# Where Public SNF Benchmarks Break

2026 National Skilled Nursing Facility Benchmarking Study | Astrelis State of the Industry  
A public SNF filing can be completed exactly as instructed and still hand management the wrong conclusion.  
Page: https://astrelis.co/studies/skilled-nursing/2026  
This twin: https://astrelis.co/studies/skilled-nursing/2026.md  
Edition: 2026  
Published: 2026-07-14  
Author: Matt Borchardt, Founder, Astrelis  
Release: 2321a4fc37a7 (2026-10-22)

## Data vintage

This 2026 edition stands on public data through June 2026, cost report anchor FY2024, an analytic universe of 13,970 eligible filers.
- Public data through June 2026
- Cost report anchor: FY2024
- Analytic universe: 13,970 eligible filers
- Analytic universe: 13,970 (SNF)

## Headline findings, as printed

1. **The industry benchmarks fee-for-service Medicare. It is 7.3 percent of the days.** The median facility draws 7.3 percent of its resident-days from fee-for-service Medicare and 62.7 percent from reported Medicaid.
   1. Payer definition: 7.3% FFS Medicare at the median. Is your benchmark measuring your actual business?
2. **26 percent of nursing homes get the opposite staffing verdict, depending on the comparison group** Change the comparison group and the staffing verdict reverses for 26.0 percent of facilities, crossing the median and moving at least ten percentile points.
   2. Peer sensitivity: 26.0% material flip on staffing. Would your verdict survive a different cohort?
3. **The overall star rating is insensitive to 16 billion dollars of nursing care** Nursing homes deliver 16.0 to 19.3 billion dollars a year of staffing that their overall star rating does not register.
   3. Rating resolution: $16.0B to $19.3B unregistered. Is your staffing invisible to your overall rating?
4. **A staffing star costs $485,511 a year. For 2,545 facilities it cannot move the rating.** The next staffing star costs $485,511 a year at the median. For 2,545 facilities, a perfect staffing score would not move the overall rating at all.
   4. Rating composition: 2,545 facilities survey-capped. Would staffing dollars actually move your rating?
5. **The legacy Medicaid column does not contain Medicaid** Nineteen of Vermont's thirty-two nursing homes file exactly zero Medicaid days. They are full of Medicaid residents.
   5. Legacy Medicaid field: Managed Medicaid booked as Other. Is your public payer mix complete?
6. **Two federal systems describe the same building's labor differently, and the pattern tracks the owner** In one national chain, 96 of 97 facilities show the same disagreement between the two federal staffing systems. In another, 121 of 132. Elsewhere, near zero.
   6. Labor sourcing seam: 96 of 97 inside one chain. Do the two federal systems agree about your labor?

## Sources

Every figure is attributed in the text to its originating source; the full source list is the study's appendix on the page. Print layout (PDF): https://astrelis.co/studies/skilled-nursing/2026/ground_truth_snf_2026_brief.pdf. Also in the series: https://astrelis.co/studies

## Cite

Astrelis, "Where Public SNF Benchmarks Break" (2026 edition), https://astrelis.co/studies/skilled-nursing/2026, published 2026-07-14; release 2321a4fc37a7 (2026-10-22).

Figures are as published by the named sources and were not audited by Astrelis. Astrelis is not a CPA firm and performs no audit, review or attestation of any facility.