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Rural Health
Resources by Topic: Long-term care

Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment: A Toolkit for States
Shares strategies that states can use to reform their long-term services and supports (LTSS) framework, focusing on improving LTSS in two key areas: rebalancing LTSS to increase the proportion of LTSS provided in community-based settings, and integrating LTSS with physical and behavioral health services through managed care. Uses case studies to provide real-life examples of each strategy, and discusses rural-specific considerations throughout.
Author(s): Stephanie Anthony, Arielle Traub, Sarah Lewis, et al.
Date: 12/2017
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Rural Long-Term Services and Supports: A Primer
Provides background information on rural long-term services and supports (LTSS), and examines rural access to and the use of LTSS. Describes LTSS as integral components of a high-performing rural health system, particularly for individuals with disabilities and/or over the age of 65. Three main sections discuss patterns of rural LTSS use, affordability and burden of LTSS, and rural LTSS models, policies, and trends.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad
Date: 11/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Medicare Payment Basics: Skilled Nursing Facility Services Payment System
Provides an overview of Medicare payments for skilled nursing facility services. Discusses rates for small, rural hospitals and Critical Access Hospitals.
Date: 10/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Long-term Care Hospitals Payment System
Provides an overview of Medicare payments for long-term care services. Discusses rate setting, payment updates, the 25 percent rule, and more.
Date: 10/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Learning Network: Long-Term Care Hospital Prospective Payment System
Provides an overview of Long-Term Care Hospital (LTCH) certification, along with information on patient classification, payment rates and adjustments, and quality reporting requirements. Includes a list of additional resources and helpful websites.
Date: 09/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Barriers and Facilitators to Implementation of VA Home-based Primary Care on American Indian Reservations: A Qualitative Multi-case Study
Highlights a study on the efficacy of the Veterans Health Affairs (VA) home-based primary care program at providing non-institutional long-term care for rural American Indian veterans living on reservations. Bases findings on a qualitative analysis of interviews conducted with staff, clinicians, and managers who oversaw the program's implementation. Discusses the challenges, barriers, and facilitators related the program's expansion into Indian Country.
Author(s): B. Josea Kramer, Sarah D. Cote, Diane I. Lee, Beth Creekmur, Debra Saliba
Location: Implementation Science, 12, 109
Date: 09/2017
Type: Document
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Electronic Health Record Adoption and Interoperability among U.S. Skilled Nursing Facilities in 2016
Presents the results of a 2016 survey of skilled nursing facilities related to the adoption and interoperability of electronic health records (EHRs) with data broken down by facility size, profit status, and rural/urban comparison.
Author(s): Carla S. Alvarado, Kathleen Zook, JaWanna Henry
Date: 09/2017
Type: Document
Sponsoring organization: Office of the National Coordinator for Health Information Technology
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2017
Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment issues, the redesign of the Merit-based Incentive Payment System (MIPS) and other alternative payment models, manufacturers payments to physicians and teaching hospitals, stand-alone emergency departments, skilled nursing facility use, and more. Rural hospitals, rural referral centers, and rural patient populations are discussed throughout the report.
Date: 06/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Promising Practice Issue Brief: Interdisciplinary Clinical Video - Telehealth for Geriatrics and Dementia
Highlights the development, implementation, and evaluation of an interdisciplinary telehealth program designed to help caregivers provide coordinated care for aging rural veterans suffering from dementia. Discusses the interdisciplinary team model comprised of social workers, geriatricians, primary care providers, and rural caregivers coordinating to maintain a uniform level of care. Includes outcomes regarding the increase of access to education and caregiver support, as well as the ability of providers to prescribe medication to rural patients.
Additional links: Overview
Date: 05/2017
Type: Document
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Medical Barriers to Nursing Home Care for Rural Residents
Explores challenges faced by rural people seeking placement in nursing homes, especially those with behavioral or psychiatric conditions, complex care needs, dementia, or obesity, and identifies possible solutions through policy changes. Uses data from telephone interviews with 23 discharge planners from rural hospitals in Georgia, Idaho, Minnesota, Pennsylvania, and Wisconsin.
Author(s): Carrie Henning-Smith, Michelle Casey, Shailendra Prasad, Katy Kozhimannil
Date: 05/2017
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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