Hospital length of stay continues to trend downward across much of the U.S., reflecting sustained efforts to improve throughput, manage capacity and shift care to lower-acuity settings, according to new data from Kaufman Hall’s “National Hospital Flash Report.”
Across 1,300 hospitals nationally, average length of stay declined 2% from September 2025 to October 2025. Compared with October 2024, length of stay was down 3%, and relative to 2022 levels, hospitals are operating with an 8% shorter average length of stay.
Incremental improvements show operational efficiencies take hold
The data points to steady, incremental improvement rather than sharp month-to-month swings, suggesting hospitals have embedded length-of-stay management more deeply into daily operations. Most regions followed the national pattern, though the pace of improvement varied.
Hospitals in the Midwest saw some of the steepest declines. Length of stay fell 4% month over month and 3% year over year, and is down 10% compared with 2022. The South posted similar longer-term improvement, with an 8% decline since 2022 and a 3% year-over-year decrease.
In the West, length of stay declined 2% month over month and 2% year over year, but longer-term improvement has been more modest, down 3% since 2022.
The Northeast and Mid-Atlantic stood out as an exception. Length of stay increased 1% from September to October, was flat year over year, and is down just 2% compared with 2022. The Great Plains showed relatively stable performance, with a 1% month-over-month decline, a 3% year-over-year decrease and only a 1% reduction since 2022.
Smaller hospitals show sharper shifts
By bed size, the most dramatic changes were concentrated among the smallest hospitals.
Critical access hospitals with 25 or fewer beds reduced length of stay by 3% month over month and 13% year over year, with a 7% decline since 2022. Facilities with 26 to 99 beds were flat year over year but still posted a 9% reduction compared with 2022.
Mid-size hospitals with 300 to 499 beds showed steadier movement, with length of stay down 2% month over month and year over year, and 3% lower than 2022 levels.
The largest hospitals, with 500 or more beds, reported smaller short-term changes but significant longer-term improvement. Length of stay declined 1% month over month and year over year, and is down 10% compared with 2022.
Hospitals need continued investment for 2026 success
Declining length of stay remains a critical lever for hospitals facing tight margins, staffing constraints and rising demand. Shorter stays can free up inpatient capacity, reduce staffing pressure and support better patient flow across emergency departments and surgical services.
At the same time, the flatter trends in certain regions underscore the limits of operational gains alone, particularly in markets facing higher acuity, discharge barriers or post-acute capacity constraints. As hospitals move into 2026, sustained progress on length of stay is likely to depend on continued investment in care coordination, post-acute partnerships and data-driven capacity management, rather than one-time fixes.
