Rural Health
Research Gateway

Long-term care

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2024

2023

  • Availability of Dialysis Facilities in Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2023
    This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. The brief looks at the availability of dialysis providers in minoritized racial/ethnic areas.
  • Availability of Primary Care Safety Net Providers in Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2023
    This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the distance to the nearest primary care safety net provider.
  • Multi-Sector Collaboration to Support Rural Aging
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    In this paper, researchers examine the lessons rural areas present for supporting aging, including the role that aging and social services, public health systems, and health care have to play.
  • Distribution of Direct Care Workforce COVID-19 Funding Between Rural and Urban Counties in Minnesota and Illinois
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2023
    The purpose of this policy brief is to examine trends in the distribution of federal Coronavirus Aid, Relief, and Economic Securities Act of 2020 (CARES Act) funding designed to support the direct care workforce between rural and urban counties in Minnesota and Illinois.
  • Access to Health Services Across Rural and Urban Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 03/2023
    This brief summarizes selected results from a series of reports documenting disparities in geographic access to health services for rural and urban places that have a relatively high proportion of residents from minoritized racial and ethnic groups. "Areas" were examined at the ZIP Code Tabulation Area level.
  • Who Will Care for Rural Older Adults? Measuring the Direct Care Workforce in Rural Areas (journal article)
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 02/2023
    In this manuscript, the research team used data from the 2021 Occupational Employment and Wage Statistics dataset to calculate the ratio of direct care workers relative to the population of older adults (ages 65+) across rural and urban areas in the US.

2022

  • Who Will Care for Rural Older Adults? Measuring the Direct Care Workforce in Rural Areas (policy brief)
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2022
    The policy brief examines disparities in the supply of home health aides and nursing assistants in rural areas compared to urban areas. Researchers estimate the ratio of home health aides and nursing assistants relative to the population of adults (age 65+) across rural and urban areas in the U.S.
  • Availability of Nursing Homes in Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 09/2022
    This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of nursing homes at the ZCTA level.
  • Availability of Home Health Services in Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2022
    This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of home health services in minoritized racial/ethnic areas.
  • Availability of Pharmacies in Minoritized Racial/Ethnic Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2022
    This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at access to pharmacies.
  • Spatial Access to Hospital-based Obstetric Units in Minoritized Racial/Ethnic Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2022
    This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial access to hospital-based obstetric units in minoritized racial/ethnic areas.
  • Nursing Homes in Rural America: A Chartbook
    Chartbook
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2022
    Closure of nursing homes and hospitals with swing beds in recent years has changed the availability of post-acute and long-term care services in rural areas. This study examines the availability of post-acute and long-term care services as well as characteristics of residents and nursing homes in noncore, micropolitan, and metropolitan counties.
  • Approaches to Serving Rural Older Adults in State Plans on Aging: A Policy Content Evaluation
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2022
    In this article, we share a policy content evaluation of State Plans on Aging from all 50 U.S. states, focusing on how the states will serve older adults and including common and innovative approaches to doing so.
  • Contact by Collection Agencies for Medical Debt: Rural-Urban Differences Among Older and Younger Medicare Beneficiaries
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 02/2022
    This study uses data from the 2016 Medicare Current Beneficiary Survey (n = 12,688 U.S. community-dwelling beneficiaries) to understand the impact of medical debt for rural residents. The study analyzed rural-urban differences in rates of collection agency contact for unpaid medical bills.
  • The Problem of the Color Line: Place, Race, and Access to Health Care in America
    Journal Article
    Rural and Minority Health Research Center
    Date: 02/2022
    Using ZIP Code Tabulation Area boundaries and associated rural-urban commuting area codes, urban and rural places with the largest share of minoritized racial and ethnic groups were identified. A StoryMap was then created to illustrate disparities experienced based on where Indigenous populations and people of color reside spatially.

2021

2020

  • Acuity Differences Among Newly Admitted Older Residents in Rural and Urban Nursing Homes
    Journal Article
    Maine Rural Health Research Center
    Date: 11/2020
    This study found newly admitted residents of rural nursing homes were more likely to have cognitive issues/problem behaviors than those in urban facilities. Yet rural facilities admitted less complex older (age 75+) residents than urban, raising questions about the rural long-term services and supports system and capacity of rural nursing homes.
  • Long-Term Care Planning, Preparedness, and Response Among Rural Long-Term Care Providers
    Journal Article
    Southwest Rural Health Research Center
    Date: 09/2020
    This manuscript explores how rural long-term care providers plan, prepare, and respond to slowly or rapidly unfolding disasters (i.e., hurricanes, wildfires, and environmental spills) in three U.S. geographic areas. Data includes secondary sources and semi-constructed interviews with long-term care facilities and disaster management organizations.

