Plains and Southeast areas received largest share of Federal Community Facilities Program’s rural hospital funding, 2000 to 2020

The Community Facilities Program, administered by USDA Rural Development, provides Federal grants and loans to improve rural facilities and infrastructure. These facilities include hospitals, health care clinics, assisted living facilities, rehabilitation centers, public buildings, schools, community-based facilities, and fire and rescue stations. From 2000 to 2020, the Community Facilities Program invested $4.7 billion for hospitals in 330 rural counties. Much of this funding was in areas with a history of rural hospital closures. For instance, the Southeast region, which had the most hospital closures (64) from 2005 to 2023, received almost a fourth (23 percent) of rural hospital funding at $1.1 billion from 2000 to 2020. The Plains region received $1.8 billion from 2000 to 2020, or 38 percent of rural program hospital investments, while the Great Lakes region received $700 million (15 percent), and the Rocky Mountain region received $400 million (9 percent). From 2005 to 2023, 28 hospitals closed in the Plains, 15 closed in the Great Lakes region, and no hospitals closed in the Rocky Mountain region, according to a USDA, Economic Research Service (ERS) study. ERS researchers also found that individual hospitals that received Community Facilities Program funding were less likely to close compared with similar hospitals that did not receive funding. A version of this figure appears in the ERS report Federal Assistance and Rural Hospital Closings: The Impact of the USDA Community Facilities Program, published in January 2025.