Beyond Clinical Complexity: Nonmedical Barriers to Nursing Home Care for Rural Residents

ABSTRACT

We conducted a qualitative content analysis of barriers to nursing home admission for rural residents. Data came from semi-structured interviews with 23 rural hospital discharge planners across five states (Georgia, Idaho, Minnesota, Pennsylvania, and Wisconsin). From those, we identified four themes around nonmedical barriers to rural nursing home placement with particular salience in rural areas: financial issues, transportation, nursing home availability and infrastructure, and timeliness. We also identified policy and programmatic interventions across four themes: loosen bureaucratic requirements, improve communication between facilities, increase rural long-term care capacity, and address underlying social determinants of health.

KEYWORDS:

• Rural
• nursing home care
• discharge planning
• access to care

Acknowledgements

We would like to thank the 23 discharge planners who took the time to talk with us and share their experiences and ideas.

Disclosures

The authors have no conflicts of interest to disclose.

Additional information

Funding

This study was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS) under PHS Grant No. 5U1CRH03717. The information, conclusions, and opinions expressed in this article are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.