Study: Rural hospitals that closed had 3 common factors; no surprises, but it helps to know what to look or ask for

Rural hospitals are often the lifeblood of their communities, in terms of jobs provided and lives saved, but hundreds have shuttered in recent decades and the pandemic has accelerated that trend. A recently published study found three common financial factors that most often heralded the 56 rural hospital closures between 2017 and 2020.

"In the year before their closure, most of the now-closed rural hospitals nationwide had low cash on hand, negative operating margins, and negative total margins, compared to rural hospitals that stayed open," Clarissa Donnelly-DeRoven reports for North Carolina Health News. Those last two factors means they lost money. Though buyouts from larger health systems and subsequent consolidation might be responsible for a few closures, the researchers found that the vast majority closed for financial reasons. Though this study didn't examine the role of Medicaid expansion in keeping rural hospitals open, a 2018 study out of Colorado found that it makes a big difference in keeping rural hospitals open.

The study was a collaboration between the North Carolina Rural Health Research Program and the Cecil G. Sheps Center for Health Services Research at the University of North Carolina Chapel Hill. UNC researcher George Pink, one of the authors, said the study is the first he's seen that analyzes a hospital's finances immediately before its closure, Donnelly-DeRoven reports. How does your local hospital score? If it won't tell you, trouble may be brewing.