Provision of Long Term Care Services by CAHs: Are Things Changing? (Policy Brief #19)


This policy brief uses data from the 2004 and 2008 American Hospital Association’s Annual Survey of Hospitals to assess whether and how the provision of Long-Term Care (LTC) services by CAHs has changed and how CAH involvement with LTC services compares with other rural and urban hospitals. We also examine the characteristics of hospitals providing those services and discuss the implications of recent trends for rural health care.

Key Findings

  • CAHs play an important role in the provision of LTC services in rural communities.
  • CAHs are more likely than other rural and urban hospitals to provide “core” LTC including skilled and intermediate care nursing services.
  • CAHs offering these “core” LTC services are also more likely than other hospitals to offer a wider array of LTC services such as home health, residential care, and other social support services.
  • CAHs showed a somewhat greater decline in the provision of LTC services over the study period than other hospitals, suggesting that changes in LTC reimbursement policies could affect LTC access in rural communities.


Community Impact Health Care Services Hospital Services Nursing Facilities