Ideas That Move Skilled Nursing Forward

Culture is the single most underrated driver of census in skilled nursing. That sounds like a stretch until you look at the data: nursing staff turnover correlates with occupancy nearly twice as strongly as your CMS star rating does. I spent ten years at Eduro Healthcare, the last three as VP of Brand and Culture, while we grew from 4 facilities to more than 40. I watched culture get built, I watched what it did to our buildings, and I can tell you it was never about ping pong tables.

We analyzed all 14,695 Medicare and Medicaid certified skilled nursing facilities in the United States using the June 2026 CMS Provider Information release. Overall star rating explains roughly 1% of the variation in occupancy. Nursing staff turnover correlates nearly twice as strongly.