Archives of Internal Medicine: Geographic Concentration And Correlates of Nursing Home Closures: 1999-2008 - During that 10-year span "2,902 nursing homes closed, or nearly 16% of all Medicare/Medicaid-certified facilities. The cumulative closure rate was substantially higher in hospital-based facilities than in freestanding ones (50% vs 11%). Urban hospital-based facilities had the highest cumulative closure rate (60%). The closure rate among freestanding facilities was roughly the same in urban (11%) and rural (10%) areas." Additionally, the authors note, "The relative risk of closure was significantly higher in zip code areas with a higher proportion of blacks or Hispanics or a higher poverty rate. Closures tended to be spatially clustered in minority-concentrated zip codes around the urban core, often in pockets of concentrated poverty. ... Since nursing home use among the minority elderly population is growing while it is declining among whites, these findings suggest that disparities in access will increase" (Feng et al., 1/10).