By Mackenna Moralez, Associate Editor

There has been an increased need for hospitals in recent years. However, 760 rural hospitals are at risk of closure due to financial problems, with 40 percent at risk of closing immediately, according to Center for Healthcare Quality and Payment Reform. 

More than 100 hospitals have closed over the last 10 years, leaving millions of people without access to healthcare. This is coupled with dozens of hospitals across the country closing different inpatient services in order to qualify for federal grants that are only available for Rural Emergency Hospitals (REHs). Each year, thousands of seriously ill or injured individuals have to travel or be transferred long distances in order to receive care.  

Nearly half of all rural hospitals have said that they lose money delivering patient services. According to the report, it costs more to deliver healthcare in rural communities than it does in urban areas as many health insurance plans do not pay enough to cover these costs. 

Still, many hospitals have remained open because they receive local tax revenues or government grants. Though, there is no guarantee that funds will continue to be available. Hospitals did receive special federal assistance during the pandemic, but that has since ended, resulting in more than one-third of rural hospitals losing money in the fiscal 2023-24 year. According to the report, one of the great risks of closures for rural hospitals is having more debt than assets or not having adequate net assets to offset losses on patient services.  

Almost every state has a rural hospital at risk of closure. In a majority of states, nearly 25 percent of rural hospitals are at risk of closing, and in 11 states 50 percent or more are at risk. States with the number of hospitals at risk include: 

• Alabama - 28 hospitals at risk of closing (60%) 
• Alaska - 3 hospitals at risk of closing (18%) 
• Arizona - 4 hospitals at risk of closing (14%) 
• Arkansas - 30 hospitals at risk of closing (64%) 
• California - 22 hospitals at risk of closing (38%) 
• Colorado - 11 hospitals at risk of closing (26%) 
• Connecticut - 3 hospitals at risk of closing (75%) 
• Florida - 10 hospitals at risk of closing (45%) 
• Georgia - 20 hospitals at risk of closing (28%) 
• Hawaii - 8 hospitals at risk of closing (62%) 
• Idaho - 8 hospitals at risk of closing (29%) 
• Illinois - 17 hospitals at risk of closing (22%) 
• Indiana - 5 hospitals at risk of closing (9%) 
• Iowa - 20 hospitals at risk of closing (22%) 
• Kansas - 66 hospitals at risk of closing (66%) 
• Kentucky - 16 hospitals at risk of closing (22%) 
• Louisiana - 25 hospitals at risk of closing (45%) 
• Maine - 12 hospitals at risk of closing (50%) 
• Massachusetts - 2 hospitals at risk of closing (33%) 
• Michigan - 13 hospitals at risk of closing (20%) 
• Minnesota - 20 hospitals at risk of closing (21%) 
• Mississippi - 36 hospitals at risk of closing (54%) 
• Missouri - 25 hospitals at risk of closing (43%) 
• Montana - 18 hospitals at risk of closing (33%) 
• Nebraska - 6 hospitals at risk of closing (8%)  
• Nevada - 5 hospitals at risk of closing (36%)  
• New Hampshire - 4 hospitals at risk of closing (24%)  
• New Mexico - 9 hospitals at risk of closing (33%) 
• New York - 29 hospitals at risk of closing (58%) 
• North Carolina -10 hospitals at risk of closing (18%) 
• North Dakota -13 hospitals at risk of closing (33%) 
• Ohio - 5 hospitals at risk of closing (7%) 
• Oklahoma - 47 hospitals at risk of closing (60%) 
• Oregon - 8 hospitals at risk of closing (24%) 
• Pennsylvania -17 hospitals at risk of closing (34%) 
• South Carolina - 7 hospitals at risk of closing (29%) 
• South Dakota - 9 hospitals at risk of closing (18%) 
• Tennessee -17 hospitals at risk of closing (33%) 
• Texas - 87 hospitals at risk of closing (56%) 
• Vermont - 8 hospitals at risk of closing (62%) 
• Virginia - 9 hospitals at risk of closing (29%)  
• Washington -18 hospitals at risk of closing (40%) 
• West Virginia -13 hospitals at risk of closing (39%) 
• Wisconsin -10 hospitals at risk of closing (13%) 
• Wyoming -7 hospitals at risk of closing (27%) 

Mackenna Moralez is the associate editor of the facilities market and the host of the Facilities in Focus podcast.