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Rural Health
Resources by Topic: Post-acute 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.
Additional links: External FAQs
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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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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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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Research Institute for Home Care Chartbook 2023
Provides an overview of home health, including patient demographics and clinical profiles, organizational trends, the economic contribution of home health agencies, and patient outcomes. Includes charts and graphs throughout, as well as state-by-state data. Slide 11 highlights the rural-urban distribution of home health users.
Date: 11/2023
Type: Document
Sponsoring organizations: KNG Health Consulting, National Association for Home Care and Hospice, Research Institute for Home Care
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Medicare Payment Basics: Skilled Nursing Facility Services Payment System
Overview of Medicare payments for skilled nursing and rehabilitation services. Describes what constitutes a skilled nursing facility and how small, rural hospitals and Critical Access Hospitals (CAHs) may be used to provide these services with CMS approval. Compares Medicare daily base rates for urban and rural skilled nursing facilities.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Inpatient Rehabilitation Facilities Payment System
Overview of Medicare's payment system for inpatient rehabilitation services in freestanding facilities or within acute care hospitals. Demonstrates how payment rates are adjusted to account for certain facility characteristics, including facilities in rural areas.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Implementation of Acute Care Services and Long-Term Services and Supports System Redesign for Individuals with an Intellectual or Developmental Disability
Report on 2022 initiatives related to acute care and long-term services and supports (LTSS) systems for people with intellectual or developmental disabilities (IDD) in Texas. Includes both assessment of implementation and recommendations to the state legislature for improvements. Includes rural considerations throughout.
Date: 09/2023
Type: Document
Sponsoring organization: Texas Health and Human Services
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Quality Time: Sharing PIE – Improving Swing Bed Quality
Podcast episode discussing how two Critical Access Hospital (CAH) quality improvement leaders in Mississippi and Nevada used proactive approaches to improve their swing bed programs. Describes efforts in reducing healthcare-associated infections with pneumonia and improving the documentation and coordination of swing bed patients.
Date: 09/2023
Type: Audio
Sponsoring organization: Stratis Health
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