20 States With the Most Rural Hospital Closures

From Becker’s Financial Management

Nearly 200 rural hospitals have closed since 2005, and some states bear the brunt of this reduction to healthcare access more than others.

Since 2005, 192 hospitals in rural America have shut down, and the COVID-19 pandemic only accelerated rural hospitals’ risk of closure. Eight rural hospitals closed in 2023, as many as in 2022 and 2021 combined, according to the report. This followed a landmark 18 rural hospital closures in 2020, more than any year in the previous decade.

The counts come from the Center for Healthcare Quality and Payment Reform’s latest report, “Rural Hospitals at Risk of Closing.” CHQPR tracks rural hospital closures on an annual basis and, using the latest hospital financial information released by CMS in April 2024, analyzes rural hospitals’ risk of closure.

Below is a listing of the states that have seen the greatest number of rural hospital closures over the past 19 years. For a forward-looking way of looking at the risks of rural hospital closures, here are 25 states ranked by the percentage of their rural hospitals at risk of closure in the next two to three years maximum. The report from CHQPR assessing each state’s rural hospital health and risks can be found in full here.

  • Texas: 25
  • Tennessee: 15
  • North Carolina: 12
  • Kansas: 10
  • Missouri: 10
  • California: 9
  • Georgia: 9
  • Florida: 8
  • Oklahoma: 8
  • Alabama: 7
  • Minnesota: 6
  • Mississippi: 6
  • New York: 6
  • Pennsylvania: 6
  • West Virginia: 5
  • Arizona: 4
  • Illinois: 4
  • Indiana: 4
  • Kentucky: 4
  • South Carolina: 4