More than 500 rural hospitals in the U.S. were at immediate risk of closure before the COVID-19 pandemic because of financial losses and lack of reserves to maintain operations, according to a report from the Center for Healthcare Quality and Payment Reform.
Nearly every state had at least one rural hospital at immediate risk of closure before the pandemic. In 22 states, 25 percent or more of rural hospitals were at immediate risk, according to the report.
The hospitals identified as being at immediate risk of closure had a cumulative negative total margin over the most recent three-year period, and their financial situation has likely deteriorated because of the pandemic.
Across the U.S., more than 800 hospitals — 40 percent of all rural hospitals in the country — are either at immediate or high risk of closure. The more than 300 hospitals at high risk closure either have low financial reserves or high dependence on nonpatient service revenues such as local taxes or state subsidies, according to the report.
Here are the number and percentage of rural hospitals at risk of closing in each state as of January 2021 based on the CHQPR analysis:
Alabama
Rural hospitals at high risk of closing: 30 (63 percent)
Alaska
Rural hospitals at high risk of closing: 5 (38 percent)
Arizona
Rural hospitals at high risk of closing: 4 (22 percent)
Arkansas
Rural hospitals at high risk of closing: 29 (60 percent)
California
Rural hospitals at high risk of closing: 16 (31 percent)
Colorado
Rural hospitals at high risk of closing: 11 (27 percent)
Connecticut
Rural hospitals at high risk of closing: 3 (100 percent)
Delaware
Rural hospitals at high risk of closing: 0 (0 percent)
Florida
Rural hospitals at high risk of closing: 7 (35 percent)
Georgia
Rural hospitals at high risk of closing: 26 (43 percent)
Hawaii
Rural hospitals at high risk of closing: 8 (67 percent)
Idaho
Rural hospitals at high risk of closing: 7 (25 percent)
Illinois
Rural hospitals at high risk of closing: 20 (27 percent)
Indiana
Rural hospitals at high risk of closing: 20 (38 percent)
Iowa
Rural hospitals at high risk of closing: 40 (44 percent)
Kansas
Rural hospitals at high risk of closing: 76 (72 percent)
Kentucky
Rural hospitals at high risk of closing: 16 (23 percent)
Louisiana
Rural hospitals at high risk of closing: 26 (53 percent)
Maine
Rural hospitals at high risk of closing: 10 (40 percent)
Maryland
Rural hospitals at high risk of closing: 1 (25 percent)
Massachusetts
Rural hospitals at high risk of closing: 2 (40 percent)
Michigan
Rural hospitals at high risk of closing: 19 (30 percent)
Minnesota
Rural hospitals at high risk of closing: 28 (31 percent)
Mississippi
Rural hospitals at high risk of closing: 41 (62 percent)
Missouri
Rural hospitals at high risk of closing: 31 (54 percent)
Montana
Rural hospitals at high risk of closing: 19 (37 percent)
Nebraska
Rural hospitals at high risk of closing: 24 (33 percent)
Nevada
Rural hospitals at high risk of closing: 6 (46 percent)
New Hampshire
Rural hospitals at high risk of closing: 4 (24 percent)
New Jersey
Rural hospitals at high risk of closing: 0 (0 percent)
New Mexico
Rural hospitals at high risk of closing: 6 (25 percent)
New York
Rural hospitals at high risk of closing: 30 (59 percent)
North Carolina
Rural hospitals at high risk of closing: 19 (36 percent)
North Dakota
Rural hospitals at high risk of closing: 16 (43 percent)
Ohio
Rural hospitals at high risk of closing: 19 (27 percent)
Oklahoma
Rural hospitals at high risk of closing: 41 (56 percent)
Oregon
Rural hospitals at high risk of closing: 11 (34 percent)
Pennsylvania
Rural hospitals at high risk of closing: 18 (42 percent)
Rhode Island
Rural hospitals at high risk of closing: 0 (0 percent)
South Carolina
Rural hospitals at high risk of closing: 12 (48 percent)
South Dakota
Rural hospitals at high risk of closing: 11 (24 percent)
Tennessee
Rural hospitals at high risk of closing: 30 (59 percent)
Texas
Rural hospitals at high risk of closing: 82 (56 percent)
Utah
Rural hospitals at high risk of closing: 3 (14 percent)
Vermont
Rural hospitals at high risk of closing: 2 (15 percent)
Virginia
Rural hospitals at high risk of closing: 14 (50 percent)
Washington
Rural hospitals at high risk of closing: 20 (50 percent)
West Virginia
Rural hospitals at high risk of closing: 11 (46 percent)
Wisconsin
Rural hospitals at high risk of closing: 16 (22 percent)
Wyoming
Rural hospitals at high risk of closing: 7 (30 percent)