40 Percent of Rural Hospitals are at Risk

February 13, 2026

More than 40 percent of rural hospitals are operating at a loss, putting care in jeopardy in rural regions across the country.

The analysis, released this week from Chartis, reviews the stability of the rural health safety net in America.

“Rural (health care) is at a crossroads,” the study notes. “Rural Health Transformation-funded initiatives will support innovation and improve care delivery, but our latest analysis suggests that time is of the essence.”

Here are a few key takeaways:

• In Pennsylvania:  Between 10 and 15 percent of the state’s rural hospitals are at risk of closing, per the analysis.
  • By state:   Tennessee has the most rural hospitals at risk (61%), followed by Arkansas (55%), Florida (52%),
• Top concern:  The loss of obstetrics (OB) is a top concern in rural communities.
  • Florida has lost 71 percent of its rural OB units. Pennsylvania has lost the fourth most, losing 42 percent of its OB units.
• Slim margins:  Rural hospitals have a national median operating margin of two percent and 41.2 percent of all rural hospitals are operating in the red.
• What’s next?:  The report notes several important considerations for rural hospitals around the Rural Health Transformation Program, addressing staffing challenges, developing new models of care, implementing technology, and quantifying unmet needs and care gaps, among other strategies.
• Quotable:  “While this is a significant step forward, the RHT program may be too late to prevent more hospitals from closing their doors or removing service lines such as OB or general surgery,” the report notes.

HAP continues to support policies and legislation that ensure rural hospitals can be anchors of their communities. Read the Chartis report online.