146 rural hospitals closed or stopped providing inpatient services from 2005 to 2023 in the United States

Between 2005 and 2023, 146 hospitals in rural U.S. counties closed or were converted to non-acute care (meaning they stopped providing general, short-term, acute inpatient care). Of the 146 hospitals, 81 shut down completely. The others underwent “conversion,” a term that describes when a hospital stops providing inpatient services but still offers services such as primary and outpatient care or treatment of emergency cases. Although the number of rural hospital closures and conversions slowed in 2010, 2015, 2017, and 2021, it started to rise again after 2022. Financial stress is the primary driver of rural hospital closures. Contributing factors include smaller size, lower occupancy rates, and greater vulnerability to economic fluctuations than urban hospitals. The Federal Government has provided financial support for rural hospitals through various programs, including USDA’s Community Facilities Program, and a recent USDA, Economic Research Service (ERS) study found that hospitals receiving Community Facilities Program funding had a higher probability of survival than those that did not. For more information, see the ERS report Federal Assistance and Rural Hospital Closings: The Impact of the USDA Community Facilities Program, published in January 2025.