Report names states whose rural hospitals are most vulnerable to closure, and the number in each

Percentage of rural hospitals in each state deemed "most
vulnerable." Click the image to enlarge it. (Chartis Center map)

Rural hospitals have been closing at unprecedented rates over the past decade, and the trend is accelerating, according to a new report by The Chartis Center for Rural Health, part of health care analytics consultancy The Chartis Group.

In the last decade, 120 rural hospitals have closed. The closures slowed a little in 2016 and 2017, but picked back up in 2018. There have been 34 in the past two years, and 2019 was the single worst year yet, with 19.

The report digs into the reasons for the closures, and shares the metrics the researchers used to predict future closures among the 1,844 hospitals they studied. Their statistical model identifies the factors most likely to impact a hospital's ability to cope during a critical window about two years before closure. The model also identifies which rural hospitals are performing like those that have closed, and explores those vulnerable hospitals' performance.

Among the factors most likely to influence a hospital's closure: the average age of the building, percentage of occupancy, affiliation with a larger health-care system, and whether it's in a state with expanded Medicaid.

The states with the highest numbers of hospital closures since 2010 are Texas (20), Tennessee (12), Oklahoma (7) and Georgia (7). The states with the highest number of vulnerable hospitals are Texas (36), Kansas (19), Missouri (15), Nebraska (14) and Mississippi (13). And in seven states, more than 20 percent of the rural hospitals are extremely vulnerable to closure: Alabama, Florida, Mississippi, Oklahoma, South Carolina, Tennessee and Texas.