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Rural Health
Resources by Topic: Long-term care

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule for minimum staffing standards for long-term care facilities. Details three core staffing proposals: 1) minimum nurse staffing standards; 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements. Outlines a staggered implementation approach, including a later implementation date for rural facilities, and hardship exemption qualification requirements. Also describes Medicaid payment transparency reporting provisions for nursing and intermediate care facilities related to the percentage of Medicaid funds spent on compensation to direct care workers and support staff.
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Research Recap: Quality Star Ratings: Hospitals, Skilled Nursing Facilities, and Home Health Agencies
Examines the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Rating system among hospitals, skilled nursing facilities, and home health agencies in 2021 and 2022. Features statistics including number of rural hospitals without a star rating with breakdowns by census region, and percentage of hospitals without star rating, with breakdowns by urban or rural location.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban and rural freestanding SNFs in 2022.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2024
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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2023 National Healthcare Quality and Disparities Report: Chartbook on Patient Safety
Summarizes trends in healthcare quality across 28 measures of patient safety. Presents findings for four settings of care: ambulatory care, home health, hospitals, and nursing homes. Describes disparities in patient safety by race/ethnicity, sex, age, and insurance status. Highlights disparities for maternal morbidity and mortality measures by rurality.
Author(s): Barbara Barton, Darryl Gray, Cecilia Hahn, et al.
Date: 03/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Pre-Rulemaking Measure Review Measures Under Consideration: 2023 Recommendations Report
Reviews the 42 pre-rulemaking quality measures the Battelle's Partnership for Quality Measurement (PQM) considered during the 2023-2024 Pre-Rulemaking Measure Review (PRMR) cycle. Discusses measures for clinician, hospital, and post-acute care/long-term care programs. Includes rural references and considerations throughout.
Date: 02/2024
Type: Document
Sponsoring organization: Partnership for Quality Measurement
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Infection Control Policies and Practices in Residential Care Communities by Selected Organizational and Geographic Characteristics: United States, 2020
Presents nationally representative data on the percentage of residential care communities with emergency operations plans that are specific to or include pandemic response, approaches to implement these plans, and infection control policies and practices. Compares infection control policies and practices by metropolitan status, community bed size, ownership status, chain affiliation, and whether the community has a designated space for dementia care.
Author(s): Amanuel Melekin, Manisha Sengupta
Date: 02/2024
Type: Document
Sponsoring organization: National Center for Health Statistics
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Nursing Home Workforce Issues and Inequities
Offers an overview of issues related to the direct care workforce in nursing homes including staffing shortages, recruitment and retention, low wages, job training, interdisciplinary care, and more. Discusses proposed policies offering workforce-related reforms. Discusses rural throughout.
Author(s): Jasmine L. Travers, Rita Choula, Edem Hado
Date: 02/2024
Type: Document
Sponsoring organization: AARP Public Policy Institute
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Hospital Financing: Volume Limits and Reporting Could Help Manage Risks of Expanding FHA's Mortgage Insurance Program
Describes the Federal Housing Administration's (FHA) Hospital Mortgage Insurance Program, which insures loans for capital improvements at hospitals; loans insured through the program between 2000 and 2022. Explores characteristics of hospitals ineligible for the program that may impact their financing options. Examines the potential effects and risks of extending Hospital Mortgage Insurance Program eligibility to currently ineligible hospital types on program participation risks. Offers recommendations to Congress if it decides to expand program eligibility to hospitals that primarily provide non-acute care services.
Additional links: Full Report
Date: 01/2024
Type: Document
Sponsoring organization: Government Accountability Office
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