Analysis concludes that 453 rural hospitals are vulnerable to closure, partly because of the pandemic

States ranked by percentage of rural hospitals losing money

New research and analysis from the Chartis Center for Rural Health, part of health-care analytics consultancy The Chartis Group, provides a detailed look at how the coronavirus pandemic has affected rural hospitals and weakened the rural health safety net. Since 2010, 135 rural hospitals have closed, and this new research found that 453 more are vulnerable to closure. 

Rural communities nationwide face health and health-care disparities because of a wide range of factors such as transportation, underlying health conditions, age, difficulty in recruiting and retaining health-care professionals, government policy, and prolonged resistance to Medicaid expansion.

"All of the key metrics we track to assess the stability of the rural health safety net indicate that the situation for rural hospitals continues to be tenuous,” said Michael Topchik, national leader at the Chartis Center for Rural Health. "Nearly half of all rural hospitals operate in the red; the speed with which closures are occurring has not abated; services are disappearing; and rural hospitals are struggling to provide the operational and financial resources required to adequately respond to Covid-19.”

More insights from the report:

• 46% of rural hospitals have a negative operating margin. 
• In states that haven't expanded Medicaid, 50% of rural hospitals are in the red.
• Services are on the decline in rural communities as 166 rural hospitals have ceased to provide obstetrics and 252 rural hospitals stopped providing chemotherapy services.
• 62% of rural hospitals lack intensive care unit (ICU) beds, and outpatient services represent 77 percent of total revenue.
• By January 8, 2021, 34% of adult hospitalizations at rural hospitals were related to Covid-19, and 83% of staffed rural ICU beds for adults were occupied.