Changes in Staffing, Resident Health, Closure, and Financial Performance of Rural Nursing Homes From 2017 to 2022
Link
Date
05/2026
Description
This policy brief summarizes staffing, resident health, mortality, closures, and financial performance of nursing homes in small or isolated rural towns, micropolitan, and metropolitan areas between 2017 to 2022.
Key Findings:
- From 2017 to 2022, average staffing hours per resident-day in nursing homes decreased for certified nursing assistants and licensed practical nurses but increased for registered nurses across small or isolated rural towns, micropolitan, and metropolitan areas.
- A higher percentage of nursing home residents in small or isolated rural towns have depression and psychiatric needs in 2019 and 2022, compared to micropolitan and metropolitan areas.
- A lower percentage of nursing home residents have activities of daily living (ADL) limitations in 2019 and 2022 in small or isolated rural towns compared to metropolitan areas.
- Between 2017 and 2022, nursing home closures were more common in small or isolated rural towns (10.3 percent) than in micropolitan (7.9 percent) or metropolitan (8.5 percent) areas.
- Average nursing home occupancy rates dropped significantly from 2017 to 2021, particularly in small or isolated rural towns; occupancy increased slightly in 2022.
- Since 2020, total profit margins, and especially profit margins from patient care services, have declined substantially across small or isolated rural towns, micropolitan, and metropolitan areas.
Center
RUPRI Center for Rural Health Policy Analysis
Authors
Gulrukh Mehboob, Hari Sharma, Fred Ullrich, Keith Mueller