2019

  • Long-Term Services and Supports Use Among Older Medicare Beneficiaries in Rural and Urban Areas
    Journal Article
    Maine Rural Health Research Center
    Date: 01/2019
    Analyzing the Medicare Current Beneficiary Survey, authors from the Maine Rural Health Research Center found that compared to their urban counterparts, rural Medicare beneficiaries had higher odds of nursing home use after controlling for beneficiary characteristics and contextual factors including nursing home bed supply.

2018

2017

  • 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.
  • Rural Long-Term Services and Supports: A Primer
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 11/2017
    This paper provides policymakers and other interested stakeholders a primer on the fundamentals of the rural LTSS system, rural access to and use of LTSS, and the opportunities and limitations of current federal and state LTSS policy for advancing rural health system transformation toward a high-performing rural health delivery system.
  • The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2017
    This brief describes Medicare post-acute and hospice care provided by hospitals in rural areas by characterizing the variation in the number of rural hospitals that provide PAC and hospice care, the average amount of Medicare revenue rural hospitals receive for these services, and the financial importance of PAC and hospice care to rural hospitals.
  • 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.

2016

2015

  • Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2015
    This study's purpose was to examine the relationship between nurse staffing levels and care quality in rural nursing homes and to assess potential differences between hospital-based and freestanding rural nursing homes.

2014

  • Profile of Rural Residential Care Facilities: A Chartbook
    Chartbook
    Maine Rural Health Research Center
    Date: 05/2014
    This chartbook offers information on part of the rural long-term services and supports (LTSS) continuum—the residential care facility (RCF). Survey results identify national/regional differences between rural and urban RCFs, focusing on facilities, resident and service characteristics of RCFs, and the ability to meet the LTSS needs of residents.

2013

2010

2006

2005

2004

  • Rurality and Nursing Home Quality: Results From a National Sample of Nursing Home Admissions
    Journal Article
    Southwest Rural Health Research Center
    Date: 10/2004
    There are higher percentages of elderly population in and the utilization rates of nursing homes are higher in rural areas. Overall, problems in rural nursing homes are at a much higher risk for poor outcomes, but it is most apparent in extremely isolated rural areas.
  • Nursing Homes in Rural And Urban Areas, 2001
    Southwest Rural Health Research Center
    Date: 06/2004
    This chartbook provides descriptive data on the entire population of longer-stay nursing home residents in the country in 2001 and categorizes them according to the rurality of the nursing homes in which they receive care in an effort to address questions related to residents' characteristics and quality of care.are.
  • Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2004
    This study examines the behavioral and financial impacts of the initial 10-DRG policy and projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
  • Assisted Living: Is It an Option for Rural Areas?
    Southwest Rural Health Research Center
    Date: 05/2004
    The key findings of a national survey on assisted living are highlighted, including supply, services, and affordability of assisted living facilities in rural areas.
  • Expanding Residential Care and Assisted Living in Rural America
    Southwest Rural Health Research Center
    Date: 05/2004
    There is an undersupply of assisted living facilities in rural areas. This policy brief provides options for state policy makers and advocates to consider in expanding the availability and nature of assisted living and other types of housing with supportive services in rural areas.
  • Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 3
    Southwest Rural Health Research Center
    Date: 04/2004
    This report includes the overview of research and accompanying models for practice on five new focus areas in Rural Healthy People 2010, along with the more detailed literature reviews for each.
  • Rural-Urban Issues in the Wage Index Adjustment for Prospective Payment in Skilled Nursing Facilities (Brief Report)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2004
    Hourly wage data from Medicare-participating nursing homes were used to examine urban/rural patterns in average hourly nursing home wages and wage variation within the statewide rural labor markets defined by CMS. The data were also used to examine the adequacy of the hospital wage index as an adjuster for skilled nursing facility rates.

2003

2001

2000