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

Place and Population Matter in General Surgeon Location and Practice Structure
Examines ways in which population changes over time in different geographical regions of the United States have affected the availability of general surgeons and quality of care. Explores the implications of hospital mergers on the viability of rural hospitals.
Author(s): Thomas C. Ricketts
Citation: JAMA Network Open, 4(4)
Date: 04/2021
Type: Document
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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 the number of hospitals offering various types of healthcare services 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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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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Will Community Health Centers Survive COVID-19?
Evaluates the financial vulnerability of rural Federally Qualified Health Centers (FQHCs) during the COVID-19 pandemic. Discusses the importance of FQHCs to rural and underserved communities and makes suggestions to fortify FQHC revenue.
Author(s): Brad Wright, Erin Fraher, Marni Gwyther Holder, et al.
Citation: Journal of Rural Health, 37(1), 235-238
Date: 01/2021
Type: Document
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Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana
Results of a study exploring whether living in a county with no hospital offering obstetric care and no OB/GYN or certified nurse midwife providers was associated with risk of death during pregnancy and up to 1 year postpartum among women in Louisiana from 2016–2017. Features demographics, county-level maps showing level of access to maternity care, and statistics
Author(s): Maeve Wallace, Lauren Dyer, Erica Felker-Kantor, et al.
Citation: Women's Health Issues, 31(2), 122-129
Date: 2021
Type: Document
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