Rural Health Research Gateway

Quality Differences between Rural and Non-Rural Nursing Homes

Funder: Office of Rural Health Policy (ORHP)
Research center: Southwest Rural Health Research Center
Phone: 979.458.0653
Lead researcher: Charles D. Phillips, PhD , 979.458.0080, phillipscd@srph.tamushsc.edu
Project completed:October 2002
Topics: Long term care
Quality

The quality of care in nursing homes has been a widespread concern for some years in the U.S., and recent reports by the General Accounting Office and hearings by the Senate Special Committee on Aging have heightened those concerns. However, little is known about whether there are differences in quality between facilities in rural and non-rural areas. This study has four specific aims: - To determine whether there are significant differences between the nursing home populations in rural and non-rural areas in terms of their characteristics and care needs; - To focus on whether there are significant differences between rural and non-rural nursing homes in their characteristics and in the services that they provide; - To determine whether the quality of care provided to residents in rural settings differs significantly from that provided in non-rural nursing homes; and - To develop a database for use in subsequent epidemiological and health services research, as well as shorter turnaround policy analyses. The quality indicators that will be used in the study include measures of process and outcome. They were developed as part of the HCFA Case-Mix and Quality Demonstration and are now being used in the survey process through which states evaluate the quality of care in nursing facilities. The proposed research will provide important information about rural nursing facilities and rural nursing facility residents to policy-makers, researchers, and consumer advocates.

Publications

  • Nursing Homes in Rural and Urban Areas, 2000
    Author(s): Charles D. Phillips, Catherine Hawes, Malgorzata Leyk Williams
    Date: 02 / 2003
    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.