Koskamo

Per Patient Day MCP

An MCP server providing skilled nursing facility (SNF) operating benchmarks derived from CMS Medicare cost reports, including state-level metrics on occupancy, revenue, and expenses per patient day. It also offers a valuation calculator tool to compute EBITDAR, NOI, property value, and debt service coverage ratios based on user-provided census and financial inputs.

Endpoint and access

No sign-in to connect and list tools. Individual tools may still need a vendor account, credentials, or permissions; check the documented prerequisites.

Per Patient Day MCP logo, by Janover Capital LLCVendor evidenceStreamable HTTPNo sign-inEndpoint checked 2026-11-01Operated by Janover Capital LLC
MCP endpoint (Streamable HTTP)
https://fhaskillednursing.loan/mcp
Vendor documentation

What you can do with it

  • Retrieve state-level SNF occupancy and revenue benchmarks from CMS cost reports
  • Calculate EBITDAR, NOI, and DSCR for a specific skilled nursing facility
  • Compare a facility's performance against state medians and payer mix data
  • Access valuation estimates using cap rates and HUD 232/223(f) assumptions

Source and maintenance

Vendor evidenceRegistry 1.2026.1101.1

Protocol and capabilities

Server
per-patient-day 1.0.0
MCP protocol
2025-06-18
Tools
2 advertised
Resources
Not advertised
Resource templates
Not advertised
Prompts
Not advertised
Server-advertised capabilities
{
  "tools": {
    "listChanged": false
  }
}

Server-provided instructions

Untrusted server output shown for inspection. It is not Koskamo guidance and is excluded from knowledge search.

Per Patient Day (fhaskillednursing.loan) answers questions about skilled nursing facility (SNF) operating benchmarks and valuation math. state_benchmarks returns state, US, ownership and bed-size quartiles of occupancy, revenue and operating expense per patient day, reported margin, payer mix (Medicare/Medicaid/other days), Medicare PPS payment per Medicare day and contract labor share, computed from CMS Skilled Nursing Facility Cost Report data (full-year reports; the release and fiscal years come back with every result). snf_valuation runs the site's valuation calculator: EBITDAR, NOI, value at the user's cap rate, DSCR and a HUD 232/223(f) estimate. Cap rate, rate and fees are the user's assumptions. Cost reports are self-reported and the reported margin includes building and related-party costs. California and Vermont payer mix is flagged as not comparable. Results are estimates, not an appraisal, a loan quote or advice. Every result carries its CMS source link; cite it. The site is published by Janover Capital LLC and is not affiliated with HUD, FHA, CMS or any government agency. Data downloads and methods: https://fhaskillednursing.loan/data/

Tools

2 advertised

state_benchmarks — Skilled nursing benchmarks for a state
Advertised by the server during the last successful anonymous check.
Advertised read-only

Medicare cost-report benchmarks for skilled nursing facilities in one state (or the US, or a national ownership or size group): 25th percentile, median and 75th percentile occupancy, net patient revenue and operating expense per patient day, reported operating margin, Medicare/Medicaid/other share of days, Medicare PPS payment per Medicare day, contract labor share and beds, with the US median, the prior-year medians and the report count.

state_benchmarks input schema
{
  "type": "object",
  "properties": {
    "state": {
      "type": "string",
      "maxLength": 30,
      "minLength": 2,
      "description": "Two-letter state code or state name, e.g. TX or Texas. \"US\" (the default) for the national figures."
    },
    "national_group": {
      "enum": [
        "For-profit",
        "Nonprofit",
        "Government",
        "Under 60 beds",
        "60 to 99 beds",
        "100 to 149 beds",
        "150 beds or more"
      ],
      "type": "string",
      "description": "Optional, with state US only: a national ownership (type of control) or bed-size group instead of all facilities."
    }
  },
  "additionalProperties": false
}
state_benchmarks annotations
{
  "title": "Skilled nursing benchmarks for a state",
  "readOnlyHint": true,
  "openWorldHint": false,
  "idempotentHint": true,
  "destructiveHint": false
}
snf_valuation — SNF valuation and debt coverage
Advertised by the server during the last successful anonymous check.
Advertised read-only

The Per Patient Day valuation calculator: from beds, occupancy and revenue and operating expense per patient day, returns patient days, EBITDARM, EBITDAR, rent coverage, NOI, value and value per bed at your cap rate, DSCR and loan to value on a loan you give, a HUD 232/223(f) loan estimate, and where your occupancy and revenue per day fall against the state's cost-report quartiles.

