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Rural Hospital Programs

Rural hospitals represent more than half of all hospitals in the United States, providing essential access to inpatient, outpatient, and emergency medical services in rural communities. FORHP provides technical assistance and support to address the unique needs of rural hospitals through the following programs. Learn more about the Hospital State Division at FORHP (PDF - 73 KB).

State Offices of Rural Health Program (SORH)

Medicare Rural Hospital Flexibility Program Evaluation

Medicare Rural Hospital Flexibility Grant (Flex)

Small Rural Hospital Improvement Program (SHIP)

Rural Quality Improvement Technical Assistance Cooperative Agreement

Rural Healthcare Provider Transition Project (RHPTP)

Rural Veterans Health Access Program (RVHAP)

Vulnerable Rural Hospitals Assistance Program (VRHAP)

Delta Region Community Health Systems Development (DRCHSD)

Hospital Closures

Between January 2010 and January 2019, 95 rural hospitals closed, 32 of which were Critical Access Hospitals. Events such as these have caused rural hospitals to receive increased attention from policy makers, advocates, and the media.

FORHP evaluates the impact of rural hospital closures. Working with external partners, FORHP identifies actual and planned closures from direct reports and the media, which provides real-time monitoring of closures exit disclaimer not possible from administrative data files.

FOHRP grantees, the State Offices of Rural Health, and State Flex Programs have worked with communities to assess the impact of hospital closures. In recent years, the FORHP-funded Rural Health Research Gateway HRSA Exit Disclaimer published the following research:

The National Organization of State Offices of Rural Health developed the State Office of Rural Health Roadmap for Working with Vulnerable Hospitals exit disclaimer (October 2016) to identify tools and resources to help SORHs and communities deal with closures.

Resources for Hospitals

Technical Assistance and Services Center exit disclaimer receives a cooperative agreement from FORHP to develop resources and provide trainings to assist with CAH quality financial and operational improvement; population health; and emergency medical service activities. The center website houses toolkits, webinars and other resources on these topics.

The Flex Monitoring Team exit disclaimer is supported by a cooperative agreement to analyze data from CAHs and evaluate the impact of Medicare Rural Hospital Flexibility investments. Data and reports specific to CAH quality, finance, and community health topics are available on the website. CAH managers can request a password to access CAHMPAS, the Critical Access Hospital Measurement and Performance Assessment System, to compare their hospital’s performance on numerous quality and financial indicators with other CAHs in the state and around the country.

Date Last Reviewed:  November 2020

Project Officers for Rural Hospital Programs

U.S. map showing regions

Additional Resources

Guide for Rural Health Care Collaboration and Coordination (2019) (PDF - 2 MB) This Guide describes how rural hospitals, community health centers, local public health departments, and other rural stakeholders can work together to assess and address their rural communities’ health needs.

North Carolina Rural Health Research and Policy Analysis Center exit disclaimer maintains a publicly available map for tracking and counting rural hospital closures.

For more information about services and population characteristics of rural hospitals, review The 21 Century Rural Hospital Chartbook exit disclaimer (PDF - 3.8 MB).

Please share information regarding hospital closures with the research center at