Skip to main content

Rural Long-Term Care Facilities – Resources

Selected recent or important resources focusing on Rural Long-Term Care Facilities.

COVID-19 Survey Activities, CARES Act Funding, Enhanced Enforcement for Infection Control Deficiencies, and Quality Improvement Activities in Nursing Homes
Provides guidance to state survey agencies on nursing home infection control surveys in response to COVID-19, CARES Act funding, enhanced enforcement for infection control deficiencies, and Quality Improvement Organization support in preventing COVID-19 transmission in nursing homes.
Date: 06/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Infection Control Deficiencies Were Widespread and Persistent in Nursing Homes Prior to COVID-19 Pandemic
Explores the prevalence of infection prevention and control deficiencies in nursing homes prior to the COVID-19 pandemic. Examines the percentage of nursing homes that had deficiencies cited in multiple years. Provides charts noting the number of nursing homes with an infection prevention and control deficiency by state. Includes a chart that describes the data by urban and rural status.
Additional links: Full Report
Date: 05/2020
Type: Document
Sponsoring organization: Government Accountability Office
view details
Nursing Home Reopening Recommendations for State and Local Officials
Provides recommendations to help state and local officials determine the level of mitigation needed to prevent the transmission of COVID-19 in nursing homes. Discusses criteria to inform decisions for relaxing restrictions, considerations for allowing visitation, and recommendations for restarting survey activities. Includes a chart outlining the criteria for reopening nursing homes at each phase of the "Opening Up America Again" framework.
Additional links: Nursing Home Reopening Recommendations Frequently Asked Questions
Date: 05/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes
Provides a compilation of resources and strategies for quality improvement, management, and prevention of the spread of COVID-19 within nursing homes. Includes information on testing, workforce and staffing, infection control, personal protective equipment, patient transfers, telehealth services, and more. Includes recommendations and examples from rural areas throughout.
Date: 05/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes
Provides an overview of a May 2020 CMS interim final rule outlining COVID-19 infection control, surveillance, and reporting requirements for nursing homes and long-term care facilities. Discusses updates to the "COVID-19 Focused Survey for Nursing Homes." Includes responses to Frequently Asked Questions regarding long-term care facility requirements for reporting confirmed and suspected cases of COVID-19.
Date: 05/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit
Identifies the significant telehealth-related changes made by CMS in response to the COVID-19 National Health Emergency. Provides resources to help long-term care facilities develop a telemedicine program. Addresses vendor selection, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools.
Date: 03/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
COVID-19 Emergency Declaration Health Care Providers Fact Sheet
Lists 1135 waivers available from CMS to help healthcare providers respond to COVID-19, with information for specific facility types including skilled nursing facilities, Critical Access Hospitals, and home health agencies.
Date: 03/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Trends in Electronic Health Record Use Among Residential Care Communities: United States, 2012, 2014, and 2016
Examines electronic health record (EHR) use trends and health information exchange (HIE) capability among residential care communities. Includes data by metropolitan statistical area (MSA) status, comparing MSA and non-MSA areas.
Author(s): Christine Caffrey, Christopher Cairns, Vincent Rome
Date: 03/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
view details
Nursing Home Closures and Trends: June 2015 - June 2019
Provides an overview of the causes and implications of 500 nursing home closures between June 2015 and June 2019. Examines the geographic distribution of these closures, including states in which closures are concentrated in rural areas. Explores nursing home closures in relation to occupancy rates, quality ratings, tax status, and the impact of Medicaid payment policies. Offers recommendations for policymakers and nursing homes.
Date: 02/2020
Type: Document
Sponsoring organization: LeadingAge
view details
Skilled Nursing Facilities - Dually Certified Outside of Urbanized Areas
Printable map that shows the location of skilled nursing facilities and nursing facilities that are dually certified and located outside of urbanized areas by state. Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 01/2020
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
view details
Quality Measures for Critical Access Hospital Swing-Bed Patients
Policy brief describing a study to identify quality measures for Critical Access Hospital (CAH) swing-bed patients, focused on outcome and functional status measures. Includes information from key informant interviews on discharge disposition and 30-day follow-up status.
Author(s): Michelle Casey, Ira Moscovice, Henry Stabler
Date: 10/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
view details
Medicare Payment Basics: Long-term Care Hospitals Payment System
Overview of Medicare payments for long-term care hospitals (LTCH) and services. Discusses the LTCH prospective payment system (PPS), and payment rate settings for LTCH and site neutral cases.
