Rural Health
Resources by Topic: Long-term care
Rural-Urban Comparisons of Nursing Staff Turnover among Skilled Nursing Facilities
Results of a study assessing facility-level turnover rates for nursing personnel across levels of rurality and by region, using data from 14,986 facilities. Features statistics on turnover rates in 2022, with breakdowns by total nursing staff and registered nurses only, and by rural or urban areas. Also includes a county-level map showing average nursing staff turnover rates.
Author(s): Michael D. Wirth, Nick Yell, Peiyin Hung, Elizabeth Crouch
Date: 09/2025
Sponsoring organization: University of South Carolina Rural Health Research Center
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Results of a study assessing facility-level turnover rates for nursing personnel across levels of rurality and by region, using data from 14,986 facilities. Features statistics on turnover rates in 2022, with breakdowns by total nursing staff and registered nurses only, and by rural or urban areas. Also includes a county-level map showing average nursing staff turnover rates.
Author(s): Michael D. Wirth, Nick Yell, Peiyin Hung, Elizabeth Crouch
Date: 09/2025
Sponsoring organization: University of South Carolina Rural Health Research Center
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Nursing Homes Failed to Report 43 Percent of Falls With Major Injury and Hospitalization among Their Medicare-Enrolled Residents
Explores the extent to which falls with major injury that resulted in hospitalization among Medicare-enrolled nursing home residents were accurately reported by nursing homes in Minimum Data Set (MDS) assessments between July 2022 and June 2023. Compares the nursing home and patient characteristics associated with higher rates of unreported falls, including nursing home size, ownership structure, rurality, and overall star rating.
Additional links: Report Highlights
Date: 09/2025
Sponsoring organization: Office of Inspector General (HHS)
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Explores the extent to which falls with major injury that resulted in hospitalization among Medicare-enrolled nursing home residents were accurately reported by nursing homes in Minimum Data Set (MDS) assessments between July 2022 and June 2023. Compares the nursing home and patient characteristics associated with higher rates of unreported falls, including nursing home size, ownership structure, rurality, and overall star rating.
Additional links: Report Highlights
Date: 09/2025
Sponsoring organization: Office of Inspector General (HHS)
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The National Dementia Workforce Study: The Plan for Organization Sample Frames and Data Collection
Details a plan for sampling and recruitment procedures of the dementia workforce, focusing on previously unsampled populations working in assisted living communities or home health agencies. Discusses sampling and recruitment strategies with considerations for Census region and rural areas.
Author(s): James Wagner, Laura M. Wagner, Sheryl Zimmerman, et al.
Citation: Journal of the American Geriatrics Society
Date: 09/2025
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Details a plan for sampling and recruitment procedures of the dementia workforce, focusing on previously unsampled populations working in assisted living communities or home health agencies. Discusses sampling and recruitment strategies with considerations for Census region and rural areas.
Author(s): James Wagner, Laura M. Wagner, Sheryl Zimmerman, et al.
Citation: Journal of the American Geriatrics Society
Date: 09/2025
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FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Performance of Rural and Urban Nursing Homes: A Comparative Analysis
Presents a study comparing the financial performance between rural and urban nursing homes. Discusses the different structural barriers and facilitators that affect the operating margins in rural and urban facilities.
Author(s): Gregory N. Orewa, Rohit Pradhan, Akbar Ghiasi, et al.
Citation: Journal of Rural Health, 41(3), e70053
Date: 07/2025
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Presents a study comparing the financial performance between rural and urban nursing homes. Discusses the different structural barriers and facilitators that affect the operating margins in rural and urban facilities.
Author(s): Gregory N. Orewa, Rohit Pradhan, Akbar Ghiasi, et al.
Citation: Journal of Rural Health, 41(3), e70053
Date: 07/2025
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)
Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that expired at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that expired at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Skilled Nursing Facilities - Dually Certified in Rural Areas
Printable map that shows the location of skilled nursing facilities and nursing facilities that are dually certified located in rural areas (outside U.S. Census Bureau Urban Areas with a population of 50,000 or more). Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 07/2025
Sponsoring organization: Rural Health Information Hub
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Printable map that shows the location of skilled nursing facilities and nursing facilities that are dually certified located in rural areas (outside U.S. Census Bureau Urban Areas with a population of 50,000 or more). Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 07/2025
Sponsoring organization: Rural Health Information Hub
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LTSS Users by State, County, and Setting
Interactive dashboard presenting data on the number of Medicaid enrollees that use long-term services and supports (LTSS) at the national, state, and county-levels in 2022. Includes data on LTSS users, Medicaid Home- and Community-Based Services (HCBS) users, and institutional LTSS users by age, dual-enrollment status, and sex.
Date: 06/2025
Sponsoring organizations: ATI Advisory, The SCAN Foundation
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Interactive dashboard presenting data on the number of Medicaid enrollees that use long-term services and supports (LTSS) at the national, state, and county-levels in 2022. Includes data on LTSS users, Medicaid Home- and Community-Based Services (HCBS) users, and institutional LTSS users by age, dual-enrollment status, and sex.
Date: 06/2025
Sponsoring organizations: ATI Advisory, The SCAN Foundation
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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