Most Americans don’t think about where their nearest hospital is until they need it. Sometimes it’s a car accident. Other times it’s a child with a fever that won’t break at 2 a.m. In those moments, the hospital and its highly trained, competent staff are simply there.

The One Big Beautiful Bill Act, signed into law by President Trump on July 4, 2025, could change that assumption for millions of Americans. A March 2026 analysis by Public Citizen identified 446 hospitals at heightened risk of closure from the law’s Medicaid cuts. Together, the hospitals have 69,000 beds, serve 6.6 million patients annually and employ roughly 275,000 staff.

To be clear, Public Citizen’s list doesn’t predict all 446 will close or even any specific one will. What it offers is a map of where the financial pain from Trump’s law will land first.

Why Trump’s Law May Lead To Hospital Closures

When patients with Medicaid go to the hospital, their insurance pays less than 65 cents on the dollar relative to the actual cost of their care. For hospitals that serve low-income communities which serve a high percentage of Medicaid patients, they rely on those payments adding up so they can stay afloat.

If a Medicaid patient loses coverage and becomes uninsured, the reimbursement it often drops to near zero. Despite that, hospitals are legally required under federal Emergency Medical Treatment and Active Labor Act ( EMTALA ) laws to treat all patients regardless of ability to pay.

So uninsured patients still get care. The hospital simply isn’t paid. Since many hospitals are already on thin or even negative profit margins, the impact of the Trump’s Law could end up putting some hospitals out of business.

The Congressional Budget Office estimates Trump’s law will result in 10 million more uninsured Americans by 2034, with 7.5 million of those losses attributable to Medicaid and CHIP cuts. A Commonwealth Fund analysis found that if Medicaid expansion were discontinued, hospital revenues would decline by nearly $20 billion annually.

Public Citizen’s list includes safety-net hospitals with 20% or more of revenue from Medicaid. Since many are already losing money, they have little to no capacity to absorb more losses.

Trump’s Law cuts dollars to hospitals in five ways. First, work requirements and eligibility checks will disenroll millions of Medicaid beneficiaries. Beginning January 1, 2027, adults in the Medicaid expansion population must document 80 hours per month of work, volunteering, or educational activities or prove they qualify for an exemption.

The administrative burden will cause mass disenrollment. In Arkansas’ 2018 work requirement pilot, 18,000 people lost coverage over several months, the vast majority not because they weren’t working, but because they couldn’t navigate the reporting system.

Second, Disproportionate Share Hospital (DSH) payments which are federal supplemental payments designed to compensate hospitals for providing care to Medicaid and the uninsured were cut when the law took effect. The ACA had already reduced DSH payments under the assumption that Medicaid expansion would reduce uncompensated care. This is a double hit that compounds the uncompensated care burden.

Third, State Directed Payments (SDPs) which are extra dollars states require Medicaid managed care plans to make to hospitals are now capped at Medicare rates under Trump’s law. These payments are critical for safety-net hospitals.

When Washington State’s SDPs weren’t renewed at the end of 2024, Valley Medical Center in Renton anticipated $80 to $100 million in state-directed payments. The result were layoffs of more than 100 workers within weeks. RAND projects total SDP reductions will reach $169 billion over the decade, hitting Georgia, Mississippi, South Carolina, Tennessee and Texas the hardest.

Fourth, provider tax restrictions limit states’ ability to generate matching funds they use to supplement Medicaid payments to hospitals. Many states have levied taxes on hospitals and other health care providers. Then, those revenues are used to draw down federal matching dollars, effectively recycling money back into the Medicaid system at a multiplier.

Trump’s law bars new provider taxes and phases down existing ones in expansion states to roughly half their current rates by 2031. States began revising those taxes for some categories starting April 1, 2026. The KFF lists seven states facing immediate impact: California, Illinois, Massachusetts, Michigan, Ohio, New York and West Virginia.

Fifth, because Trump’s law increases the federal deficit, the CBO projects it will trigger roughly $500 billion in mandatory Medicare spending reductions between 2026 and 2034 under existing budget law. This will include a 4% cut in payments to hospitals unless Congress acts to circumvent them. While Congress has historically taken action to block Medicare cuts, there is no guarantee it will do so. For a hospital already running negative margins, a 4% cut in Medicare revenue on top of the Medicaid pressure could accelerate insolvency.

An Injection Of $50 Billion for Rural Health

Trump’s law’s primary mitigation measure for hospitals is the Rural Health Transformation Program (RHTP): a $50 billion fund available over five years to help rural hospitals adjust. The first $10 billion tranche was distributed across states in 2026.

Experts across the political spectrum have described this as insufficient. Public Citizen calculates that $50 billion represents just 37% of the estimated loss in federal Medicaid funding to rural areas over ten years. Rich Rasmussen, president of the Oklahoma Hospital Association, called it “a drop in the bucket.” Importantly, federal guidance for the fund emphasizes investment in new technology and activities, not backfilling revenue losses. It also caps provider payments at 15% of each state’s allocation. It is also partly competitive, meaning hospitals that most need relief must apply and compete for it.

What Leads To Actual Hospital Closure

Hospital closure is rarely an immediate shutdown. The more common trajectory: service elimination, then staffing reductions, then eventual closure or conversion. Obstetrics often emerges as the first service line to go.

Take St. Mary’s Sacred Heart Hospital in Lavonia, Georgia. In November 2025, it closed its maternity unit (Note that St. Mary’s is not on the Public Citizen list because it only as 15%+ Medicaid). A month later, Centra Southside Community Hospital in Farmville, Virginia closed its labor and delivery unit and OB surgical services, noting it “like other rural health care providers, must adapt to significant financial and operational challenges, including recently enacted reductions in federal health care funding.” In January 2026, Greene County General Hospital in Linton, Indiana ended obstetric services.

A 2025 GAO study found that closures of urban hospitals outpaced new openings from 2019 to 2023. The Steward Health system collapse in 2024 eliminated six Massachusetts hospitals before Trump’s Law took effect. Alameda Health System in Oakland announced nearly 300 layoffs in December 2025 and projects losses exceeding $100 million annually by 2030.

For patients, the clinical effects of closure are well-documented. Studies of rural hospital closures find increased pre-hospital transport times, higher out-of-hospital cardiac arrest mortality and delayed diagnosis of serious illness. Counterintuitively, prices tend to rise at surviving nearby hospitals, which lose a competitor and face less pressure to keep costs down.

