25 states at most risk of rural hospital closures

Rural hospital closures picked up in 2023 and nearly 700 rural hospitals face continued risk of closing due to serious financial challenges, with some states facing critical conditions in the short term. 

The finding comes from the Center for Healthcare Quality and Payment Reform's latest report, "Rural Hospitals at Risk of Closing." Eight rural hospitals closed in 2023, as many as in 2022 and 2021 combined, according to the report. This followed a landmark 18 rural hospital closures in 2020, more than any year in the previous decade.

Based on the latest hospital financial information released by CMS in April 2024, CHQPR analyzes rural hospitals' financial vulnerability in two ways: risk of closure and immediate risk of closure. 

For the first category, there are hospitals at risk of closure in nearly every state. This is partly measured by financial reserve limitations that cannot offset hospital losses on patient services for more than six to seven years. In more than half of states, 25% or more of the rural hospitals are at risk of closing; in eight states, the majority of rural hospitals are at risk.

Immediate risk of closure is partly measured by tougher financial reserve limitations: those that could offset hospital losses on patient services two to three years at most. Over 300 rural hospitals are at immediate risk of closing because of the severity of their financial problems, with nearly half of rural hospitals in New York and Alabama facing such an outlook. 

Given that immediate risk of closure is the more urgent of the two categories, Becker's has ranked 25 states by the percentage of their rural hospitals at risk of closure in the next two to three years maximum. The listing for each state also contains broader information about the number of hospitals at risk of closure over the next six to seven years. The report from CHQPR assessing each state's rural hospital health and risks can be found in full here.

New York 
45% of rural hospitals — 23 — are at immediate risk of closure in the next 2-3 years 
57% of rural hospitals — 29 — are at risk of closure in the next 6-7 years 

Alabama 
44% of rural hospitals — 23 — are at immediate risk of closure in the next 2-3 years 
58% of rural hospitals — 30 — are at risk of closure in the next 6-7 years 

Mississippi
34% of rural hospitals — 25 — are at immediate risk of closure in the next 2-3 years 
52% of rural hospitals — 38 — are at risk of closure in the next 6-7 years 

Connecticut
33% of rural hospitals — 1 — are at immediate risk of closure in the next 2-3 years 
67% of rural hospitals — 2 — are at risk of closure in the next 6-7 years 

Tennessee
31% of rural hospitals — 17 — are at immediate risk of closure in the next 2-3 years 
35% of rural hospitals — 19 — are at risk of closure in the next 6-7 years 

Vermont
31% of rural hospitals — 4 — are at immediate risk of closure in the next 2-3 years 
62% of rural hospitals — 8 — are at risk of closure in the next 6-7 years 

Oklahoma
29% of rural hospitals — 23 — are at immediate risk of closure in the next 2-3 years 
43% of rural hospitals — 34 — are at risk of closure in the next 6-7 years

Arkansas
29% of rural hospitals — 14 — are at immediate risk of closure in the next 2-3 years 
53% of rural hospitals — 26 — are at risk of closure in the next 6-7 years

Maine 
28% of rural hospitals — 7 — are at immediate risk of closure in the next 2-3 years 
44% of rural hospitals — 11 — are at risk of closure in the next 6-7 years

Virginia
27% of rural hospitals — 8 — are at immediate risk of closure in the next 2-3 years 
30% of rural hospitals — 9 — are at risk of closure in the next 6-7 years

Kansas
26% of rural hospitals — 26 — are at immediate risk of closure in the next 2-3 years 
56% of rural hospitals — 57 — are at risk of closure in the next 6-7 years

Florida
24% of rural hospitals — 5 — are at immediate risk of closure in the next 2-3 years 
38% of rural hospitals — 8 — are at risk of closure in the next 6-7 years

Nevada
23% of rural hospitals — 3 — are at immediate risk of closure in the next 2-3 years 
38% of rural hospitals — 5 — are at risk of closure in the next 6-7 years

New Mexico
21% of rural hospitals — 6 — are at immediate risk of closure in the next 2-3 years 
25% of rural hospitals — 7 — are at risk of closure in the next 6-7 years

West Virginia
21% of rural hospitals — 6 — are at immediate risk of closure in the next 2-3 years 
36% of rural hospitals — 10 — are at risk of closure in the next 6-7 years

South Carolina
20% of rural hospitals — 5 — are at immediate risk of closure in the next 2-3 years 
40% of rural hospitals — 10 — are at risk of closure in the next 6-7 years

Massachusetts
20% of rural hospitals — 1 — are at immediate risk of closure in the next 2-3 years 
40% of rural hospitals — 2 — are at risk of closure in the next 6-7 years

Texas
18% of rural hospitals — 29 — are at immediate risk of closure in the next 2-3 years 
48% of rural hospitals — 77 — are at risk of closure in the next 6-7 years

California
18% of rural hospitals — 10 — are at immediate risk of closure in the next 2-3 years 
32% of rural hospitals — 18 — are at risk of closure in the next 6-7 years

Louisiana
17% of rural hospitals — 9 — are at immediate risk of closure in the next 2-3 years 
44% of rural hospitals — 23 — are at risk of closure in the next 6-7 years

Pennsylvania
17% of rural hospitals — 7 — are at immediate risk of closure in the next 2-3 years 
32% of rural hospitals — 13 — are at risk of closure in the next 6-7 years

Missouri
16% of rural hospitals — 9 — are at immediate risk of closure in the next 2-3 years 
38% of rural hospitals — 21 — are at risk of closure in the next 6-7 years

Georgia
15% of rural hospitals — 10 — are at immediate risk of closure in the next 2-3 years 
32% of rural hospitals — 22 — are at risk of closure in the next 6-7 years

Colorado
12% of rural hospitals — 5 — are at immediate risk of closure in the next 2-3 years 
21% of rural hospitals — 9 — are at risk of closure in the next 6-7 years

Alaska
12% of rural hospitals — 2 — are at immediate risk of closure in the next 2-3 years 
18% of rural hospitals — 3 — are at risk of closure in the next 6-7 years

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars