With the aging of the U.S. population, the number of adults with complex care needs is rising, particularly in rural areas. Despite this, nursing homes often lack the staffing, funding, and infrastructure to adequately care for them. As a result, access to appropriate, timely long-term care in skilled nursing facilities may be constrained for rural residents who need it most. This project will examine barriers to skilled nursing facility placement for rural residents with complex care needs, including obesity, dementia, and behavioral health problems, and explore potential implications for access to and quality of care.

Publications

• Barriers to Nursing Home Care for Nonelderly Rural Residents
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 12/2017
  This study uses data from 23 semi-structured interviews with rural hospital discharge planners in five states to identify specific barriers to finding nursing home care for nonelderly rural residents. We found three primary themes—payment status, fit, and medical complexity—as well as two minor themes—caregivers and bureaucratic processes.
• Beyond Clinical Complexity: Nonmedical Barriers to Nursing Home Care for Rural Residents
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 02/2018
  Using data from interviews with rural hospital discharge planners, we identified four themes around nonmedical barriers to rural nursing home placement with particular salience in rural areas: financial issues, transportation, nursing home availability and infrastructure, and timeliness. We also identified policy and programmatic interventions.
• Challenges to Admitting Residents: Perspectives From Rural Nursing Home Administrators and Staff
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 03/2021
  This study uses a survey of rural nursing home administrators (n=209) to assess perceptions of difficulty rural nursing homes encounter in admitting and serving individuals with dementia, obesity, mental and behavioral health conditions, and medically complex conditions.
• Medical Barriers to Nursing Home Care for Rural Residents
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2017
  This policy brief describes barriers rural residents with complex medical care needs may face when seeking placement in a nursing home and identifies potential policy strategies to overcome them.