Nearly 800 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 count is 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 June 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, 314 rural hospitals 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 (60%)
23 at immediate risk of closing in next 2-3 years (45%)
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%)
2 at immediate risk of closing in next 2-3 years (7%)
Arkansas
30 hospitals at risk of closing (64%)
11 at immediate risk of closing in next 2-3 years (23%)
California
22 hospitals at risk of closing (38%)
4 at immediate risk of closing in next 2-3 years (7%)
Colorado
11 hospitals at risk of closing (26%)
3 at immediate risk of closing in next 2-3 years (7%)
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
10 hospitals at risk of closing (45%)
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
8 hospitals at risk of closing (29%)
1 at immediate risk of closing in next 2-3 years (4%)
Illinois
17 hospitals at risk of closing (22%)
9 at immediate risk of closing in next 2-3 years (11%)
Indiana
5 hospitals at risk of closing (9%)
5 at immediate risk of closing in next 2-3 years (9%)
Iowa
20 hospitals at risk of closing (22%)
2 at immediate risk of closing in next 2-3 years (2%)
Kansas
66 hospitals at risk of closing (66%)
29 at immediate risk of closing in next 2-3 years (29%)
Kentucky
16 hospitals at risk of closing (22%)
4 at immediate risk of closing in next 2-3 years (6%)
Louisiana
25 hospitals at risk of closing (45%)
7 at immediate risk of closing in next 2-3 years (12%)
Maine
12 hospitals at risk of closing (50%)
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
13 hospitals at risk of closing (20%)
5 at immediate risk of closing in next 2-3 years (8%)
Minnesota
20 hospitals at risk of closing (21%)
9 at immediate risk of closing in next 2-3 years (9%)
Mississippi
36 hospitals at risk of closing (54%)
20 at immediate risk of closing in next 2-3 years (30%)
Missouri
25 hospitals at risk of closing (43%)
10 at immediate risk of closing in next 2-3 years (17%)
Montana
18 hospitals at risk of closing (33%)
5 at immediate risk of closing in next 2-3 years (9%)
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
9 hospitals at risk of closing (33%)
4 at immediate risk of closing in next 2-3 years (15%)
New York
29 hospitals at risk of closing (58%)
18 at immediate risk of closing in next 2-3 years (36%)
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 (33%)
4 at immediate risk of closing in next 2-3 years (10%)
Ohio
5 hospitals at risk of closing (7%)
3 at immediate risk of closing in next 2-3 years (4%)
Oklahoma
47 hospitals at risk of closing (60%)
23 at immediate risk of closing in next 2-3 years (29%)
Oregon
8 hospitals at risk of closing (24%)
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%)
3 at immediate risk of closing in next 2-3 years (12%)
South Dakota
9 hospitals at risk of closing (18%)
3 at immediate risk of closing in next 2-3 years (6%)
Tennessee
17 hospitals at risk of closing (33%)
13 at immediate risk of closing in next 2-3 years (25%)
Texas
87 hospitals at risk of closing (56%)
22 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
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%)
7 at immediate risk of closing in next 2-3 years (23%)
Washington
18 hospitals at risk of closing (40%)
6 at immediate risk of closing in next 2-3 years (13%)
West Virginia
13 hospitals at risk of closing (39%)
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%)
