Zachariah T. Croll, MPH

Maine Rural Health Research Center

Phone: 207.228.8247
Fax: 207.228.8138

University of Southern Maine
PO Box 9300
34 Bedford Street
Portland, ME 04104-9300

Publications - (17)



  • Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
    Maine Rural Health Research Center
    Date: 05/2023
    Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.
  • Rural-Urban Differences in Workers' Access to Paid Sick Leave
    Journal Article
    Maine Rural Health Research Center
    Date: 02/2023
    The authors analyzed the prevalence of paid sick leave (PSL) among rural versus urban workers and found that rural workers had lower access to PSL than urban workers, even after adjusting for worker and employment characteristics, especially those who were Hispanic, lacked employer-sponsored insurance, and reported poorer health status.



  • 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.


  • Rural Health Clinic Costs and Medicare Reimbursement
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2019
    We used cost report data to examine Rural Health Clinic (RHC) services costs. The findings support the National Advisory Committee on Rural Health & Human Service's conclusion that the cost-based methodology used to determine Medicare reimbursement for RHCs is outdated and RHCs subject to the reimbursement cap are paid less than their costs.





  • 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.
  • Meaningful Use of the Electronic Health Records by Rural Health Clinics
    Maine Rural Health Research Center
    Date: 02/2014
    This paper identifies the rates of electronic health record adoption among a random national sample of rural health clinics (RHCs) and the extent to which RHCs that have adopted an EHR are likely to achieve Stage 1 meaningful use.


  • Telemental Health in Today's Rural Health System
    Maine Rural Health Research Center
    Date: 12/2013
    This policy brief describes the organizational setting, services provided, and staff used in 53 telemental rural health programs. It also outlines the opportunities and challenges for telemental health in the rural health system.