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Rural Health
Resources by Topic: Long-term care

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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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 & Medicaid Services
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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 & Medicaid Services
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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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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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Rural Hospital Closures and Nursing Home Outcomes
Details a study exploring the effect of rural hospital closures on rural nursing home outcomes in the corresponding county. Discusses care utilization and resident health and compares effects of hospital-based and non-hospital-based long-term care facilities.
Author(s): Emmaline Keesee, Tyler Malone, Susie Gurzenda, George Pink
Citation: Journal of Rural Health, 41(2), e70026
Date: 04/2025
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Home Healthcare Establishments Serving Rural Areas Increased about 36 Percent from 2010 to 2023
Chart showing the change for home healthcare services, assisted living facilities, and skilled nursing facilities in nonmetropolitan areas between 2010 and 2023.
Author(s): Brandon Genetin
Date: 03/2025
Sponsoring organization: USDA Economic Research Service
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As Older Rural Population Grew, Ratio of Rural U.S. Eldercare Establishments Fell
Bar chart comparing the number of eldercare establishments per 1,000 adults 65 or older in rural and urban areas between 2010 and 2023. Eldercare establishments include those that provide home health, long-term care, or assisted living services, as noted in the 2024 Rural America At a Glance report.
Author(s): Brandon Genetin
Date: 03/2025
Sponsoring organization: USDA Economic Research Service
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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, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2025
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.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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