Skilled Healthcare Group was the first of the skilled nursing companies to report earnings, and it did not set a good tone. Year-over-year, occupancy was down but worse, the quality mix revenues was down 140 basis points from a year ago. It is still high, at 69.4%, but the trend is not their friend. Adjusted EBITDA was down as was the EBITDA margin, which dropped 140 basis points to 10.9% from a year ago. About the only bright spot was that managed care patient days increased by 10.5% from last year’s fourth quarter, which was offset by an 11.9% drop in Medicare days. Investors seemed ready for the news, as the share price dropped by less than 2%. But remember, its price is already down 17% year-to-date.