Across the U.S., 220 rural hospitals — more than 10 percent nationwide — are at immediate risk of closing because of financial losses and lack of financial reserves to sustain operations, according to the Center for Healthcare Quality and Payment Reform.
All but seven states have at least one rural hospital at immediate risk of shutting down, while six have none, according to the report. The hospitals identified as being at immediate risk of closure had either low or non-existent financial reserves and a cumulative negative total margin over the most recent three-year period.
Rural hospitals at immediate risk of closing in each state as of October 2022, ranked by percent of state totals:
Note: Rhode Island was omitted because it has no rural hospitals, according to the report.
For information on specific at-risk hospitals, see this database.
| Rank |
State |
Total rural hospitals |
Immediate risk of closing |
Percent of state total |
|---|---|---|---|---|
| 1 |
Tennessee |
48 |
17 |
35% |
| 2 |
Mississippi |
70 |
24 |
34% |
| 3 |
Connecticut |
3 |
1 |
33% |
| 4 |
Alabama |
48 |
15 |
31% |
| 5 |
Oklahoma |
72 |
15 |
21% |
| 6 |
Maine |
25 |
5 |
20% |
| 7 |
South Carolina |
26 |
5 |
19% |
| 8 |
Virginia |
29 |
5 |
17% |
| 9 |
Hawaii |
12 |
2 |
17% |
| 10 |
New York |
51 |
8 |
16% |
| 11 |
Kansas |
104 |
16 |
15% |
| 12 |
Alaska |
13 |
2 |
15% |
| 13 |
Indiana |
53 |
7 |
13% |
| 14 |
Arkansas |
48 |
6 |
13% |
| 15 |
Wyoming |
24 |
3 |
13% |
| 16 |
North Carolina |
53 |
6 |
11% |
| 17 |
Georgia |
66 |
7 |
11% |
| 18 |
Pennsylvania |
40 |
4 |
10% |
| 19 |
Ohio |
70 |
7 |
10% |
| 20 |
Florida |
21 |
2 |
10% |
| 21 |
Oregon |
32 |
3 |
9% |
| 22 |
Illinois |
72 |
6 |
8% |
| 23 |
North Dakota |
37 |
3 |
8% |
| 24 |
Michigan |
62 |
5 |
8% |
| 25 |
Texas |
152 |
12 |
8% |
| 26 |
Vermont |
13 |
1 |
8% |
| 27 |
South Dakota |
45 |
3 |
7% |
| 28 |
Idaho |
30 |
2 |
7% |
| 29 |
New Hampshire |
17 |
1 |
6% |
| 30 |
Montana |
52 |
3 |
6% |
| 31 |
Kentucky |
71 |
4 |
6% |
| 32 |
California |
55 |
3 |
5% |
| 33 |
Washington |
39 |
2 |
5% |
| 34 |
Utah |
21 |
1 |
5% |
| 35 |
New Mexico |
23 |
1 |
4% |
| 36 |
Louisiana |
51 |
2 |
4% |
| 37 |
West Virginia |
26 |
1 |
4% |
| 38 |
Missouri |
57 |
2 |
4% |
| 39 |
Minnesota |
92 |
3 |
3% |
| 40 |
Colorado |
41 |
1 |
2% |
| 41 |
Iowa |
93 |
2 |
2% |
| 42 |
Nebraska |
71 |
1 |
1% |
| 43 |
Wisconsin |
72 |
1 |
1% |
| 44 |
Nevada |
13 |
0 |
0% |
| 45 |
Massachusetts |
5 |
0 |
0% |
| 46 |
Arizona |
17 |
0 |
0% |
| 47 |
Delaware |
2 |
0 |
0% |
| 48 |
Maryland |
4 |
0 |
0% |
| 49 |
New Jersey |
1 |
0 |
0% |