Rural Long-Term Care Facilities – Resources
Selected recent or important resources focusing on Rural Long-Term Care Facilities.
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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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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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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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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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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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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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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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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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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Last Updated: 9/23/2025