After expansion took effect Jan. 1, 2014, more than two-thirds of rural closings occurred in the 14 states that chose not to expand. Scroll over the map for detailed state information.
Note: *Number of rural hospitals per state as of January, 2019. Data on closures through April, 2020. Based on data from the North Carolina Rural Health Research Program. *Nebraska has adopted expansion but it has not yet been implemented (scheduled to start 10/1/20). *Since Jan. 1, 2014, 99 rural hospitals have closed; 69 of the closings were in non-expansion states.