Seven hundred fifty-six rural U.S. hospitals are at risk of closure due to financial problems, with more than 40% of those hospitals at immediate risk of closure.
The counts are drawn from the Center for Healthcare Quality and Payment Reform’s most recent analysis, based on hospitals’ latest cost reports submitted to CMS and verified as current through December 2025. The analysis identifies two distinct tiers of rural hospital vulnerability: those at risk of closure and those facing an immediate risk of closure.
In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with 10 states having 50% or more of their rural hospitals in jeopardy.
The report also analyzes hospitals facing immediate risk of closure, meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 323 rural hospitals — one more than six months ago — are at immediate risk of shutting down due to severe financial difficulties.
Below is a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years.
Alabama
28 hospitals at risk of closing (58%)
23 at immediate risk of closing in next 2-3 years (48%)
Alaska
3 hospitals at risk of closing (19%)
1 at immediate risk of closing in next 2-3 years (6%)
Arizona
4 hospitals at risk of closing (15%)
0 at immediate risk of closing in next 2-3 years (0%)
Arkansas
30 hospitals at risk of closing (64%)
12 at immediate risk of closing in next 2-3 years (26%)
California
18 hospitals at risk of closing (31%)
5 at immediate risk of closing in next 2-3 years (8%)
Colorado
11 hospitals at risk of closing (26%)
2 at immediate risk of closing in next 2-3 years (5%)
Connecticut
3 hospitals at risk of closing (75%)
2 at immediate risk of closing in next 2-3 years (50%)
Delaware
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Florida
8 hospitals at risk of closing (36%)
2 at immediate risk of closing in next 2-3 years (9%)
Georgia
22 hospitals at risk of closing (30%)
11 at immediate risk of closing in next 2-3 years (15%)
Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing in next 2-3 years
Idaho
9 hospitals at risk of closing (33%)
1 at immediate risk of closing in next 2-3 years (4%)
Illinois
17 hospitals at risk of closing (22%)
10 at immediate risk of closing in next 2-3 years (13%)
Indiana
9 hospitals at risk of closing (16%)
8 at immediate risk of closing in next 2-3 years (15%)
Iowa
19 hospitals at risk of closing (20%)
4 at immediate risk of closing in next 2-3 years (4%)
Kansas
68 hospitals at risk of closing (68%)
30 at immediate risk of closing in next 2-3 years (30%)
Kentucky
17 hospitals at risk of closing (25%)
2 at immediate risk of closing in next 2-3 years (3%)
Louisiana
27 hospitals at risk of closing (48%)
9 at immediate risk of closing in next 2-3 years (16%)
Maine
11 hospitals at risk of closing (46%)
5 at immediate risk of closing in next 2-3 years (21%)
Maryland
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Massachusetts
2 hospitals at risk of closing (29%)
1 at immediate risk of closing in next 2-3 years (14%)
Michigan
10 hospitals at risk of closing (15%)
4 at immediate risk of closing in next 2-3 years (6%)
Minnesota
18 hospitals at risk of closing (19%)
7 at immediate risk of closing in next 2-3 years (7%)
Mississippi
36 hospitals at risk of closing (54%)
23 at immediate risk of closing in next 2-3 years (34%)
Missouri
29 hospitals at risk of closing (50%)
12 at immediate risk of closing in next 2-3 years (21%)
Montana
16 hospitals at risk of closing (30%)
4 at immediate risk of closing in next 2-3 years (8%)
Nebraska
7 hospitals at risk of closing (10%)
3 at immediate risk of closing in next 2-3 years (4%)
Nevada
5 hospitals at risk of closing (36%)
1 at immediate risk of closing in next 2-3 years (7%)
New Hampshire
4 hospitals at risk of closing (22%)
3 at immediate risk of closing in next 2-3 years (17%)
New Jersey
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
New Mexico
8 hospitals at risk of closing (30%)
4 at immediate risk of closing in next 2-3 years (15%)
New York
24 hospitals at risk of closing (48%)
15 at immediate risk of closing in next 2-3 years (30%)
North Carolina
10 hospitals at risk of closing (18%)
6 at immediate risk of closing in next 2-3 years (11%)
North Dakota
13 hospitals at risk of closing (34%)
4 at immediate risk of closing in next 2-3 years (11%)
Ohio
7 hospitals at risk of closing (9%)
3 at immediate risk of closing in next 2-3 years (4%)
Oklahoma
48 hospitals at risk of closing (64%)
22 at immediate risk of closing in next 2-3 years (29%)
Oregon
7 hospitals at risk of closing (21%)
3 at immediate risk of closing in next 2-3 years (9%)
Pennsylvania
17 hospitals at risk of closing (33%)
9 at immediate risk of closing in next 2-3 years (17%)
Rhode Island
1 hospital at risk of closing (100%)
1 at immediate risk of closing in next 2-3 years (100%)
South Carolina
7 hospitals at risk of closing (32%)
4 at immediate risk of closing in next 2-3 years (18%)
South Dakota
9 hospitals at risk of closing (19%)
3 at immediate risk of closing in next 2-3 years (6%)
Tennessee
16 hospitals at risk of closing (31%)
14 at immediate risk of closing in next 2-3 years (27%)
Texas
82 hospitals at risk of closing (53%)
21 at immediate risk of closing in next 2-3 years (14%)
Utah
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Virginia
9 hospitals at risk of closing (29%)
6 at immediate risk of closing in next 2-3 years (19%)
Washington
19 hospitals at risk of closing (42%)
7 at immediate risk of closing in next 2-3 years (16%)
West Virginia
15 hospitals at risk of closing (44%)
6 at immediate risk of closing in next 2-3 years (18%)
Wisconsin
10 hospitals at risk of closing (12%)
5 at immediate risk of closing in next 2-3 years (6%)
Wyoming
7 hospitals at risk of closing (26%)
4 at immediate risk of closing in next 2-3 years (15%)