Here’s What Comes Next With Trump’s Law and Hospital Closures

Ultimately, what is coming may be a slow-motion contraction of the healthcare infrastructure that low-income communities, rural regions, and underserved urban neighborhoods depend on.

How many hospitals close in the end depends heavily on how states implement work requirements: how broadly they define “medically frail,” how much automated data-matching they deploy, and how accessible their reporting portals are. States that build administrative barriers will see more disenrollment, more uncompensated care and more hospitals pushed to the brink.

State-by-State: The Complete At-Risk Hospital List

Note: The table below uses exact figures from Public Citizen’s appendix (March 2026), which drew on CMS cost report data from 2022–2024 covering 4,241 hospitals. This is approximately 95% of U.S. acute care facilities.

A hospital is designated at-risk if (1) Medicaid, SCHIP, and other low-income government programs constitute ≥20% of its payer mix, and (2) it posted negative net profit margins on average from 2022–2024.

CMS payment designations: CAH = Critical Access Hospital; SCH = Sole Community Hospital; RRC = Rural Referral Center; MDH = Medicare Dependent Hospital; PPS = Prospective Payment System (standard payment).

California — 83 of 269 hospitals (30.9%) at risk

  • Pih Health Good Samaritan Hospital (Los Angeles) — RRC, 308 beds, Rural
  • Coalinga Regional Medical Center (Coalinga) — CAH, 24 beds, Rural
  • Martin Luther King Community Hosp (Los Angeles) — PPS, 152 beds, Rural
  • Pioneers Mem. Hospital (Brawley) — PPS, 107 beds, Rural
  • Mad River Community Hospital (Arcata) — PPS, 49 beds, Rural
  • Hollywood Presbyterian Medical Cntr (Los Angeles) — RRC, 317 beds, Rural
  • Sierra View Medical Center (Porterville) — PPS, 128 beds, Rural
  • El Centro Regional Medical Center (El Centro) — PPS, 161 beds, Rural
  • Adventist Health Bakersfield (Bakersfield) — PPS, 254 beds, Rural
  • East Los Angeles Doctors Hospital (Los Angeles) — PPS, 102 beds, Rural
  • St. Agnes Medical Center (Fresno) — PPS, 384 beds, Rural
  • St. Joseph Hospital - Eureka (Eureka) — RRC, 131 beds, Rural
  • Delano Regional Med. Ctr. (Delano) — PPS, 105 beds, Rural
  • Adventist Health Tulare (Tulare) — PPS, 73 beds, Rural
  • St. Bernardine Medical Center (San Bernardino) — RRC, 318 beds, Rural
  • Valley Presbyterian Hospital (Van Nuys) — PPS, 333 beds, Rural
  • Greater El Monte Community Hospital (South El Monte) — PPS, 104 beds, Rural
  • Dameron Hospital (Stockton) — PPS, 170 beds, Rural
  • Mark Twain Medical Center (San Andreas) — CAH, 25 beds, Rural
  • St. Mary Medical Center (Long Beach) — PPS, 273 beds, Rural
  • Kaweah Delta Medical Center (Visalia) — PPS, 430 beds, Rural
  • Saint Francis Memorial Hospital (San Francisco) — PPS, 171 beds, Rural
  • Adventist Health And Rideout (Marysville) — SCH, 209 beds, Rural
  • Glendale Memorial Hospital & Hlth Ct (Glendale) — RRC, 241 beds, Rural
  • Southern Inyo Hospital (Lone Pine) — CAH, 4 beds, Rural
  • Palmdale Regional Medical Center (Palmdale) — PPS, 157 beds, Rural
  • L A Downtown Medical Center (Los Angeles) — PPS, 282 beds, Rural
  • Redwood Memorial Hospital (Fortuna) — CAH, 19 beds, Rural
  • San Gorgonio Memorial (Banning) — PPS, 79 beds, Rural
  • Pacifica Hospital Of The Valley (Sun Valley) — PPS, 133 beds, Rural
  • Garfield Medical Center (Monterey Park) — PPS, 182 beds, Rural
  • Glenn Medical Center (Willows) — CAH, 25 beds, Rural
  • Menifee Valley Medical Center (Sun City) — PPS, 84 beds, Rural
  • Shasta Regional Medical Center (Redding) — PPS, 118 beds, Rural
  • Anaheim Global Medical Center (Anaheim) — PPS, 103 beds, Rural
  • Adventist Health Glendale (Glendale) — RRC, 318 beds, Rural
  • Uc Davis Medical Center (Sacramento) — RRC, 661 beds, Rural
  • Providence Lttl Co Mary Mc San Pedro (San Pedro) — PPS, 97 beds, Rural
  • Methodist Hospital Of Sacramento (Sacramento) — PPS, 154 beds, Rural
  • Garden Grove Hospital Medical Center (Garden Grove) — PPS, 167 beds, Rural
  • San Gabriel Valley Medical Center (San Gabriel) — PPS, 187 beds, Rural
  • Zuckerberg San Francisco General (San Francisco) — PPS, 284 beds, Rural
  • Ridgecrest Regional Hospital (Ridgecrest) — CAH, 25 beds, Rural
  • Providence St Joseph Medical Center (Burbank) — RRC, 368 beds, Rural
  • Providence Holy Cross Med. Center (Mission Hills) — RRC, 297 beds, Rural
  • Anaheim Regional Medical Center (Anaheim) — PPS, 223 beds, Rural
  • Scripps Mercy Hospital (San Diego) — RRC, 550 beds, Rural
  • Watsonville Community Hosptial (Watsonville) — PPS, 106 beds, Rural
  • Banner Lassen Medical Center (Susanville) — CAH, 25 beds, Rural
  • Coast Plaza Hospital (Norwalk) — PPS, 117 beds, Rural
  • Adventist Health Lodi Memorial (Lodi) — PPS, 186 beds, Rural
  • Adventist Health Mendocino Coast (Ft Bragg) — CAH, 25 beds, Rural
  • Sutter Solano Medical Center (Vallejo) — PPS, 106 beds, Rural
  • Laguna Honda Hospital (San Francisco) — PPS, 6 beds, Rural
  • Cpmc - Mission Bernal Campus (San Francisco) — PPS, 120 beds, Rural
  • Alta Bates Medical Center (Berkeley) — PPS, 315 beds, Rural
  • Huntington Beach Hospital (Huntington Beach) — PPS, 82 beds, Rural
  • Biggs-Gridley Memorial Hospital (Gridley) — CAH, 24 beds, Rural
  • Llumc Murrieta (Murrieta) — PPS, 111 beds, Rural
  • Sharp Chula Vista Medical Center (Chula Vista) — PPS, 349 beds, Rural
  • Providence Cedars-Sinai Tarzana Medi (Tarzana) — RRC, 204 beds, Rural
  • Ventura County Medical Center (Ventura) — PPS, 272 beds, Rural
  • Providence Lttl Co Mary Mc Torrance (Torrance) — PPS, 360 beds, Rural
  • Emanate Health Medical Center (Covina) — PPS, 481 beds, Rural
  • Northern Inyo Hospital (Bishop) — CAH, 25 beds, Rural
  • South Coast Global Medical Center (Santa Ana) — PPS, 109 beds, Rural
  • Orange County Global Medical Center (Santa Ana) — PPS, 254 beds, Rural
  • Ucsf Medical Center (San Francisco) — RRC, 887 beds, Rural
  • Chapman Global Medical Center (Orange) — PPS, 75 beds, Rural
  • Sutter Delta Medical Center (Antioch) — PPS, 119 beds, Rural
  • Encino Hospital (Encino) — PPS, 82 beds, Rural
  • St. Joseph Hospital Of Orange (Orange) — PPS, 330 beds, Rural
  • St. Johns Regional Medical Center (Oxnard) — PPS, 298 beds, Rural
  • San Dimas Community Hospital (San Dimas) — PPS, 94 beds, Rural
  • Santa Rosa Memorial Hospital (Santa Rosa) — RRC, 255 beds, Rural
  • St Rose Hospital (Hayward) — PPS, 171 beds, Rural
  • Queen Of The Valley Medical Center (Napa) — RRC, 139 beds, Rural
  • Regional Medical Center Of San Jose (San Jose) — PPS, 252 beds, Rural
  • La Palma Intercommunity Hospital (La Palma) — PPS, 115 beds, Rural
  • Tri-City Medical Center (Oceanside) — PPS, 263 beds, Rural
  • Healdsburg Hospital (Healdsburg) — CAH, 25 beds, Rural
  • Petaluma Valley Hospital (Petaluma) — PPS, 59 beds, Rural
  • Stanislaus Surgical (Modesto) — PPS, 23 beds, Rural

