Abstract: In the shared context of rural revitalization and urbanization development, the mobility of population and industry has intensified, exhibiting dynamic changes and introducing uncertainty in the allocation of public services in villages. This phenomenon is more pronounced in mountainous villages, particularly in the countylevel coordination of public services in mountainous regions, which has created a new polarity between county towns and village groups. The National Rural Construction Evaluation has revealed that the current coverage, utilization rate, and satisfaction of rural elderly care services are low, and development is uneven across different regions. Enhancing the level and scope of public services through reasonable investments is a common issue in current research on rural public service development. Taking Shizhu County, a typical sample county in Chongqing Municipality, as an example, this paper analyzes the current situation and problems in the configuration and utilization of elderly care facilities in mountainous villages, points out the developmental contradiction of a mismatch between supply and demand, proposes a hierarchical and zoned configuration strategy for mountainous villages, and clarifies the pathway and methodology for centralizing elderly care homes at the county level and decentralizing service stations to villages and groups. The aim is to provide a reference for the allocation of public services in the context of phased development and high mobility.