Nearly 700 rural hospitals across the country, about one-third of all rural facilities in the U.S., are at risk of closing due to severe financial problems, according to an Oct. 28 Center for Healthcare Quality and Payment Reform analysis.
Of the 698 hospitals at risk, 260 face immediate risk of closure. Rural hospitals are at risk of closing in almost every state, except four: Utah, Delaware, Maryland and New Jersey. More than 25% of rural hospitals are at risk of closure in the majority of states and 50% or more are at risk in 11 states.
The numbers are slightly lower than the July CHQPR analysis, which found 700 hospitals at risk of closure and 264 at risk of immediate closure. They are also down from the think tank’s May report, in which 720 hospitals were at risk of closure with 294 at immediate risk.
Becker’s has reported on just six planned hospital and emergency department closures so far in 2026. At this point in 2025, Becker’s had already reported on 22.
Since 2015, 110 hospitals have closed, the report found. Since 2023, 56 hospitals have ended inpatient services to qualify for grants that are available only to rural emergency hospitals. That number was 53 in July 2026.
More than 40% of rural hospitals are still losing money on delivering patient services, and more than a quarter of rural hospitals lost money overall in 2025. In July, the analysis reported nearly one-third of rural hospitals had lost money in 2024 and 2025.
The center’s report said private insurers are the primary reason rural hospitals are at risk of losing money. About half of the services at an average rural hospital go to patients with private insurance, including employer-sponsored plans and Medicare Advantage. Losses on these patients, not Medicare or Medicaid payments, determines in many cases whether a rural hospital loses money.
Increased payments enough to prevent closures of at-risk hospitals would cost about $4 billion per year, the analysis said. The July report estimated $5 billion.
“Rural hospitals should not be forced to eliminate inpatient care in order to receive higher payments for other services, as is required under the federal ‘Rural Emergency Hospital’ program,” the analysis said. “Federal programs should preserve and expand rural healthcare services, not reduce them.”
The state-by-state breakdown below shows rural hospitals at risk of closing and those at immediate risk, with the percentage of rural hospitals that number represents:
Alabama
24 hospitals at risk of closing (52%)
17 at immediate risk of closing (37%)
Alaska
2 hospitals at risk of closing (12%)
1 at immediate risk of closing (6%)
Arizona
4 hospitals at risk of closing (15%)
0 at immediate risk of closing (0%)
Arkansas
32 hospitals at risk of closing (70%)
8 at immediate risk of closing (17%)
California
16 hospitals at risk of closing (27%)
4 at immediate risk of closing (7%)
Colorado
11 hospitals at risk of closing (26%)
3 at immediate risk of closing (7%)
Connecticut
3 hospitals at risk of closing (75%)
2 at immediate risk of closing (50%)
Delaware
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
Florida
9 hospitals at risk of closing (41%)
3 at immediate risk of closing (14%)
Georgia
22 hospitals at risk of closing (30%)
9 at immediate risk of closing (12%)
Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing (0%)
Idaho
8 hospitals at risk of closing (30%)
2 at immediate risk of closing (7%)
Illinois
15 hospitals at risk of closing (19%)
8 at immediate risk of closing (10%)
Indiana
10 hospitals at risk of closing (18%)
5 at immediate risk of closing (9%)
Iowa
8 hospitals at risk of closing (9%)
2 at immediate risk of closing (2%)
Kansas
58 hospitals at risk of closing (58%)
21 at immediate risk of closing (21%)
Kentucky
13 hospitals at risk of closing (19%)
2 at immediate risk of closing (3%)
Louisiana
24 hospitals at risk of closing (43%)
10 at immediate risk of closing (18%)
Maine
10 hospitals at risk of closing (42%)
2 at immediate risk of closing (8%)
Maryland
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
Massachusetts
1 hospital at risk of closing (14%)
0 at immediate risk of closing (0%)
Michigan
10 hospitals at risk of closing (15%)
3 at immediate risk of closing (5%)
Minnesota
15 hospitals at risk of closing (15%)
3 at immediate risk of closing (3%)
Mississippi
35 hospitals at risk of closing (52%)
24 at immediate risk of closing (36%)
Missouri
29 hospitals at risk of closing (51%)
10 at immediate risk of closing (18%)
Montana
15 hospitals at risk of closing (29%)
3 at immediate risk of closing (6%)
Nebraska
5 hospitals at risk of closing (7%)
0 at immediate risk of closing (0%)
Nevada
4 hospitals at risk of closing (31%)
1 at immediate risk of closing (8%)
New Hampshire
5 hospitals at risk of closing (28%)
1 at immediate risk of closing (6%)
New Jersey
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
New Mexico
7 hospitals at risk of closing (26%)
1 at immediate risk of closing (4%)
New York
22 hospitals at risk of closing (43%)
10 at immediate risk of closing (20%)
North Carolina
9 hospitals at risk of closing (16%)
5 at immediate risk of closing (9%)
North Dakota
13 hospitals at risk of closing (35%)
3 at immediate risk of closing (8%)
Ohio
6 hospitals at risk of closing (8%)
3 at immediate risk of closing (4%)
Oklahoma
44 hospitals at risk of closing (61%)
17 at immediate risk of closing (24%)
Oregon
7 hospitals at risk of closing (21%)
3 at immediate risk of closing (9%)
Pennsylvania
18 hospitals at risk of closing (35%)
9 at immediate risk of closing (17%)
Rhode Island
1 hospital at risk of closing (100%)
0 at immediate risk of closing (0%)
South Carolina
7 hospitals at risk of closing (32%)
2 at immediate risk of closing (9%)
South Dakota
5 hospitals at risk of closing (10%)
3 at immediate risk of closing (6%)
Tennessee
19 hospitals at risk of closing (36%)
12 at immediate risk of closing (23%)
Texas
84 hospitals at risk of closing (55%)
26 at immediate risk of closing (17%)
Utah
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
Vermont
8 hospitals at risk of closing (62%)
0 at immediate risk of closing (0%)
Virginia
6 hospitals at risk of closing (18%)
3 at immediate risk of closing (9%)
Washington
19 hospitals at risk of closing (43%)
6 at immediate risk of closing (14%)
West Virginia
8 hospitals at risk of closing (24%)
4 at immediate risk of closing (12%)
Wisconsin
13 hospitals at risk of closing (16%)
6 at immediate risk of closing (7%)
Wyoming
6 hospitals at risk of closing (22%)
3 at immediate risk of closing (11%)
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