New York — 45 of 146 hospitals (30.8%) at risk

  • Metropolitan Hospital Center (New York) — PPS, 196 beds, Rural
  • Harlem Hospital Center (New York) — PPS, 217 beds, Rural
  • Brookdale Hospital Medical Center (Brooklyn) — PPS, 450 beds, Rural
  • Wyckoff Heights Medical Center (Brooklyn) — PPS, 240 beds, Rural
  • The Mount Vernon Hospital (Mount Vernon) — PPS, 63 beds, Rural
  • Schuyler Hospital (Montour Falls) — CAH, 25 beds, Rural
  • The Brooklyn Hospital Center (Brooklyn) — PPS, 236 beds, Rural
  • Maimonides Medical Center (Brooklyn) — RRC, 641 beds, Rural
  • Niagara Falls Memorial Medical Cente (Niagara Falls) — PPS, 133 beds, Rural
  • Mount Sinai St. Lukes Roosevelt Hosp (New York) — RRC, 644 beds, Rural
  • Erie County Medical Center (Buffalo) — RRC, 410 beds, Rural
  • Mount Sinai Hospital (New York) — PPS, 1046 beds, Rural
  • Garnet Health Medical Center - Catsk (Harris) — SCH/RRC, 76 beds, Rural
  • Sisters Of Charity Hospital (Buffalo) — RRC, 296 beds, Rural
  • Uhs Hospitals (Binghamton) — RRC, 428 beds, Rural
  • Arnot-Ogden Medical Center (Elmira) — PPS, 191 beds, Rural
  • Nathan Littauer Hospital & Nursing H (Gloversville) — MDH, 57 beds, Rural
  • St. Johns Riverside Hospital (Yonkers) — RRC, 319 beds, Rural
  • Claxton Hepburn Medical Center (Ogdensburg) — SCH, 38 beds, Rural
  • St. James Hospital (Hornell) — SCH, 15 beds, Rural
  • Carthage Area Hospital (Carthage) — CAH, 25 beds, Rural
  • Richmond University Medical Center (Staten Island) — PPS, 209 beds, Rural
  • Rochester General Hospital (Rochester) — PPS, 470 beds, Rural
  • St. Marys Healthcare (Amsterdam) — MDH, 100 beds, Rural
  • Newyork-Presbyterian/Queens (Flushing) — RRC, 480 beds, Rural
  • Rome Memorial Hospital Inc. (Rome) — PPS, 79 beds, Rural
  • Kaleida Health (Buffalo) — RRC, 954 beds, Rural
  • Good Samaritan Hospital (Suffern) — PPS, 286 beds, Rural
  • Newark Wayne Community Hospital (Newark) — MDH, 100 beds, Rural
  • Jamaica Hospital Medical Center (Jamaica) — RRC, 275 beds, Rural
  • St. Lukes Cornwall Hospital (Newburgh) — RRC, 193 beds, Rural
  • Columbia Memorial Hospital (Hudson) — RRC, 192 beds, Rural
  • Albany Medical Center Hospital (Albany) — RRC, 719 beds, Rural
  • The Unity Hospital Of Rochester (Rochester) — RRC, 283 beds, Rural
  • Bon Secours Community Hospital (Port Jervis) — PPS, 62 beds, Rural
  • Bertrand Chaffee Hospital (Springville) — PPS, 23 beds, Rural
  • Staten Island University Hospital (Staten Island) — PPS, 544 beds, Rural
  • Montefiore Nyack Hospital (Nyack) — PPS, 235 beds, Rural
  • Margaretville Hospital (Margaretville) — CAH, 15 beds, Rural
  • Mercy Medical Center (Rockville Centre) — PPS, 166 beds, Rural
  • Nassau University Medical Center (East Meadow) — PPS, 372 beds, Rural
  • Stony Brook University Hospital (Stony Brook) — RRC, 725 beds, Rural
  • New York Eye And Ear Infirmary (New York) — PPS, 12 beds, Rural
  • Clifton-Fine Hospital (Star Lake) — CAH, 20 beds, Rural
  • Cuba Memorial Hospital Inc (Cuba) — CAH, 20 beds, Rural

