Rural hospitals drove the entirety of the U.S.’ net hospital losses since 2001, closing at more than three times the rate they opened, according to data shared with Becker’s from Yale University’s Health Care Affordability Lab in New Haven, Conn.
Between 2001 and 2023, the period for which both openings and closures are fully tracked, rural hospitals posted a net loss of 234 nationally — 348 closures against 114 openings. Urban hospitals over the same period saw a net gain of 92. The data covers general, short-term acute-care hospitals and excludes specialty facilities such as psychiatric, rehabilitation, children’s and VA hospitals. Rural and urban classifications follow the census-tract-level definition from the Health Resources & Services Administration’s Federal Office of Rural Health Policy.
The table below shows rural hospital net change by state from 2001 to 2023, total rural closures by state from 2000 through June 2026, and each state’s fiscal 2026 allocation under the $50 billion Rural Health Transformation Program, established under HR 1 and administered by CMS. RHTP award amounts are sourced from CMS. States with no rural hospital activity in the Yale dataset are not listed. (Note: The lab did not systematically track openings from 2024 forward; net figures are drawn from the 2001-2023 dataset only.)
Here is the rural hospital net change, total closures through June 2026, and RHTP funding, by state, according to data from the Affordability Lab and CMS:
Alabama: 4 openings, 10 closures, net -6 (2001-2023) | Total closures 2000-June 2026: 15 | RHTP FY2026 award: $203 million
Alaska: 0 openings, 1 closure, net -1 (2001-2023) | Total closures 2000-June 2026: 1 | RHTP FY2026 award: $272 million
Arizona: 4 openings, 4 closures, net 0 (2001-2023) | Total closures 2000-June 2026: 4 | RHTP FY2026 award: $167 million
Arkansas: 1 opening, 8 closures, net -7 (2001-2023) | Total closures 2000-June 2026: 10 | RHTP FY2026 award: $209 million
California: 0 openings, 12 closures, net -12 (2001-2023) | Total closures 2000-June 2026: 13 | RHTP FY2026 award: $234 million
Colorado: 4 openings, 1 closure, net +3 (2001-2023) | Total closures 2000-June 2026: 2 | RHTP FY2026 award: $200 million
Florida: 2 openings, 8 closures, net -6 (2001-2023) | Total closures 2000-June 2026: 8 | RHTP FY2026 award: $210 million
Georgia: 3 openings, 15 closures, net -12 (2001-2023) | Total closures 2000-June 2026: 15 | RHTP FY2026 award: $219 million
Hawaii: 1 opening, 0 closures, net +1 (2001-2023) | Total closures 2000-June 2026: 0 | RHTP FY2026 award: $189 million
Idaho: 0 openings, 1 closure, net -1 (2001-2023) | Total closures 2000-June 2026: 3 | RHTP FY2026 award: $186 million
Illinois: 0 openings, 5 closures, net -5 (2001-2023) | Total closures 2000-June 2026: 6 | RHTP FY2026 award: $193 million
Indiana: 0 openings, 5 closures, net -5 (2001-2023) | Total closures 2000-June 2026: 5 | RHTP FY2026 award: $207 million
Iowa: 2 openings, 2 closures, net 0 (2001-2023) | Total closures 2000-June 2026: 3 | RHTP FY2026 award: $209 million
Kansas: 2 openings, 12 closures, net -10 (2001-2023) | Total closures 2000-June 2026: 14 | RHTP FY2026 award: $222 million
Kentucky: 2 openings, 6 closures, net -4 (2001-2023) | Total closures 2000-June 2026: 7 | RHTP FY2026 award: $213 million
Louisiana: 3 openings, 5 closures, net -2 (2001-2023) | Total closures 2000-June 2026: 5 | RHTP FY2026 award: $208 million
