This report focuses on two basic dimensions of nursing homes; Federally-certified nursing homes and the residents in those homes, and homes operating in settings that differ in their degree of rurality and their geographic location.

The study found that there are higher percentages of elderly population in rural areas, and also that the utilization rates of nursing homes is higher in rural areas. Homes in rural areas are more likely to have fewer beds than urban homes and are also more likely to be government-funded and owned than urban nursing homes. Rural nursing homes are more likely to be below the nursing staff and aides' threshold than homes in urban areas. Overall, these problems put rural nursing homes at higher risk for poor outcomes in nursing homes, but it is most apparent in extremely isolated rural areas.