Date: 10/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
States' Medicaid Fee-for-Service Nursing Facility Payment Policies
Spreadsheet outlining each state's Medicaid fee-for-service (FFS) nursing facility payment policy. Lists how each state sets the payment rate and any adjustments and supplemental payments. Includes information on rural/urban aspects of setting or adjustment to the payment in each state.
Date: 10/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Long-term Care Providers and Services Users in the United States, 2015-2016
Describes the supply, organizational characteristics, staffing, and services offered by providers. Gives descriptions of services users, including residents of nursing homes and residential care communities, patients receiving home health or hospice care, and people who attend adult day care centers. Features statistics including distribution of long-term care providers in 2016, with breakdowns by metropolitan, micropolitan, or other area.
Additional links: State Estimates Supplement
Author(s): L. Harris-Kojetin, M. Sengupta, J.P. Lendon, et al.
Date: 02/2019
Type: Document
Sponsoring organization: National Center for Health Statistics
view details
Skilled Nursing Data Report: Key Occupancy & Revenue Trends
Provides statistics on occupancy, patient day mix, revenue per patient day, and revenue mix including Medicare and Medicaid reimbursement, with breakdowns by rural location, urban cluster, urban area, and national total. Uses data from January 2012-December 2018. Requires free registration for download.
Date: 2019
Type: Document
Sponsoring organization: National Investment Center for Seniors Housing & Care
view details
Electronic Health Record Adoption and Interoperability Among U.S. Skilled Nursing Facilities and Home Health Agencies in 2017
Presents data for home health agencies and skilled nursing facilities describing their use of health information technology (HIT) in 2017. Includes statistics on electronic health record (EHR) adoption and interoperability. Covers information telehealth use in home health agencies by rural versus urban location and ownership type.
Author(s): JaWanna Henry, Yuriy Pylypchuk, Vaishali Patel
Date: 11/2018
Type: Document
Sponsoring organization: Office of the National Coordinator for Health Information Technology
view details
Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study
Results of a study of 2,514 nursing homes to assess infection preventionist training and certification, staff turnover, and infection control program characteristics. Features statistics on facility characteristics, with breakdowns by locations in metro, large urban, small urban, or rural areas.
Author(s): Patricia W. Stone, Carolyn T.A. Herzig, Mansi Agarwal, Monika Pogorzelska-Maziarz, Andrew W. Dick
Citation: Inquiry, 55:1-7
Date: 05/2018
Type: Document
view details
Tribal Nursing Home Directory
Directory lists all the tribally operated nursing homes across the country. Lists the tribal affiliation, number of beds, and contact information for each facility.
Date: 03/2018
Type: Directory
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Tribal Nursing Home Best Practices: Cultural Sensitivity
Details several models for culturally competent tribal nursing homes and the measures the facilities implemented to provide appropriate care for American Indian and Alaska Native elders. Discusses some initiatives implemented, such as hiring a cultural liaison to coordinate traditional activities and providing person-centered care.
Date: 03/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Tribal Nursing Homes: Communicating with Your Governing Board
Presents methods for tribal nursing home administrators to effectively communicate with their governing boards. Features examples from several tribes of the southern and western U.S., as well as several resources and toolkits that further explore effective modes of communication for long-term care facility governance.
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
view details
The Economic Impact of Rural Nursing Homes
Discusses the projected national total health expenditures and national nursing home expenditures that are affected by the aging population of the U.S. and increased life expectancies. Identifies how nursing homes contribute economically to the community through wages, salaries and benefits.
Author(s): Cheryl F. St. Clair, Gerald A. Doeksen, Fred C. Eilrich
Date: 07/2017
Type: Document
Sponsoring organization: National Center for Rural Health Works
view details
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
view details
Animals Help People Heal in Rural Areas
Discusses the role of service and therapy animals in rural communities. Features service dogs of Hawaii, therapeutic riding horses of Wyoming, and a Florida skilled nursing facility with a therapy pig and tortoise.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 12/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Are Rural Older Adults Benefiting from Increased State Spending on Medicaid Home and Community-Based Services?
Discusses the availability and use of home and community-based services (HCBS) by rural and urban elderly receiving Medicaid funding for long term services and supports (LTSS) using national Medicaid Analytical Extract claims data.