Illinois — 28 of 166 hospitals (16.9%) at risk

  • St. Bernard Hospital (Chicago) — PPS, 114 beds, Rural
  • Provident Hospital (Chicago) — PPS, 34 beds, Rural
  • West Suburban Hosp Med Ctr (Oak Park) — PPS, 135 beds, Rural
  • Mount Sinai Hospital Medical Center (Chicago) — PPS, 236 beds, Rural
  • Iroquois Memorial Hospital (Watseka) — CAH, 25 beds, Rural
  • Holy Cross Hospital (Chicago) — PPS, 153 beds, Rural
  • Union County Hospital District (Anna) — CAH, 25 beds, Rural
  • Insights Hospital And Medical Center (Chicago) — PPS, 72 beds, Rural
  • Ingalls Memorial Hospital (Harvey) — PPS, 165 beds, Rural
  • Advocate Southland Health Network (Chicago) — PPS, 438 beds, Rural
  • Osf Sacred Heart Medical Center (Danville) — RRC, 100 beds, Rural
  • Little Company Of Mary (Evergreen Park) — RRC, 217 beds, Rural
  • Gateway Regional (Granite City) — PPS, 288 beds, Rural
  • Thomas H Boyd Critical Acc Hospital (Carrollton) — CAH, 25 beds, Rural
  • Vista Medical Center - East (Waukegan) — PPS, 166 beds, Rural
  • Osf Saint Anthonys Health Center (Alton) — PPS, 49 beds, Rural
  • Presence Saint Francis Hospital (Evanston) — RRC, 146 beds, Rural
  • St. Johns Hospital (Springfield) — RRC, 442 beds, Rural
  • Deaconess Illinois Crossroads (Mt Vernon) — MDH, 47 beds, Rural
  • Hoopeston Community Memorial Hospita (Hoopseton) — CAH, 22 beds, Rural
  • St Marys Hospital (Decatur) — PPS, 131 beds, Rural
  • Community First Medical Center (Chicago) — PPS, 213 beds, Rural
  • Gottlieb Memorial Hospital (Melrose Park) — RRC, 135 beds, Rural
  • Presence St. Joseph Medical Center (Joliet) — PPS, 425 beds, Rural
  • Ucm Adventhealth Glenoaks (Glendale Heights) — PPS, 134 beds, Rural
  • St. Alexius Medical Center (Hoffman Estates) — RRC, 313 beds, Rural
  • Roseland Community Hospital (Chicago) — PPS, 134 beds, Rural
  • Fairfield Memorial Hospital (Fairfield) — CAH, 25 beds, Rural

Washington — 22 of 84 hospitals (26.2%) at risk

  • North Valley Hospital (Tonasket) — CAH, 18 beds, Rural
  • Mid-Valley Hospital (Omak) — CAH, 25 beds, Rural
  • Columbia Basin Hospital (Ephrata) — CAH, 25 beds, Rural
  • Toppenish Community Hospital (Toppenish) — PPS, 45 beds, Rural
  • Coulee Medical Center (Grand Coulee) — CAH, 25 beds, Rural
  • Grays Harbor Community Hospital (Aberdeen) — SCH, 49 beds, Rural
  • Providence Holy Family Hospital (Spokane) — PPS, 187 beds, Rural
  • St Clare Hospital (Lakewood) — PPS, 106 beds, Rural
  • Othello Community Hospital (Othello) — CAH, 16 beds, Rural
  • Prov Sacred Heart Medical Center (Spokane) — RRC, 633 beds, Rural
  • Trios Health (Kennewick) — PPS, 111 beds, Rural
  • Providence St Josephs Hospital (Chewelah) — CAH, 23 beds, Rural
  • Valley Hospital & Medical Center (Spokane) — PPS, 123 beds, Rural
  • St Joseph Medical Center (Tacoma) — PPS, 337 beds, Rural
  • Highline Medical Center (Seattle) — PPS, 132 beds, Rural
  • Garfield Memorial Hospital (Pomeroy) — CAH, 25 beds, Rural
  • Odessa Memorial Hospital (Odessa) — CAH, 25 beds, Rural
  • Dayton General Hospital (Dayton) — CAH, 25 beds, Rural
  • Valley Medical Center (Renton) — PPS, 328 beds, Rural
  • Multicare Auburn Medical Center (Auburn) — PPS, 91 beds, Rural
  • Good Samaritan Hospital (Puyallup) — PPS, 314 beds, Rural
  • Ferry County Memorial Hospital (Republic) — CAH, 25 beds, Rural

Louisiana — 20 of 101 hospitals (19.8%) at risk

  • Ochsner Lsu Health Monroe (Monroe) — PPS, 85 beds, Rural
  • Minden Medical Center (Minden) — RRC, 129 beds, Rural
  • North Louisiana Medical Center (Ruston) — RRC, 122 beds, Rural
  • New Orleans East Hospital (New Orleans) — PPS, 40 beds, Rural
  • Our Lady Of The Angels Hospital Mc (Bogalusa) — PPS, 36 beds, Rural
  • The General (Baton Rouge) — PPS, 169 beds, Rural
  • University Hospital & Clinics (Lafayette) — PPS, 52 beds, Rural
  • Acadian Medical Center (Eunice) — PPS, 49 beds, Rural
  • Mercy Regional Medical Center (Ville Platte) — MDH, 27 beds, Rural
  • Winn Parish Medical Center (Winnfield) — MDH, 45 beds, Rural
  • Oakdale Community Hospital (Oakdale) — MDH, 49 beds, Rural
  • Touro Infirmary (New Orleans) — PPS, 254 beds, Rural
  • West Jefferson Medical Center (Marrero) — PPS, 181 beds, Rural
  • Ochsner St. Mary (Morgan City) — SCH, 60 beds, Rural
  • Southern Regional Medical Corp (Houma) — PPS, 64 beds, Rural
  • East Jefferson General Hospial (Metairie) — PPS, 516 beds, Rural
  • Lane Regional Medical Center (Zachary) — PPS, 109 beds, Rural
  • Ochsner Lsu Health - St Mary Med Ctr (Shreveport) — PPS, 110 beds, Rural
  • West Ascension Parish Hospital (Donaldsonville) — CAH, 25 beds, Rural
  • Lallie Kemp Regional Medical Center (Independence) — CAH, 24 beds, Rural