snf_valuation input schema
{
  "type": "object",
  "required": [
    "beds",
    "occupancy_pct",
    "revenue_ppd",
    "expense_ppd",
    "cap_rate_pct"
  ],
  "properties": {
    "beds": {
      "type": "integer",
      "maximum": 2000,
      "minimum": 1,
      "description": "Licensed beds, e.g. 120."
    },
    "state": {
      "type": "string",
      "maxLength": 30,
      "minLength": 2,
      "description": "State to compare against: two-letter code or name, e.g. TX. Default \"US\"."
    },
    "annual_rent": {
      "type": "number",
      "default": 0,
      "maximum": 1000000000,
      "minimum": 0,
      "description": "Annual rent in dollars if the operator leases the building; 0 if owned."
    },
    "expense_ppd": {
      "type": "number",
      "maximum": 5000,
      "minimum": 0,
      "description": "Operating expense per patient day in dollars, before rent, interest, depreciation and the management fee, e.g. 300."
    },
    "loan_amount": {
      "type": "number",
      "default": 0,
      "maximum": 10000000000,
      "minimum": 0,
      "description": "Loan amount in dollars to test DSCR and loan to value; 0 to see only what the building supports."
    },
    "revenue_ppd": {
      "type": "number",
      "maximum": 5000,
      "minimum": 0,
      "description": "Net revenue per patient day in dollars, all payers, after contractual allowances, e.g. 350."
    },
    "cap_rate_pct": {
      "type": "number",
      "maximum": 30,
      "minimum": 1,
      "description": "Cap rate in percent: your assumption or your broker's (no public source sets it), e.g. 12."
    },
    "mgmt_fee_pct": {
      "type": "number",
      "default": 5,
      "maximum": 15,
      "minimum": 0,
      "description": "Management fee, percent of revenue. Default 5 (the calculator's example input)."
    },
    "occupancy_pct": {
      "type": "number",
      "maximum": 100,
      "minimum": 1,
      "description": "Occupancy in percent, e.g. 85."
    },
    "reserve_per_bed": {
      "type": "number",
      "default": 400,
      "maximum": 10000,
      "minimum": 0,
      "description": "Replacement reserve, dollars per bed per year. Default 400 (the calculator's example input)."
    },
    "interest_rate_pct": {
      "type": "number",
      "default": 6,
      "maximum": 15,
      "minimum": 0.5,
      "description": "Interest rate in percent. Default 6 (the calculator's example input, not a quote)."
    },
    "amortization_years": {
      "type": "integer",
      "default": 35,
      "maximum": 40,
      "minimum": 5,
      "description": "Amortization in years. Default 35."
    }
  },
  "additionalProperties": false
}
snf_valuation annotations
{
  "title": "SNF valuation and debt coverage",
  "readOnlyHint": true,
  "openWorldHint": false,
  "idempotentHint": true,
  "destructiveHint": false
}

Prompts

Not advertised

No prompt definitions available.

Resources

Not advertised

No resource definitions available.

30-day availability

Aggregated from read-only remote checks; this is not a tool-execution or security guarantee.

Successful checks
1 of 1 (100%)
Average latency
327 ms
95th percentile latency
327 ms

Maintenance history

Public check and source-refresh events. Editorial and ownership records remain private.

  • · probe · passed · 327 ms · metadata changed · 2 tool(s)

Connect from your client

Each snippet registers the same endpoint; pick the client you use.

This server is operated by the named third party. Listing and endpoint checks are not an endorsement or a security audit. Review the operator's permissions, terms, and data handling before connecting. How listings are checked and corrected.

Claude Code

Run this once in a terminal. It registers the remote server. Use --scope project to write .mcp.json for the repo.
Claude Code configuration
claude mcp add --transport http per-patient-day-mcp https://fhaskillednursing.loan/mcp

Codex

Run this once. Codex stores MCP servers in ~/.codex/config.toml (or .codex/config.toml in a trusted project).
Codex configuration
codex mcp add per-patient-day-mcp --url https://fhaskillednursing.loan/mcp

Cursor

Merge this server into .cursor/mcp.json in your project, then enable per-patient-day-mcp in your MCP settings.
Cursor configuration
{
  "mcpServers": {
    "per-patient-day-mcp": {
      "url": "https://fhaskillednursing.loan/mcp"
    }
  }
}

Cline

Merge this into cline_mcp_settings.json (Cline → MCP Servers → Configure).
Cline configuration
{
  "mcpServers": {
    "per-patient-day-mcp": {
      "type": "streamableHttp",
      "url": "https://fhaskillednursing.loan/mcp",
      "disabled": false
    }
  }
}

VS Code

Merge this server into .vscode/mcp.json. Use MCP: List Servers to start per-patient-day-mcp and inspect its tools.
VS Code configuration
{
  "servers": {
    "per-patient-day-mcp": {
      "type": "http",
      "url": "https://fhaskillednursing.loan/mcp"
    }
  }
}

Gemini CLI

Run this once. It writes .gemini/settings.json in the current project; pass --scope user for ~/.gemini/settings.json.
Gemini CLI configuration
gemini mcp add --transport http per-patient-day-mcp https://fhaskillednursing.loan/mcp

Claude Desktop

Merge this into claude_desktop_config.json (macOS: ~/Library/Application Support/Claude/, Windows: %APPDATA%\Claude\), then restart Claude Desktop.
Claude Desktop configuration
{
  "mcpServers": {
    "per-patient-day-mcp": {
      "url": "https://fhaskillednursing.loan/mcp"
    }
  }
}

Windsurf

Merge this into ~/.codeium/windsurf/mcp_config.json, then refresh MCP in Cascade. Windsurf remote servers use serverUrl, not url.
Windsurf configuration
{
  "mcpServers": {
    "per-patient-day-mcp": {
      "serverUrl": "https://fhaskillednursing.loan/mcp"
    }
  }
}

Let your agent find its tools

Find servers like Per Patient Day MCP from your agent. Add Koskamo once to search the index for endpoints, access requirements, and client setup. Public discovery needs no key.

Do you run Per Patient Day MCP?

Prove ownership with a DNS record, a well-known file, or your Official MCP Registry entry, and your edits publish immediately. Proofs are re-checked weekly; admins can still hide or remove a listing.

Claim this listing