Author(s): Andrew F. Coburn, Eileen Griffin, Deborah Thayer, Zachariah T. Croll, Erika C. Ziller
Date: 06/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
view details
Swing Bed Reimbursement in Critical Access Hospitals
March 2015 webinar discussion in response to the release of a report from the Office of the Inspector General (OIG) on the value of swing bed programs vs. skilled nursing facilities (SNF) in Critical Access Hospitals. Covers the major components of the swing bed program, reviews the report, and provides an example of a successful program in Kentucky. Presented by Brock Slabach, National Rural Health Association; Kristin L. Reiter, Associate Professor in the Department of Health Policy and Management at the University of North Carolina at Chapel Hill and Research Fellow at the Cecil G. Sheps Center for Health Services Research; and Susan Starling, CEO/President at Marcum and Wallace Memorial Hospital. 60 minutes.
Additional links: Audio Recording, PowerPoint Handout, Transcript
Date: 03/2015
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
view details
The Need to Reform Medicare's Payments to Skilled Nursing Facilities Is as Strong as Ever
Compares payments made to skilled nursing facilities (SNFs) and costs over time to see if changes made by the Centers for Medicare and Medicaid Services (CMS) to the payment system have improved payment accuracy. Table 3 and Table 4 compare healthcare facility characteristics, including rural location.
Author(s): Carol Carter, Bowen Garrett, Doug Wissoker
Date: 01/2015
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
view details
Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
Examines the relationship between nurse staffing levels (registered nurse, licensed practical nurse, and certified nurse aide hours per resident per day) and the quality of care in rural nursing homes. Includes data for hospital-based facilities and freestanding nursing homes.
Author(s): Peiyin Hung, Michelle Casey, Ira Moscovice
Date: 01/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
view details
Housing an Aging Rural America: Rural Seniors and Their Homes
Discusses housing options to help rural seniors age in place. Topics covered include assisted living, home modification, transportation and other supportive services. Also addresses housing quality and affordability.
Date: 10/2014
Type: Document
Sponsoring organization: Housing Assistance Council
view details
Profile of Rural Residential Care Facilities: A Chartbook
Reports on rural/urban differences in residential care facilities, focusing the facilities themselves, their residents, and the services they offer. Addresses how facility policies affect aging-in-place options.
Author(s): Jennifer D. Lenardson, Eileen Griffin, Zach Croll, Erika C. Ziller, Andrew F. Coburn
Date: 05/2014
Type: Document
Sponsoring organization: Maine Rural Health Research Center
view details
2014 Quality Report
Provides an overview of latest trends in quality for skilled nursing facilities and highlights efforts to improve quality care through specific programs and initiatives. Includes statistics on urban or rural location, improvement in rehospitalization rate from 2011-2014 by state, and reduction in off-label use of antipsychotics by state.
Date: 2014
Type: Document
Sponsoring organization: American Health Care Association
view details
Long-Term Care Services in the United States: 2013 Overview
Presents descriptive results from the first findings of the National Study of Long-Term Care Providers (NSLTCP). Provides information on the supply, staffing, and services offered by providers of long-term care services; and the demographic, health, and users of these services. Figure 2 shows the distribution of providers among metropolitan, micropolitan, and non-metro areas by type of service: adult day services, home health, hospice, nursing home, and residential care community.
Author(s): Lauren Harris-Kojetin, Manisha Sengupta, Eunice Park-Lee, Roberto Valverde
Date: 12/2013
Type: Document
Sponsoring organization: National Center for Health Statistics
view details
Mental Health Services in Rural Long-Term Care: Challenges and Opportunities for Improvement
This research and policy brief examines promising practices for enhancing mental health services to the elderly living in rural long-term care facilities or in their own homes.
Author(s): Jean A. Talbot, Andrew F. Coburn
Date: 06/2013
Type: Document
Sponsoring organization: Maine Rural Health Research Center
view details
Challenges and Opportunities for Improving Mental Health Services in Rural Long-Term Care
Explores practices for increasing the quality, quantity, and accessibility of mental health services in rural long-term care. Addresses finances, workforce challenges, physical access barriers, integrated care, and policy considerations.
Author(s): Jean A. Talbot, Andrew F. Coburn
Date: 06/2013
Type: Document
Sponsoring organization: Maine Rural Health Research Center
view details
Design and Operation of the 2010 National Survey of Residential Care Facilities
An overview of the NSRCF that was conducted between March and November 2010. Includes residential care facilities consisting of assisted living residences, board and care homes, congregate care, enriched housing programs, homes for the aged, personal care homes, and shared housing establishments. National data was collected on 2,302 facilities and 8,094 current residents.