Maine: 0 openings, 2 closures, net -2 (2001-2023) | Total closures 2000-June 2026: 3 | RHTP FY2026 award: $190 million
Maryland: 1 opening, 3 closures, net -2 (2001-2023) | Total closures 2000-June 2026: 3 | RHTP FY2026 award: $168 million
Michigan: 1 opening, 8 closures, net -7 (2001-2023) | Total closures 2000-June 2026: 8 | RHTP FY2026 award: $173 million
Minnesota: 0 openings, 5 closures, net -5 (2001-2023) | Total closures 2000-June 2026: 7 | RHTP FY2026 award: $193 million
Mississippi: 8 openings, 13 closures, net -5 (2001-2023) | Total closures 2000-June 2026: 17 | RHTP FY2026 award: $206 million
Missouri: 3 openings, 10 closures, net -7 (2001-2023) | Total closures 2000-June 2026: 12 | RHTP FY2026 award: $216 million
Montana: 3 openings, 1 closure, net +2 (2001-2023) | Total closures 2000-June 2026: 2 | RHTP FY2026 award: $234 million
Nebraska: 1 opening, 3 closures, net -2 (2001-2023) | Total closures 2000-June 2026: 4 | RHTP FY2026 award: $219 million
Nevada: 4 openings, 1 closure, net +3 (2001-2023) | Total closures 2000-June 2026: 1 | RHTP FY2026 award: $180 million
New Jersey: 0 openings, 1 closure, net -1 (2001-2023) | Total closures 2000-June 2026: 1 | RHTP FY2026 award: $147 million
New Mexico: 2 openings, 1 closure, net +1 (2001-2023) | Total closures 2000-June 2026: 1 | RHTP FY2026 award: $211 million
New York: 1 opening, 7 closures, net -6 (2001-2023) | Total closures 2000-June 2026: 10 | RHTP FY2026 award: $212 million
North Carolina: 2 openings, 8 closures, net -6 (2001-2023) | Total closures 2000-June 2026: 8 | RHTP FY2026 award: $213 million
North Dakota: 0 openings, 1 closure, net -1 (2001-2023) | Total closures 2000-June 2026: 2 | RHTP FY2026 award: $199 million
Ohio: 5 openings, 4 closures, net +1 (2001-2023) | Total closures 2000-June 2026: 5 | RHTP FY2026 award: $202 million
Oklahoma: 7 openings, 13 closures, net -6 (2001-2023) | Total closures 2000-June 2026: 17 | RHTP FY2026 award: $223 million
Oregon: 1 opening, 0 closures, net +1 (2001-2023) | Total closures 2000-June 2026: 0 | RHTP FY2026 award: $197 million
Pennsylvania: 3 openings, 7 closures, net -4 (2001-2023) | Total closures 2000-June 2026: 9 | RHTP FY2026 award: $193 million
South Carolina: 3 openings, 7 closures, net -4 (2001-2023) | Total closures 2000-June 2026: 8 | RHTP FY2026 award: $200 million
South Dakota: 2 openings, 3 closures, net -1 (2001-2023) | Total closures 2000-June 2026: 4 | RHTP FY2026 award: $189 million
Tennessee: 3 openings, 17 closures, net -14 (2001-2023) | Total closures 2000-June 2026: 19 | RHTP FY2026 award: $207 million
Texas: 13 openings, 37 closures, net -24 (2001-2023) | Total closures 2000-June 2026: 39 | RHTP FY2026 award: $281 million
Utah: 2 openings, 0 closures, net +2 (2001-2023) | Total closures 2000-June 2026: 0 | RHTP FY2026 award: $196 million
Virginia: 1 opening, 4 closures, net -3 (2001-2023) | Total closures 2000-June 2026: 4 | RHTP FY2026 award: $190 million
Washington: 1 opening, 0 closures, net +1 (2001-2023) | Total closures 2000-June 2026: 1 | RHTP FY2026 award: $181 million
West Virginia: 1 opening, 5 closures, net -4 (2001-2023) | Total closures 2000-June 2026: 5 | RHTP FY2026 award: $199 million
Wisconsin: 5 openings, 3 closures, net +2 (2001-2023) | Total closures 2000-June 2026: 4 | RHTP FY2026 award: $204 million
Wyoming: 5 openings, 0 closures, net +5 (2001-2023) | Total closures 2000-June 2026: 0 | RHTP FY2026 award: $205 million
Explore the data here.
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