Becker's Hospital Review

15 CFO / FINANCE State-by-state breakdown of 354 rural hospitals at high risk of closing By Ayla Ellison T wenty-five percent of the 1,430 rural hospitals in the U.S. are at high risk of closing unless their finances improve, according to an annual analysis from Guide- house, a consulting firm. e 354 rural hospitals at high risk of closing are spread across 40 states and represent more than 222,000 annual discharges. According to the analysis, 287 of these hospitals — 81 percent — are considered highly essential to the health and economic well-being of their communities. Several factors are putting rural hospitals at risk of closing, according to the analysis, which looked at operating margin, days cash on hand, debt-to-capitalization ratio, current ratio and inpatient census to determine the fi- nancial viability of rural hospitals. Declining inpatient volume, clinician shortages, payer mix degradation and revenue cycle manage- ment challenges are among the factors driv- ing the rural hospital crisis. e Guidehouse study analyzed the finan- cial viability of rural hospitals prior to the COVID-19 pandemic, and the authors noted that the rural hospital crisis could significant- ly worsen due to the pandemic or any down- turn in the economy. Here are the number and percentage of rural hospitals at high risk of closing in each state based on the analysis: Tennessee Rural hospitals at high risk of closing: 19 (68 percent) Alabama Rural hospitals at high risk of closing: 18 (60 percent) Oklahoma Rural hospitals at high risk of closing: 28 (60 percent) Arkansas Rural hospitals at high risk of closing: 18 (53 percent) Mississippi Rural hospitals at high risk of closing: 25 (50 percent) West Virginia Rural hospitals at high risk of closing: 9 (50 percent) South Carolina Rural hospitals at high risk of closing: 4 (44 percent) Georgia Rural hospitals at high risk of closing: 14 (41 percent) Kentucky Rural hospitals at high risk of closing: 18 (40 percent) Louisiana Rural hospitals at high risk of closing: 11 (37 percent) Maine Rural hospitals at high risk of closing: 7 (33 percent) Indiana Rural hospitals at high risk of closing: 8 (31 percent) Kansas Rural hospitals at high risk of closing: 26 (31 percent) New Mexico Rural hospitals at high risk of closing: 3 (30 percent) Michigan Rural hospitals at high risk of closing: 13 (29 percent) Missouri Rural hospitals at high risk of closing: 10 (26 percent) Virginia Rural hospitals at high risk of closing: 5 (25 percent) Oregon Rural hospitals at high risk of closing: 4 (24 percent) California Rural hospitals at high risk of closing: 6 (23 percent) North Carolina Rural hospitals at high risk of closing: 6 (23 percent) Florida Rural hospitals at high risk of closing: 2 (22 percent) North Dakota Rural hospitals at high risk of closing: 7 (21 percent) Ohio Rural hospitals at high risk of closing: 6 (20 percent) Vermont Rural hospitals at high risk of closing: 2 (20 percent) Idaho Rural hospitals at high risk of closing: 4 (19 percent) Pennsylvania Rural hospitals at high risk of closing: 4 (19 percent) Washington Rural hospitals at high risk of closing: 5 (18 percent) Wyoming Rural hospitals at high risk of closing: 3 (18 percent) Texas Rural hospitals at high risk of closing: 14 (16 percent) Colorado Rural hospitals at high risk of closing: 4 (14 percent) Illinois Rural hospitals at high risk of closing: 7 (14 percent) Montana Rural hospitals at high risk of closing: 7 (14 percent) Nebraska Rural hospitals at high risk of closing: 8 (13 percent) New York Rural hospitals at high risk of closing: 4 (13 percent) Iowa Rural hospitals at high risk of closing: 9 (12 percent) Minnesota Rural hospitals at high risk of closing: 8 (11 percent) Alaska Rural hospitals at high risk of closing: 1 (10 percent) Arizona Rural hospitals at high risk of closing: 1 (10 percent) New Hampshire Rural hospitals at high risk of closing: 1 (9 percent) Wisconsin Rural hospitals at high risk of closing: 5 (9 percent) n

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