Rural Residential Care: The Implications of Federal and State Policy Changes

Research center:
Lead researcher:
Project funded:
September 2012
Project completed:
May 2014
In rural communities, residential services provide an important alternative to institutional services, compensating for the fewer available in-home supports. However, rural residential settings have been found to offer less privacy and to be less likely to support aging in place, suggesting that rural residential settings may be less likely to comply with new and proposed federal policy implementing the "integration mandate" under the Americans with Disabilities Act and the Olmstead v. L.C. decision.

These policies could restrict the provision of Medicaid-funded home care services in residential settings not meeting "integration" criteria with potentially significant consequences for the availability of Medicaid-funded residential services in rural areas and could have the potential for increasing dependence on nursing facility services where in-home options are not available. This study will use the recently released National Survey of Residential Care Facilities (NSRCF) to evaluate rural and urban differences in the characteristics of residential care facilities and their residents and to assess differences in the impact of these policies on urban and rural residential care service options.


  • Profile of Rural Residential Care Facilities: A 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.