Seven-hundred and fifty-nine rural U.S. hospitals are at risk of closure due to financial problems, with about 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 August 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 11 states having a majority of their rural hospitals in jeopardy.
The report also analyzes hospitals facing immediate threat of closure, meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 322 rural hospitals — eight more than just two 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
29 hospitals at risk of closing (60%)
23 at immediate risk of closing in next 2-3 years (48%)
Alaska
3 hospitals at risk of closing (18%)
1 at immediate risk of closing in next 2-3 years (6%)
Arizona
4 hospitals at risk of closing (14%)
0 at immediate risk of closing in next 2-3 years (0%)
Arkansas
31 hospitals at risk of closing (66%)
12 at immediate risk of closing in next 2-3 years (26%)
California
20 hospitals at risk of closing (34%)
6 at immediate risk of closing in next 2-3 years (10%)
Colorado
12 hospitals at risk of closing (28%)
1 at immediate risk of closing in next 2-3 years (2%)
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
9 hospitals at risk of closing (41%)
2 at immediate risk of closing in next 2-3 years (9%)
Georgia
20 hospitals at risk of closing (28%)
9 at immediate risk of closing in next 2-3 years (13%)
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 (32%)
1 at immediate risk of closing in next 2-3 years (4%)
Illinois
16 hospitals at risk of closing (20%)
9 at immediate risk of closing in next 2-3 years (11%)
Indiana
9 hospitals at risk of closing (16%)
8 at immediate risk of closing in next 2-3 years (15%)
Iowa
18 hospitals at risk of closing (19%)
3 at immediate risk of closing in next 2-3 years (3%)
Kansas
67 hospitals at risk of closing (67%)
30 at immediate risk of closing in next 2-3 years (30%)
Kentucky
18 hospitals at risk of closing (25%)
4 at immediate risk of closing in next 2-3 years (6%)
Louisiana
26 hospitals at risk of closing (46%)
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 (33%)
1 at immediate risk of closing in next 2-3 years (17%)
Michigan
11 hospitals at risk of closing (17%)
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
37 hospitals at risk of closing (55%)
23 at immediate risk of closing in next 2-3 years (34%)
Missouri
27 hospitals at risk of closing (47%)
12 at immediate risk of closing in next 2-3 years (21%)
Montana
19 hospitals at risk of closing (35%)
6 at immediate risk of closing in next 2-3 years (11%)
Nebraska
6 hospitals at risk of closing (8%)
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 (24%)
2 at immediate risk of closing in next 2-3 years (12%)
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
25 hospitals at risk of closing (51%)
16 at immediate risk of closing in next 2-3 years (33%)
North Carolina
10 hospitals at risk of closing (18%)
6 at immediate risk of closing in next 2-3 years (11%)
North Dakota
14 hospitals at risk of closing (36%)
4 at immediate risk of closing in next 2-3 years (10%)
Ohio
7 hospitals at risk of closing (10%)
3 at immediate risk of closing in next 2-3 years (4%)
Oklahoma
47 hospitals at risk of closing (61%)
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 (34%)
9 at immediate risk of closing in next 2-3 years (18%)
Rhode Island
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
South Carolina
7 hospitals at risk of closing (29%)
4 at immediate risk of closing in next 2-3 years (17%)
South Dakota
10 hospitals at risk of closing (20%)
4 at immediate risk of closing in next 2-3 years (8%)
Tennessee
16 hospitals at risk of closing (31%)
14 at immediate risk of closing in next 2-3 years (27%)
Texas
84 hospitals at risk of closing (54%)
21 at immediate risk of closing in next 2-3 years (13%)
Utah
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Vermont
8 hospitals at risk of closing (62%)
1 at immediate risk of closing in next 2-3 years (8%)
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
12 hospitals at risk of closing (36%)
5 at immediate risk of closing in next 2-3 years (15%)
Wisconsin
10 hospitals at risk of closing (13%)
5 at immediate risk of closing in next 2-3 years (6%)
Wyoming
7 hospitals at risk of closing (27%)
4 at immediate risk of closing in next 2-3 years (15%)