Date: 11/2011
Type: Document
Sponsoring organization: National Center for Health Statistics
view details
Home and Community-Based Services: Meeting the Long-Term Care Needs of Rural Seniors
Describes health care needs that seniors face when long-term care and health care services are not available. Issues include provider shortages, travel distances, migration and rural population, Medicaid, and home and community-based services.
Author(s): Joshua Ewing
Date: 08/2011
Type: Document
Sponsoring organization: National Conference of State Legislatures
view details
Report to Congress: Evaluation of the Rural PACE Provider Grant Program
Evaluates rural Program of All-inclusive Care for the Elderly (PACE) pilot sites. Discusses characteristics of PACE participants, enrollment, successes and failures, and future expansion of PACE in rural communities.
Author(s): Karyn Kai Anderson
Date: 2011
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
view details
The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look
Summarizes six issue areas of the Affordable Care Act (ACA) and discusses implications for access to services and improving the health status of rural residents. These issue areas are: health insurance coverage; Medicare and Medicaid payment; quality, financing, and delivery system reform; public health; healthcare workforce; and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller
Date: 09/2010
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Systems of Care: Environmental Scan of Medicaid-Funded Long-Term Supports and Services
Assists state and federal policymakers with identifying strategies to address clinical and long-term support and service needs of Medicaid beneficiaries. Provides an overview of the state of the publicly funded long-term care delivery system in 2010 and discusses rural versus urban infrastructure. Part of the Innovations in the Medicaid Continuum of Care series.
Author(s): Gretchen Engquist, Cyndy Johnson, William Courtland Johnson
Date: 05/2010
Type: Document
Sponsoring organization: Center for Health Care Strategies
view details
Expanding Rural Elder Care Options: Models That Work
Proceedings from the 2008 Rural Long Term Care Access and Options Workshop, which discussed model options for home, community, and facility-based care by care coordination systems that enhance autonomy and quality of life for rural elders.
Author(s): Peter Fitzgerald, Andy Coburn, Sharon K. Dwyer
Date: 06/2009
Type: Document
Sponsoring organization: National PACE Association
view details
Long-Term Care: Consumers, Providers, Payers, and Programs
Discusses selected characteristics of long-term care consumers and providers and describes payers and selected programs that finance long-term care services.
Author(s): Carol O'Shaughnessy, Julie Stone, Thomas Gabe, Laura B. Shrestha
Date: 03/2007
Type: Document
Sponsoring organization: Congressional Research Service
view details
LTC Focus (Long-term Care: Facts on Care in the US)
Mapping tool presents long-term care data by a number of indicators nationally or on a state-by-state basis. Features data on facility characteristics, state policies, and resident characteristics, among other factors.
Type: Map/Mapping System
Sponsoring organization: Brown School of Public Health
view details
List of Skilled Nursing Facility (SNF) Federal Regulations
Lists federal regulations and notices related to the Prospective Payment System (PPS) for Skilled Nursing Facilities (SNFs), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Regulations and Notices
Lists federal regulations and notices related to the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
National Study of Long-Term Care Providers (NSLTCP)
Monitors trends in the major sectors of paid, regulated, long-term care services providers. Includes data and reports related to residential care communities, adult day services centers, home health agencies, nursing homes, and hospices.
Type: Website
Sponsoring organization: National Center for Health Statistics
view details
PubMed Search: Rural Long-Term Care Facilities
Searches PubMed's collection of journal article citations on topics related to rural long-term care.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
view details
Caring for the Ages
Monthly publication for post-acute and long-term care professionals covering clinical developments, best practices, and the impact of legal issues and healthcare policy on the field. Includes some articles specific to rural post-acute and long-term care.
Type: Journal/Newsletter
Sponsoring organization: AMDA – The Society for Post-Acute and Long-Term Care Medicine
view details
Provider Magazine
Published monthly. Contains information for long-term care professionals including upcoming legislation, regulations, quality care, and improving operating efficiencies. Includes some articles specific to rural long-term care.
Type: Journal/Newsletter
Sponsoring organization: American Health Care Association
view details
Nursing Home Compare
Provides detailed information on every Medicare and Medicaid-certified nursing home in the United States. Includes facility-level information on health inspections, fire inspections, staffing, quality of care, and any penalties.
Type: Database
Sponsoring organization: Centers for Medicare and Medicaid Services
view details

Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 6/2/2020