Data on Rural Hospitals

Size and Financial Status of Rural Hospitals

This table includes:

• all hospitals currently located in a geographic area that is designated as “rural”;
• hospitals that have closed since 2005 that were located in an area designated as rural;
• hospitals that have been designated as a Critical Access Hospital or Rural Emergency Hospitals, but are located in an area that is not designated as rural.

Financial data are only shown if the hospital filed a Medicare Cost Report in 2012 or later. Financial data shown are from the Medicare Cost Reports available as of July 2024. (The same data are shown in a map here.)

The table can be sorted by clicking the arrows next to each column heading. The data can be restricted to a specific state or hospital or to hospitals within a specific range of expenses or margins using the filtering boxes.

Definitions of the variables are provided below the table.

Information About the Data

• Type shows the method by which Medicare pays the rural hospital.
  • CAH = Critical Access Hospital (most rural hospitals are classified as Critical Access Hospitals)
  • REH = Rural Emergency Hospital
  • IPPS = standard Inpatient Prospective Payment System payment (most urban hospitals are are classified as IPPS hospitals).
  • Low Volume = Low Volume Adjustment in IPPS payment
  • SCH = Sole Community Hospital
  • MDH = Medicare Dependent Hospital
  • RRC = IPPS Rural Referral Center
  • Cancer = PPS-Exempt Cancer Hospital
  • Indian = Indian Health Service facility
• Total Expenses shows the relative size of the hospital in terms of both inpatient and outpatient services. The amount shown is based on the most recent Cost Report available, which is either 2022 or 2023 for most hospitals.
• Average 3 Year Margin shows the profitability of the hospital during the three most recent years for which Cost Reports are available, excluding 2020 because of the unusual changes in costs and revenues during the initial months of the coronavirus pandemic. Year-by-year data are shown in Trend in Rural Hospital Margins.
  • The Patient Service Margin represents the profit or loss from revenues and costs associated with health care services delivered to patients.
  • The Total Margin includes revenues and costs that are not directly tied to patient care as well as revenues and expenses on patient services.

Many small rural hospitals have a positive total margin despite incurring losses on patient services because they receive local tax revenues or state grants that offset the losses. If these other sources of revenue were to decrease or be terminated, the hospital would no longer have revenues sufficient to cover its costs.

Margins are not shown for Indian Health Service hospitals because they do not receive payments based on the number and types of services they deliver or report revenue in the same way as other hospitals do.

Additional details on the methodology are available in the Methodology section.