Skilled Nursing Market Watch, an example edition

Corliss Care Analytics

Skilled Nursing Market WatchQ3 2026 · October 2026

Skilled Nursing Market Watch · Ohio, Pennsylvania, Indiana, Texas and FloridaData to September 30, 2026

Ownership changes slow as Medicaid rates rise in four of five states

Facilities recorded 81 ownership changes across the five states this quarter, the fewest since we began tracking. Food safety citations rose while infection control citations fell

1The quarter by state

The five states hold 4,020 certified skilled nursing facilities. Texas recorded the most ownership changes and closures, as it does every quarter, but Ohio had the highest rate of change relative to its size. Florida held its Medicaid rates flat pending its October rate notice.^1,2

Table 1Ownership changes, closures and Medicaid rates by statefacilities and percent change in average per diem

State	Facilities	Ownership changes	Closures	Medicaid rate
Ohio	940	21	3	+4.2%
Pennsylvania	680	14	4	+3.1%
Indiana	520	11	2	+5.0%
Texas	1,190	26	6	+2.6%
Florida	690	9	1	No change
Five states	4,020	81	16

Source: CMS Care Compare provider and ownership data, state licensing records, state Medicaid rate notices

2Ownership changes and closures

Ownership changes have fallen for five quarters in a row since peaking at 118 in the second quarter of 2025. Higher borrowing costs have slowed purchases by regional operators, and fewer real estate investors are taking on new facilities. Closures remain elevated but did not rise this quarter.

Figure 1Ownership changes and closures, five statesfacilities per quarter

Source: CMS Care Compare ownership data and state licensing records

Figure 2Counties with the most ownership changes in the third quarterfacilities

Harris County, Texas: 9
Cuyahoga County, Ohio: 7
Philadelphia County, Pennsylvania: 6
Marion County, Indiana: 5
Hillsborough County, Florida: 4

Source: CMS Care Compare ownership data, July to September 2026

3Inspection deficiencies

Inspectors issued 1,455 citations in the five most cited categories this quarter, 32 more than a year ago. Infection control citations fell as surveyors moved their attention elsewhere, while food safety citations rose by 14 percent, most of them for food storage and kitchen sanitation.

Table 2Citations in the five most cited categoriescitations in standard and complaint surveys

Category	F tag	Q3 2026	Q3 2025	Change
Infection control	F880	412	455	down 43
Food safety	F812	388	341	up 47
Accident hazards	F689	296	302	down 6
Care planning	F656	241	228	up 13
Nurse staffing	F725	118	97	up 21
Five categories		1,455	1,423	up 32

Source: CMS Care Compare health inspection data, surveys completed July to September

4Against our Facility Operations Benchmark

5What to watch next quarter

Florida's rate notice for the year starting October 1, Pennsylvania's budget negotiations over its nursing facility assessment, and whether the rise in food safety citations continues into the winter survey cycle.

How this watch is built

Ownership changes are counted on the effective date recorded by CMS or the state licensing agency, whichever comes first
Medicaid rate changes are taken from each state's published notice for its current rate year
Every facility record links to its public source, held on file for partners who ask

Approved for subscribersThomas BraddockDirector of Post Acute Research · October 9, 2026

¹ Facility counts include all Medicare or Medicaid certified skilled nursing facilities active on September 30, 2026.

² Rate changes are the change in the statewide average per diem; Texas and Indiana rate years begin September 1 and July 1 respectively.