KFF Brief: A Closer Look at Rural Nursing Homes
KFF has released a brief offering "A Closer Look at Rural Nursing Homes." The brief examines the role of nursing homes in rural communities and how rural facilities compare with urban nursing homes across ownership, residents, staffing and deficiencies.
As of July 2025, about 1.2 million people in the U.S. lived in nursing facilities, and roughly one in five nursing home residents lived in a rural facility. The brief explains that rural communities have older populations and higher disability rates, which contribute to greater need for nursing homes and other long-term care services. Rural facilities are also more likely to be government-owned or nonprofit, while urban facilities are more often for-profit.
Between 2015 and 2025, the numbers of both nursing homes and residents declined faster in rural areas than in urban areas, with the steepest drops in remote communities. Rural and urban facilities are otherwise similar in staffing levels, payer mix and rates of serious deficiencies. The brief also notes that Medicaid is the primary payer for nursing home care and that recent federal policy changes could have implications for rural facilities.
Read the brief.
Explore KFF's work on nursing homes in rural areas.
Explore KFF’s data on older adults.
Learn more about KFF.
Learn more about JAHF's co-support of KFF.