Oklahoma — 19 of 106 hospitals (17.9%) at risk

  • Elkview General Hospital (Hobart) — SCH, 25 beds, Rural
  • Sequoyah County City Of Sallisaw Hos (Sallisaw) — PPS, 41 beds, Rural
  • Great Plains Regional Medical Center (Elk City) — SCH, 42 beds, Rural
  • Hillcrest Hospital Henryetta (Henryetta) — PPS, 15 beds, Rural
  • Hillcrest Hospital Cushing (Cushing) — MDH, 28 beds, Rural
  • Drumright Regional Hospital (Drumright) — CAH, 15 beds, Rural
  • Integris Miami Hospital (Miami) — SCH, 36 beds, Rural
  • Integris Southwest Medical Center (Oklahoma City) — PPS, 177 beds, Rural
  • Southwestern Medical Center (Lawton) — RRC, 126 beds, Rural
  • Mcalester Regional Health Center (Mcalester) — SCH/RRC, 103 beds, Rural
  • Nowata Health Center (Nowata) — CAH, 25 beds, Rural
  • Weatherford Regional Hospital (Weatherford) — CAH, 25 beds, Rural
  • Haskell Regional Hospital (Stigler) — CAH, 25 beds, Rural
  • Wagoner Hospital Authority (Wagoner) — PPS, 100 beds, Rural
  • Alliancehealth Madill (Madill) — CAH, 25 beds, Rural
  • Ssm Health St Anthony Hospital - Mid (Midwest City) — PPS, 164 beds, Rural
  • Bass Baptist Health Center (Enid) — PPS, 110 beds, Rural
  • St John Sapulpa (Sapulpa) — CAH, 25 beds, Rural
  • Integris Community Hospital (Oklahoma City) — PPS, 32 beds, Rural

Massachusetts — 15 of 55 hospitals (27.3%) at risk

  • Holyoke Medical Center (Holyoke) — PPS, 201 beds, Rural
  • Boston Medical Center (Boston) — RRC, 412 beds, Rural
  • The Mercy Hospital (Springfield) — PPS, 150 beds, Rural
  • North Adams Regional Hospital (North Adams) — PPS, 18 beds, Rural
  • Baystate Medical Center (Springfield) — RRC, 740 beds, Rural
  • Cambridge Health Alliance (Malden) — PPS, 225 beds, Rural
  • Baystate Franklin Medical Center (Greenfield) — PPS, 89 beds, Rural
  • Lawrence General Hospital (Lawrence) — RRC, 186 beds, Rural
  • Umass Memorial Medical Center (Worcester) — RRC, 700 beds, Rural
  • Tufts Medical Center (Boston) — RRC, 369 beds, Rural
  • Morton Hospital (Taunton) — PPS, 125 beds, Rural
  • North Shore Medical Center (Salem) — PPS, 281 beds, Rural
  • Baystate Wing Hospital & Medical Ctr (Palmer) — PPS, 41 beds, Rural
  • Steward Holy Family Hospital (Methuen) — RRC, 293 beds, Rural
  • Metrowest Medical Center (Natick) — RRC, 134 beds, Rural

Indiana — 13 of 115 hospitals (11.3%) at risk

  • Methodist Hospitals Inc (Gary) — PPS, 405 beds, Rural
  • Lutheran Downtown Hospital (Fort Wayne) — PPS, 32 beds, Rural
  • Eskenazi Health (Indianapolis) — RRC, 314 beds, Rural
  • Marion General Hospital (Marion) — SCH/RRC, 95 beds, Rural
  • Iu Health Jay Hospital (Portland) — CAH, 21 beds, Rural
  • Greene County General Hospital (Linton) — CAH, 25 beds, Rural
  • Daviess Community Hospital (Washington) — PPS, 36 beds, Rural
  • Harrison County Hospital (Corydon) — CAH, 25 beds, Rural
  • Clark Memorial Hospital (Jeffersonville) — PPS, 153 beds, Rural
  • Decatur Co. Memorial Hospital (Greensburg) — CAH, 25 beds, Rural
  • Iu Health Frankfort Hospital (Frankfort) — CAH, 12 beds, Rural
  • Putnam County Hospital (Greencastle) — CAH, 25 beds, Rural
  • Fairbanks Hospital (Indianapolis) — PPS, 52 beds, Rural

Oregon — 12 of 54 hospitals (22.2%) at risk

  • Three Rivers Medical Center (Grants Pass) — PPS, 126 beds, Rural
  • Mckenzie-Willamette Hospital (Springfield) — PPS, 113 beds, Rural
  • Bay Area Hospital (Coos Bay) — SCH/RRC, 144 beds, Rural
  • Adventist Medical Center-Portland (Portland) — PPS, 168 beds, Rural
  • Salem Hospital (Salem) — SCH/RRC, 537 beds, Rural
  • Willamette Valley Medical Center (Mcminnville) — PPS, 50 beds, Rural
  • Silverton Hospital (Silverton) — PPS, 29 beds, Rural
  • Samaritan Albany General Hospital (Albany) — PPS, 67 beds, Rural
  • Harney District Hospital (Burns) — CAH, 24 beds, Rural
  • Legacy Mount Hood Medical Center (Gresham) — PPS, 99 beds, Rural
  • Legacy Emanuel Hospital & Health Ctr (Portland) — PPS, 388 beds, Rural
  • Providence Willamette Falls Med Ctr (Oregon City) — PPS, 108 beds, Rural

Pennsylvania — 12 of 146 hospitals (8.2%) at risk

  • Roxborough Memorial Hospital (Philadelphia) — PPS, 48 beds, Rural
  • Upmc Mckeesport (Mckeesport) — PPS, 145 beds, Rural
  • Nazareth Hospital-Phila Pa (Philadelphia) — PPS, 132 beds, Rural
  • Mercy Catholic Medical Center (Darby) — PPS, 153 beds, Rural
  • Millcreek Community Hospital (Erie) — PPS, 124 beds, Rural
  • Highlands Hospital (Connellsville) — PPS, 61 beds, Rural
  • Upmc Mercy Hospital (Pittsburgh) — PPS, 336 beds, Rural
  • Upmc Greene (Waynesburg) — MDH, 18 beds, Rural
  • Suburban Community Hospital (Norristown) — PPS, 60 beds, Rural
  • Lower Bucks Hospital (Bristol) — PPS, 105 beds, Rural
  • Valley Forge Medical Center (Norristown) — PPS, 70 beds, Rural
  • Bucktail Medical Center (Renovo) — CAH, 16 beds, Rural

