while underperforming centers face pressure to improve, downsize, or consolidate.
The data in this report represents an extensive analysis of skilled nursing facility occupancy trends specific to 2026 market conditions. Understanding these patterns helps families make informed decisions about post-acute care options and rehabilitation services.
At Nightingale at Crossett, we’re committed to transparency about industry trends and how they affect the quality of care we provide. If you’d like to learn more about our occupancy levels or patient-to-staff ratios, contact us.