Traditionally, the Northeast and West regions have commanded the highest average prices per bed for skilled nursing facilities because of their high real estate values and generally higher daily rates. However, the North Central region surprised us with the highest average price per bed, up from $68,400 per bed in 2014 to $100,200 per bed in 2015. This was largely driven by a few high-priced portfolio sales as well as newly built properties that always command high prices, no matter their zip code. Next came the Northeast, which increased from $88,200 per bed in 2014 to $94,100 per bed in 2015. As for the three remaining regions, there was a sharp drop-off, most significantly for the West region, which fell from $82,900 per bed in 2014 to $67,600 per bed in 2015. Even the high-priced California real estate couldn’t compensate for older facilities with a high Medi-Cal census (the state’s Medicaid program).