Michigan — 12 of 125 hospitals (9.6%) at risk

  • Harper- Hutzel Hospital (Detroit) — RRC, 251 beds, Rural
  • Sinai-Grace Hospital (Detroit) — RRC, 242 beds, Rural
  • Hurley Medical Center (Flint) — PPS, 362 beds, Rural
  • Ascension Borgess-Lee Hospital (Dowagiac) — CAH, 25 beds, Rural
  • Aspirus Iron River Hopsital & Clinic (Iron River) — CAH, 25 beds, Rural
  • Corewell Health Wayne (Wayne) — PPS, 99 beds, Rural
  • Hillsdale Hospital (Hillsdale) — RRC, 44 beds, Rural
  • Ascension Macomb-Oakland Hospital (Warren) — RRC, 422 beds, Rural
  • Lake Huron Medical Center (Port Huron) — PPS, 129 beds, Rural
  • Insight Surgical Hospital (Warren) — PPS, 13 beds, Rural
  • Healthsource Saginaw Inc. (Saginaw) — PPS, 7 beds, Rural
  • Corewell Health- Dearborn (Dearborn) — RRC, 498 beds, Rural

New Jersey — 12 of 59 hospitals (20.3%) at risk

  • St. Michaels Medical Center (Newark) — PPS, 110 beds, Rural
  • East Orange General Hospital (East Orange) — PPS, 157 beds, Rural
  • Palisades Medical Center (North Bergen) — PPS, 186 beds, Rural
  • Bayonne Medical Center (Bayonne) — PPS, 131 beds, Rural
  • Clara Maass Medical Center (Belleville) — PPS, 267 beds, Rural
  • Capital Health Regional Medical Ctr (Trenton) — PPS, 179 beds, Rural
  • Inspira Medical Center Vineland (Vineland) — PPS, 280 beds, Rural
  • Monmouth Medical Center Southern Cam (Lakewood) — PPS, 201 beds, Rural
  • Trinitas Hospital (Elizabeth) — PPS, 182 beds, Rural
  • Hoboken University Medical Center (Hoboken) — PPS, 114 beds, Rural
  • Robert Wood Johnson University Hospi (New Brunswick) — PPS, 625 beds, Rural
  • Newark Beth Israel Medical Center (Newark) — PPS, 419 beds, Rural

Kentucky — 11 of 88 hospitals (12.5%) at risk

  • Cumberland County Hospital (Burkesville) — CAH, 25 beds, Rural
  • Tug Valley Arh (South Williamson) — RRC, 37 beds, Rural
  • Our Lady Of The Way (Martin) — CAH, 25 beds, Rural
  • Marcum & Wallace Memorial Hospital (Irvine) — CAH, 25 beds, Rural
  • Pineville Community Health Center (Pineville) — PPS, 45 beds, Rural
  • St. Claire Medical Center (Morehead) — SCH/RRC, 100 beds, Rural
  • Jennie Stuart Medical Center (Hopkinsville) — SCH, 106 beds, Rural
  • Taylor Regional Hospital (Campbellsville) — MDH, 90 beds, Rural
  • Logan Memorial Hospital (Russellville) — MDH, 37 beds, Rural
  • Uofl Health-Shelbyville (Shelbyville) — MDH, 32 beds, Rural
  • Jane Todd Crawford Hospital (Greensburg) — CAH, 25 beds, Rural

Virginia — 10 of 78 hospitals (12.8%) at risk

  • Buchanan General Hospital (Grundy) — SCH, 111 beds, Rural
  • Twin County Regional Hospital (Galax) — SCH, 141 beds, Rural
  • Southside Community Hospital (Farmville) — SCH, 77 beds, Rural
  • Community Memorial Hospital (South Hill) — SCH, 70 beds, Rural
  • Halifax Regional Hospital (South Boston) — SCH/RRC, 44 beds, Rural
  • Carilion Tazewell Community Hospital (Tazewell) — MDH, 23 beds, Rural
  • Southern Virginia Regional Med. Ctr. (Emporia) — MDH, 39 beds, Rural
  • Vcu Health Tappahannock Hospital (Tappahannock) — SCH, 66 beds, Rural
  • Sentara Northern Virginia Med Ctr (Woodbridge) — RRC, 147 beds, Rural
  • Dickenson Community Hospital (Clintwood) — CAH, 2 beds, Rural

Connecticut — 9 of 25 hospitals (36.0%) at risk

  • Waterbury Hospital (Waterbury) — PPS, 212 beds, Rural
  • Charlotte Hungerford Hospital (Torrington) — RRC, 96 beds, Rural
  • St. Vincents Medical Center (Bridgeport) — RRC, 222 beds, Rural
  • Bridgeport Hospital (Bridgeport) — RRC, 397 beds, Rural
  • Day Kimball Hospital (Putnam) — PPS, 60 beds, Rural
  • Manchester Memorial Hospital (Manchester) — PPS, 123 beds, Rural
  • John Dempsey Hospital (Farmington) — RRC, 165 beds, Rural
  • Johnson Memorial Hospital Inc. (Stafford Springs) — PPS, 44 beds, Rural
  • Rockville General Hospital Inc. (Vernon) — PPS, 102 beds, Rural

Colorado — 9 of 81 hospitals (11.1%) at risk

  • Prowers Medical Center (Lamar) — CAH, 23 beds, Rural
  • St. Mary - Corwin Hospital (Pueblo) — PPS, 42 beds, Rural
  • Denver Health Medical Center (Denver) — RRC, 387 beds, Rural
  • St. Elizabeth Hospital (Fort Morgan) — SCH, 33 beds, Rural
  • North Colorado Medical Center (Greeley) — PPS, 182 beds, Rural
  • Platte Valley Medical Center (Brighton) — PPS, 89 beds, Rural
  • Uchealth Grandview Hospital (Colorado Springs) — PPS, 22 beds, Rural
  • Longmont United Hospital (Longmont) — PPS, 127 beds, Rural
  • St Vincent General Hospital (Leadville) — CAH, 8 beds, Rural

