Abstract
As the number of medically underserved people continues to swell, core safety net providers, such as nursing centers, are finding it increasingly difficult to provide quality care and remain financially viable. The purpose of this article is to highlight the successful implementation of a quality improvement plan at one rural nursing center. Outcome measurement has been conducted since 1994 in several areas, including client, nursing, and student satisfaction, as well as a variety of measures to evaluate access to health care and its effectiveness in improving client health. The need for nursing centers to measure and publish quality outcome data is discussed, including recommendations for national health policy initiatives to support nursing centers as one of the few options remaining for the underserved in our nation.