Rural Long-Term Care Facilities – Resources
Selected recent or important resources focusing on Rural Long-Term Care Facilities.
Characteristics of People Using Medicaid Long-Term Services and Supports, 2021
Presents data on the characteristics of individuals who used Medicaid long-term services and supports (LTSS) in 2021, including age, dual-eligibility status, rural or urban residence, and race and ethnicity. Offers data on home and community-based service (HCBS) users by HCBS program and state plan option types and institutional service users by setting type.
Author(s): Cara Stepanczuk, Alexandra Carpenter, Andrea Wysocki
Date: 07/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Presents data on the characteristics of individuals who used Medicaid long-term services and supports (LTSS) in 2021, including age, dual-eligibility status, rural or urban residence, and race and ethnicity. Offers data on home and community-based service (HCBS) users by HCBS program and state plan option types and institutional service users by setting type.
Author(s): Cara Stepanczuk, Alexandra Carpenter, Andrea Wysocki
Date: 07/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Standing Technical Expert Panel for the Development, Evaluation, and Maintenance of Post-Acute Care (PAC) and Hospice Quality Reporting Program (QRP) Measurement Sets: Summary Report
Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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Assessing Medicaid Payment Rates and Costs of Caring for the Medicaid Population Residing in Nursing Homes
Explores the relationship between Medicaid per diem payment rates to nursing homes and facilities' costs of providing care to Medicaid patients for facilities with a fiscal year ending on June 30, 2019. Examines the determinants of average cost and payment variations across each state. Presents data by facility-level characteristics, including ownership status, chain affiliation, rural or urban location, and more.
Date: 06/2024
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Miami University, RTI International, University of Massachusetts
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Explores the relationship between Medicaid per diem payment rates to nursing homes and facilities' costs of providing care to Medicaid patients for facilities with a fiscal year ending on June 30, 2019. Examines the determinants of average cost and payment variations across each state. Presents data by facility-level characteristics, including ownership status, chain affiliation, rural or urban location, and more.
Date: 06/2024
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Miami University, RTI International, University of Massachusetts
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Nurse Staffing Estimates in US Nursing Homes, May 2024
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) April 2024 final rule that established minimum nurse staffing requirements for nursing homes. Analyzes May 2024 data from Nursing Home Care Compare to examine current staffing levels in U.S. nursing homes relative to specific minimum staffing requirements in the final rule. Includes an illustrative example of a 100-bed facility to explore how many nurse staff would need to be added per shift during the final rule's implementation phase to meet or exceed the final rule's minimum requirements. Presents data by facility characteristics, including ownership type, rural or urban location, and bed size.
Author(s): Martin Blanco, Iara Oliveira, Marie Squillace, Damian Da Costa
Date: 06/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) April 2024 final rule that established minimum nurse staffing requirements for nursing homes. Analyzes May 2024 data from Nursing Home Care Compare to examine current staffing levels in U.S. nursing homes relative to specific minimum staffing requirements in the final rule. Includes an illustrative example of a 100-bed facility to explore how many nurse staff would need to be added per shift during the final rule's implementation phase to meet or exceed the final rule's minimum requirements. Presents data by facility characteristics, including ownership type, rural or urban location, and bed size.
Author(s): Martin Blanco, Iara Oliveira, Marie Squillace, Damian Da Costa
Date: 06/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Nursing Home Closures Did Not Increase in 2020 and 2021, Despite Financial Challenges Caused by the COVID-19 Pandemic
Provides an overview of the financial challenges and closures experienced by nursing homes during the COVID-19 pandemic. Analyzes 2011-2021 data from 16,361 nursing homes, with breakdowns according to number of closures, staff shortages, COVID-19 infections, vaccination rates, closures by state and rural versus urban location, and more.
Author(s): Micah Segelman, Kristie A. Porter, Kelly Hughes, et al.
Date: 05/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the financial challenges and closures experienced by nursing homes during the COVID-19 pandemic. Analyzes 2011-2021 data from 16,361 nursing homes, with breakdowns according to number of closures, staff shortages, COVID-19 infections, vaccination rates, closures by state and rural versus urban location, and more.
Author(s): Micah Segelman, Kristie A. Porter, Kelly Hughes, et al.
Date: 05/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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A Closer Look at the Final Nursing Facility Rule and Which Facilities Might Meet New Staffing Requirements
Summarizes new Centers for Medicare & Medicaid Services's (CMS) nurse staffing requirements for nursing facilities outlined in the April 22, 2024, final rule. Analyzes Nursing Home Compare data from April 2024, which reflects nursing home staffing levels from December 2023, to explore the percentage of facilities that meet each of the new nurse staffing requirements. Presents data by nursing ownership status, rural and urban location, special focus facility status, and state.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 05/2024
Sponsoring organization: KFF
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Summarizes new Centers for Medicare & Medicaid Services's (CMS) nurse staffing requirements for nursing facilities outlined in the April 22, 2024, final rule. Analyzes Nursing Home Compare data from April 2024, which reflects nursing home staffing levels from December 2023, to explore the percentage of facilities that meet each of the new nurse staffing requirements. Presents data by nursing ownership status, rural and urban location, special focus facility status, and state.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 05/2024
Sponsoring organization: KFF
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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
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) 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
Sponsoring organization: Centers for Medicare and Medicaid Services
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With Current Staffing Levels, About 1 in 5 Nursing Facilities Would Meet Fully-Implemented Minimum Staffing Standards in the Final Rule
Describes a proposed federal standard for nursing home nurse staffing levels and analyzes current nursing home staffing levels, noting the percentage of facilities that will meet the proposed staffing level requirements when fully implemented.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 04/2024
Sponsoring organization: KFF
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Describes a proposed federal standard for nursing home nurse staffing levels and analyzes current nursing home staffing levels, noting the percentage of facilities that will meet the proposed staffing level requirements when fully implemented.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 04/2024
Sponsoring organization: KFF
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Rural Health Research Recap: Quality Star Ratings: Hospitals, Skilled Nursing Facilities, and Home Health Agencies
Examines the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Rating system among hospitals, skilled nursing facilities, and home health agencies in 2021 and 2022. Features statistics including number of rural hospitals without a star rating with breakdowns by census region, and percentage of hospitals without star rating, with breakdowns by urban or rural location.
Author(s): Per Ostmo
Date: 03/2024
Sponsoring organization: Rural Health Research Gateway
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Examines the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Rating system among hospitals, skilled nursing facilities, and home health agencies in 2021 and 2022. Features statistics including number of rural hospitals without a star rating with breakdowns by census region, and percentage of hospitals without star rating, with breakdowns by urban or rural location.
Author(s): Per Ostmo
Date: 03/2024
Sponsoring organization: Rural Health Research Gateway
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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
Sponsoring organization: Rural Health Research Gateway
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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
Sponsoring organization: Rural Health Research Gateway
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Last Updated: 3/28/2025