SYRACUSE, Neb. — Many rural communities like this one face a health care dilemma: Is it better to have a nursing home that struggles to hire workers or no nursing home at all? The national debate over that question will heat up now that federal regulators have proposed to improve care by setting minimum staffing levels for all U.S. nursing homes. Rural nursing homes would have five years to comply with some of the rules, versus three for their urban counterparts. Facilities also could apply for “hardship exemptions.” But industry leaders predict the rules could accelerate a wave of closures that has already claimed hundreds of rural nursing homes. Some families that rely
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