Missouri — 9 of 97 hospitals (9.3%) at risk

  • Texas County Memorial Hospital (Houston) — SCH, 47 beds, Rural
  • Christian Hospital Northeast (St. Louis) — RRC, 256 beds, Rural
  • Missouri Delta Medical Center (Sikeston) — SCH/RRC, 98 beds, Rural
  • Ssm Saint Louis University Hospital (St. Louis) — RRC, 382 beds, Rural
  • Research Medical Center (Kansas City) — PPS, 300 beds, Rural
  • Nevada Regional Medical Center (Nevada) — SCH, 41 beds, Rural
  • University Health Lakewood Med Ctr (Kansas City) — PPS, 117 beds, Rural
  • Missouri Baptist Sullivan Hospital (Sullivan) — CAH, 25 beds, Rural
  • Lafayette Regional Health Center (Lexington) — CAH, 25 beds, Rural

Ohio — 9 of 148 hospitals (6.1%) at risk

  • Coshocton Regional Medical Center (Coshocton) — SCH, 56 beds, Rural
  • Euclid Hospital (Euclid) — PPS, 90 beds, Rural
  • Uh Conneaut Medical Center (Conneaut) — CAH, 25 beds, Rural
  • Twin City Hospital (Dennison) — CAH, 25 beds, Rural
  • South Pointe Hospital (Warrensville Heights) — PPS, 172 beds, Rural
  • Mercy Regional Medical Center (Lorain) — PPS, 145 beds, Rural
  • Marymount Hospital (Garfield Hts.) — PPS, 188 beds, Rural
  • Mary Rutan Hospital (Bellefontaine) — SCH, 39 beds, Rural
  • Greene Memorial Hospital Inc. (Xenia) — PPS, 13 beds, Rural

West Virginia — 8 of 46 hospitals (17.4%) at risk

  • Welch Community Hospital (Welch) — SCH, 49 beds, Rural
  • Roane General Hospital (Spencer) — CAH, 25 beds, Rural
  • Summers County Arh (Hinton) — CAH, 25 beds, Rural
  • Logan Regional Medical Center (Logan) — SCH, 132 beds, Rural
  • Beckley Arh (Beckley) — MDH/RRC, 57 beds, Rural
  • Raleigh General Hospital (Beckley) — RRC, 300 beds, Rural
  • Greenbrier Valley Medical Center (Ronceverte) — SCH/RRC, 66 beds, Rural
  • Mon Health Marion Neighborhood Hospi (White Hall) — PPS, 10 beds, Rural

Arizona — 8 of 70 hospitals (11.4%) at risk

  • Exceptional Hlth Care Bullhead City (Bullhead City) — PPS, 8 beds, Rural
  • Abrazo Central Campus (Phoenix) — RRC, 149 beds, Rural
  • Valleywise Health Medical Center (Phoenix) — RRC, 298 beds, Rural
  • Tempe St. Lukes Hospital (Tempe) — RRC, 74 beds, Rural
  • Carondelet St. Marys Hospital (Tucson) — RRC, 357 beds, Rural
  • Banner Goldfield Medical Center (Apache Junction) — PPS, 20 beds, Rural
  • Mountain Vista Medical Center (Mesa) — RRC, 138 beds, Rural
  • Arizona General Hospital (Mesa) — PPS, 50 beds, Rural

New Mexico — 7 of 35 hospitals (20.0%) at risk

  • Sierra Vista Hospital (Truth Or Consequences) — CAH, 11 beds, Rural
  • Union County Gen. Hospital (Clayton) — CAH, 25 beds, Rural
  • Roosevelt General Hospital (Portales) — PPS, 12 beds, Rural
  • Covenant Health Hobbs Hospital (Hobbs) — SCH/RRC, 25 beds, Rural
  • Presbyterian Hospital (Albuquerque) — RRC, 772 beds, Rural
  • Santa Fe Medical Center (Santa Fe) — PPS, 36 beds, Rural
  • Artesia General Hospital (Artesia) — SCH, 25 beds, Rural

Minnesota — 7 of 121 hospitals (5.8%) at risk

  • Hennepin County Medical Center (Minneapolis) — PPS, 347 beds, Rural
  • Range Regional Health Services (Hibbing) — PPS, 73 beds, Rural
  • Lakewood Health System (Staples) — CAH, 25 beds, Rural
  • Mayo Clnic Hlth Sys-Albrt Lea Austin (Austin) — SCH, 79 beds, Rural
  • St. Gabriels Hospital (Little Falls) — CAH, 25 beds, Rural
  • Lakewood Health Center (Baudette) — CAH, 15 beds, Rural
  • Mahnomen Health Center (Mahnomen) — PPS, Rural

Mississippi — 6 of 86 hospitals (7.0%) at risk

  • Northwest Ms Regional Medical Ctr (Clarksdale) — SCH/RRC, 181 beds, Urban
  • Bolivar Medical Center (Cleveland) — SCH, 152 beds, Urban
  • Baptist Medical Center - Yazoo (Yazoo City) — CAH, 25 beds, Urban
  • Central Mississippi Medical Center (Jackson) — PPS, 238 beds, Urban
  • Biloxi Regional Medical Center (Biloxi) — PPS, 121 beds, Urban
  • Monroe Regional Hospital (Aberdeen) — CAH, 25 beds, Urban

Tennessee — 5 of 94 hospitals (5.3%) at risk

  • Regional One Health (Memphis) — PPS, 291 beds, Urban
  • Haywood County Community Hospital (Brownsville) — PPS, 9 beds, Urban
  • Methodist H/C Memphis Hospt. (Memphis) — PPS, 1368 beds, Urban
  • West Tn Healthcare Volunteer Hospita (Martin) — MDH, 38 beds, Urban
  • Hawkins County Memorial Hospital (Rogersville) — PPS, 6 beds, Urban

Wisconsin — 5 of 124 hospitals (4.0%) at risk

  • Ascension St. Francis Hospital (Milwaukee) — PPS, 88 beds, Urban
  • Ascension Columbia St Marys Milwauke (Milwaukee) — RRC, 374 beds, Urban
  • Wheaton Franciscan Healthcare - All (Racine) — RRC, 269 beds, Urban
  • St. Josephs Hospital (Chippewa Falls) — PPS, 102 beds, Urban
  • Ascension Wisconsin Emerus Menomonee (Menomonee Falls) — PPS, 24 beds, Urban

Maryland (see note) — 5 of 14 hospitals (35.7%) at risk

Note: Public Citizen flagged Maryland as a data outlier — 30 of 44 total hospitals had insufficient CMS financial data and were excluded. The figures above are based on the 14 hospitals for which sufficient data was available.

