The State of Rural Hospitals in the U.S, 2012-2023

ASPE’s Office of Health Policy has developed an Issue Brief modeling the key determinants of rural hospital closure or conversion as well as an interactive Rural Hospital Dashboard to highlight key characteristics and trends among rural hospitals. The Issue Brief uses a Cox proportional hazards model to identify low occupancy rates, for-profit ownership and proximity to an urban county as key determinants of closure or conversion to outpatient only facilities.

This interactive Dashboard provides comprehensive information on rural hospitals, both open and closed, spanning 2012 to 2023. Users can explore the dashboard data by filtering by year, hospital name, closure status, state, occupancy rate quartiles, ownership type, and system affiliation. The dashboard also allows users to view more detailed hospital-level information, including occupancy rates, number of beds, Medicare and Medicaid share of discharges, liability-to-asset ratios, and annual profit margins. In addition, it includes hospital county-level data on health care workforce (physicians, physician assistants, nurse practitioners), other healthcare facilities (e.g. rural health clinics, federally qualified health centers (FQHCs), etc.) and demographic variables (age group, sex, population density, median household income)  that offer context on the healthcare resources and community characteristics  in which these hospitals are located. Details on the data sources used to develop this dashboard are provided below.

Link to the Dashboard

Supplementary Material:

• Rural Hospital Dashboard User Guide

Data Sources

1. CMS - Hospital Cost Reports: 2012-2013   
     https://www.cms.gov/data-research/statistics-trends-and-reports/cost-reports/hospital-2552-2010-form

   Cost Report: Financial margins, Occupancy rates, Ownership Status (For Profit/Non-Profit)

    

2. American Hospital Association. AHA Annual Survey Database. Chicago: American Hospital Association, 2012-2023

   AHA Data: System affiliation

    

3. Area Health Resource File: 2012-2023 
   Health Resources and Services Administration.  Area Health Resources Files (AHRF). U.S. Department of Health and Human Service

   • Healthcare Instructions
   • Healthcare workforce (Physicians, PA, NPs)
   • Other Healthcare facilities (Rural Health Clinics, Fed Qualified Health Centers, Home Health Agencies, etc.)
   • Demographic Variables: Age, Race/ethnicity, Population density, Median income

    

4. County Health Ranking File: 2012-2023 
   https://www.countyhealthrankings.org/health-data

   • Population Health and Wellbeing (County Ranking)
     • Length of Life

    

5. Population Health and Wellbeing (County Ranking) 
   The Cecil G. Sheps Center for Health Services Research. Rural Hospital Closures. University of North Carolina at Chapel Hill, https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/. Accessed 7 Apr. 2026

    

Data Disclaimer:  
This dashboard contains hospital and county-level data, including data from CMS public-use Cost reports, American Hospital Association Survey, and other public-use sources, and is provided for informational purposes only. It does not constitute official HHS policy, guidance, or determination.

All information is provided “as is” without any representations or warranties, express or implied, including but not limited to warranties of accuracy, completeness, reliability, or fitness for a particular purpose. Data may be incomplete, subject to change, or differ from original source materials due to aggregation, transformation, or timing of updates.

By accessing or using this dashboard, you agree to these terms.

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Eden Volkov, (202) 570 6103, eden.volkov@hhs.gov . Content will be updated pending the outcome of the Section 508 review.