Since 2005, there have been 124 rural hospital closures in the United States. Rural hospital closures can intensify already challenging health and economic issues for rural communities. People served by rural hospitals tend to be older, poorer, have access to fewer health care professionals, and have overall worse health outcomes than those served by urban hospitals. To better understand the causes of hospital closure, this brief compares the characteristics of communities served by rural hospitals at high risk of financial distress to those served by rural hospitals that are not at high risk of financial distress.

Key Finding: Hospitals at high risk of financial distress serve a more vulnerable population than those not at high risk. Because hospitals at high risk of financial distress are more likely to close or curtail services, these more vulnerable populations are at increased risk of losing access to some types of health care, exacerbation of health disparities, and loss of hospital and other types of local employment.