  • Medstar Harbor Hospital (Baltimore) — PPS, 125 beds, Rural
  • St. Agnes Hospital (Baltimore) — PPS, 190 beds, Rural
  • Good Samaritan Hospital (Baltimore) — PPS, 200 beds, Rural
  • Medstar Franklin Square Medical Ctr (Baltimore) — PPS, 357 beds, Rural
  • Medstar Southern Maryland Hospital C (Clinton) — PPS, 197 beds, Rural

Hawaii — 4 of 17 hospitals (23.5%) at risk

  • Molokai General Hospital (Kaunakakai) — CAH, 15 beds, Rural
  • Kona Community Hospital (Kealakekua) — SCH, 83 beds, Rural
  • Wahiawa General Hospital (Wahiawa) — PPS, 66 beds, Rural
  • Kau Hospital (Pahala) — CAH, 21 beds, Rural

Idaho — 4 of 43 hospitals (9.3%) at risk

  • St. Lukes Jerome Ltd (Jerome) — CAH, 16 beds, Rural
  • Cassia Regional Hospital (Burley) — CAH, 25 beds, Rural
  • St Lukes Magic Valley Reg Med Ctr (Twin Falls) — SCH/RRC, 175 beds, Rural
  • Grove Creek Medical Center (Blackfoot) — PPS, 8 beds, Rural

Nevada — 4 of 34 hospitals (11.8%) at risk

  • St. Rose Dominican - Delima (Henderson) — PPS, 10 beds, Rural
  • Humboldt General Hospital (Winnemucca) — CAH, 25 beds, Rural
  • Pershing General Hospital (Lovelock) — CAH, 13 beds, Rural
  • Grover C Dils Medical Center (Caliente) — CAH, 4 beds, Rural

Texas — 4 of 347 hospitals (1.2%) at risk

  • University Medical Center Of El Paso (El Paso) — RRC, 333 beds, Urban
  • St Joseph Medical Center (Houston) — PPS, 156 beds, Urban
  • Covenant Hospital Levelland (Levelland) — PPS, 21 beds, Urban
  • Santa Rosa Healthcare (San Antonio) — RRC, 387 beds, Urban

Alabama — 3 of 84 hospitals (3.6%) at risk

  • Hale County Hospital (Greensboro) — PPS, 28 beds, Urban
  • Grove Hill Memorial Hospital (Grove Hill) — PPS, 21 beds, Urban
  • Hill Hospital Of Sumter County (York) — PPS, 33 beds, Urban

Montana — 3 of 58 hospitals (5.2%) at risk

  • Big Horn Hospital (Hardin) — CAH, 18 beds, Rural
  • Granite County Medical Center (Philipsburg) — CAH, 25 beds, Rural
  • Garfield Co. Health Center (Jordan) — CAH, 25 beds, Rural

North Carolina — 3 of 98 hospitals (3.1%) at risk

  • S.E. Regl Medical Center (Lumberton) — SCH/RRC, 186 beds, Rural
  • Central Carolina Hospital (Sanford) — PPS, 127 beds, Rural
  • The Mcdowell Hospital (Marion) — PPS, 33 beds, Rural

Iowa — 3 of 111 hospitals (2.7%) at risk

  • Ottumwa Regional Health Center (Ottumwa) — SCH/RRC, 76 beds, Rural
  • Mercyone Oelwein Medical Center (Oelwein) — CAH, 17 beds, Rural
  • Chi Health Mercy Council Bluffs (Council Bluffs) — PPS, 141 beds, Rural

Florida — 3 of 176 hospitals (1.7%) at risk

  • Lakeside Medical Center (Belle Glade) — PPS, 70 beds, Urban
  • Homestead Hospital (Homestead) — PPS, 146 beds, Urban
  • Miami Jewish Health Systems Inc. (Miami) — PPS, 32 beds, Urban

Maine — 2 of 31 hospitals (6.5%) at risk

  • St. Marys Regional Medical Center (Lewiston) — PPS, 140 beds, Rural
  • Penobscot Bay Medical Center (Rockport) — SCH, 81 beds, Rural

Rhode Island — 2 of 10 hospitals (20.0%) at risk

  • Roger Williams Medical Center (Providence) — PPS, 148 beds, Rural
  • Our Lady Of Fatima Hospital (North Providence) — PPS, 185 beds, Rural

Alaska — 2 of 15 hospitals (13.3%) at risk

  • Ketchikan Medical Center (Ketchikan) — CAH, 25 beds, Rural
  • Fairbanks Memorial (Fairbanks) — SCH/RRC, 122 beds, Rural

Arkansas — 2 of 73 hospitals (2.7%) at risk

  • Forrest City Medical Center (Forrest City) — SCH, 48 beds, Rural
  • Baptist Health Medical Center - Vb (Van Buren) — PPS, 74 beds, Rural

Kansas — 1 of 128 hospitals (0.8%) at risk

  • Stanton County Hospital (Johnson) — CAH, 16 beds, Urban

South Carolina — 1 of 53 hospitals (1.9%) at risk

  • Prisma Health Richland Hospital (Columbia) — RRC, 603 beds, Urban

South Dakota — 1 of 55 hospitals (1.8%) at risk

  • Bennett County Hospital (Martin) — CAH, 14 beds, Rural

Vermont — 1 of 14 hospitals (7.1%) at risk

  • North Country Hospital & Health Ctr (Newport) — CAH, 25 beds, Rural

Delaware — 1 of 6 hospitals (16.7%) at risk

  • Nanticoke Memorial Hospital (Seaford) — MDH/RRC, 92 beds, Rural

Washington D.C. — 1 of 5 hospitals (20.0%) at risk

  • George Washington Univ Hospital (Washington) — PPS, 339 beds, Rural