This article uses long-term care data from one state (Virginia) to examine four hypotheses: (a) Rural counties are more likely than urban counties to have no nursing facility, (b) counties without a nursing facility will have lower nursing home utilization rates than counties having a nursing facility, (c) individuals admitted to nursing facilities who originate in counties with no facility will tend to experience moves of greater distance than their counterparts originating in counties having a facility, and (d) those admitted to nursing facilities originating in counties with no facility will tend to move to more urban settings. These hypotheses were supported by the analysis. The findings suggest that access to nursing home care may be more limited for individuals who live in counties without nursing facilities. Long-term care policy makers should give careful consideration to access in their methods for determining need for nursing home care and long-term care services in rural areas.
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