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Rural Health
Resources by Topic: Closures of healthcare facilities and services

Changes in Provision of Selected Services by Rural and Urban Hospitals between 2009 and 2017
Examines the increase in number of rural hospitals that have closed or converted to a model eliminating inpatient care, as well as rural hospitals that have reduced or terminated historically essential services including obstetrics, surgery, long-term care, home health, and oncology. Features statistics on numbers of various types of healthcare services offered in hospitals in 2009 and in 2017, with breakdowns by urban and rural location.
Author(s): Kathleen Knocke, George H. Pink, Kristie W. Thompson, Randy K. Randolph, Mark Holmes
Date: 04/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural and Urban Hospital Characteristics by Obstetric Service Provision Status, 2010-2018
Illustrates the differences between urban and rural hospitals providing obstetric (OB) services. Compares them by size, capacity, location, and community characteristics, and compares these factors between rural hospitals with OB units and those that had discontinued services during the study period. Features statistics with breakdowns by urban and rural location.
Additional links: Characteristics of Rural and Urban U.S. Hospitals Based on Obstetric Services
Author(s): Julia D. Interrante, Lindsay K. Admon, Mariana S. Tuttle, Bridget Basile Ibrahim, Katy B. Kozhimannil
Date: 04/2021
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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States Work to Support Rural Hospitals Despite Pandemic Challenges
Blog post highlighting state-level policies to address and prevent rural hospital closures. Discusses proposals in state legislatures regarding alternative payment methodologies and funding, service delivery models, and the recruitment and retention of a rural healthcare workforce.
Author(s): Beth Giambrone
Date: 04/2021
Type: Document
Sponsoring organization: Association of State and Territorial Health Officials
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Rural Obstetric Unit Closures and Maternal and Infant Health
Policy paper examining the discontinuation of obstetric services in rural communities. Discusses factors contributing to obstetric unit closures, including hospital financial constraints, Medicaid reimbursement rates, and maternal health workforce concerns. Offers policy recommendations to prevent additional obstetric unit closures in rural areas.
Author(s): Lindsay Corcoran, Catherine Clary, Sarah Brinkman
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Trends in Nursing Home Closures in Nonmetropolitan and Metropolitan Counties in the United States, 2008-2018
Policy brief documenting closures of facilities dually certified by Medicare and Medicaid or facilities certified by Medicaid only. Identifies areas lacking nursing homes and summarizes characteristics of open and closed nursing homes. Features statistics with breakdowns by metropolitan and nonmetropolitan areas, and county-level maps showing areas with one or more nursing home closures from 2008-2018 and counties considered nursing home deserts.
Author(s): Hari Sharma, Redwan Bin Abdul Baten, Fred Ullrich, A. Clinton MacKinney, Keith J. Mueller
Date: 02/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Quantifying the Impact of Policy on the Rural Health Safety Net
Examines the vulnerability of 453 rural hospitals based on financial and operational metrics. Includes Crises Collide: The COVID-19 Pandemic and the Stability of the Rural Health Safety Net and presentation slides on this report from the 2021 National Rural Health Association Policy Institute. Provides national and state data tables showing the financial impact of federal policies on rural hospitals.
Date: 02/2021
Type: Website
Sponsoring organizations: Chartis Center for Rural Health, iVantage Health Analytics
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Alternatives to Hospital Closure: Findings from a National Survey of CAH Executives
Discusses factors leading to rural hospital closures and alternatives to closure to maintain access to healthcare in rural areas and/or Critical Access Hospital (CAH) viability. Presents data from a survey of 227 CAH CEOs and other management staff, discussing their responses to a list of alternatives to hospital closure, including Rural Health Clinic (RHC) certification, conversion to emergency or urgent care services, Federally Qualified Health Center (FQHC) certification, and other alternatives.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Oklahoma Rural Hospital Closures by the Numbers
Research brief discussing rural hospital closures in Oklahoma and impacts of closures on access to care. Presents data on closures between 2005 and 2020, noting driving distance to the nearest open hospital. Addresses demographic characteristics of counties with closed hospitals and health equity impacts of closures.
Date: 01/2021
Type: Document
Sponsoring organization: Oklahoma State University Center for Rural Health
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FQHC Roles and Opportunities Related to Rural Hospital Financial Distress and Closure
Explores the experiences of Federally Qualified Health Centers (FQHC) regarding hospital financial distress, downsizing, and closure. Summarizes the results of a survey of 34 FQHCs operating 277 sites in rural communities. Discusses the potential for collaboration between rural hospitals and FQHCs.
Date: 2021
Type: Document
Sponsoring organization: Capital Link
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Rural Hospital Closures: Affected Residents Had Reduced Access to Health Care Services
Examines the effects of rural hospital closures on rural residents. Discusses the distance residents in the service areas of closed facilities had to travel to access common healthcare services between 2012 and 2018, as well as the availability of providers over time. Compares the health status of Medicare beneficiaries in services areas with and without hospital closures.
Additional links: Full Report
Date: 12/2020
Type: Document
Sponsoring organization: Government Accountability Office
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