Trump’s Beautiful Bill Puts 446 Hospitals At Risk Of Closing. Here’s The Full List

US President Donald J. Trump signs the "Big Beautiful Bill Act" at the White House in Washington, DC, on July 4, 2025. (Photo by BRENDAN SMIALOWSKI/POOL/AFP via Getty Images)POOL/AFP via Getty ImagesMost 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 which of these hospitals will close. 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. Hospitals that serve low-income communities with a high percentage of Medicaid patients rely on those payments adding up so they can stay afloat. If a Medicaid patient loses coverage and becomes uninsured, the reimbursement often drops to near zero. Despite that, hospitals are legally required under federal Emergency Medical Treatment and Active Labor Act laws to treat all patients regardless of ability to pay. MORE FOR YOUSo 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 the 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 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 Jan. 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 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, 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 million 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 HealthTrump’s law’s primary mitigation measure for hospitals is the Rural Health Transformation Program, 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 10 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 has 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 ClosuresUltimately, 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 ListNote: 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% or more 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 riskPIH Health Good Samaritan Hospital (Los Angeles) — RRC, 308 beds, RuralCoalinga Regional Medical Center (Coalinga) — CAH, 24 beds, RuralMartin Luther King Community Hospital (Los Angeles) — PPS, 152 beds, RuralPioneers Memorial Hospital (Brawley) — PPS, 107 beds, RuralMad River Community Hospital (Arcata) — PPS, 49 beds, RuralHollywood Presbyterian Medical Cntr (Los Angeles) — RRC, 317 beds, RuralSierra View Medical Center (Porterville) — PPS, 128 beds, RuralEl Centro Regional Medical Center (El Centro) — PPS, 161 beds, RuralAdventist Health Bakersfield (Bakersfield) — PPS, 254 beds, RuralEast Los Angeles Doctors Hospital (Los Angeles) — PPS, 102 beds, RuralSt. Agnes Medical Center (Fresno) — PPS, 384 beds, RuralSt. Joseph Hospital - Eureka (Eureka) — RRC, 131 beds, RuralDelano Regional Medical Center (Delano) — PPS, 105 beds, RuralAdventist Health Tulare (Tulare) — PPS, 73 beds, RuralSt. Bernardine Medical Center (San Bernardino) — RRC, 318 beds, RuralValley Presbyterian Hospital (Van Nuys) — PPS, 333 beds, RuralGreater El Monte Community Hospital (South El Monte) — PPS, 104 beds, RuralDameron Hospital (Stockton) — PPS, 170 beds, RuralMark Twain Medical Center (San Andreas) — CAH, 25 beds, RuralSt. Mary Medical Center (Long Beach) — PPS, 273 beds, RuralKaweah Delta Medical Center (Visalia) — PPS, 430 beds, RuralSaint Francis Memorial Hospital (San Francisco) — PPS, 171 beds, RuralAdventist Health And Rideout (Marysville) — SCH, 209 beds, RuralGlendale Memorial Hospital & Health Center (Glendale) — RRC, 241 beds, RuralSouthern Inyo Hospital (Lone Pine) — CAH, 4 beds, RuralPalmdale Regional Medical Center (Palmdale) — PPS, 157 beds, RuralL A Downtown Medical Center (Los Angeles) — PPS, 282 beds, RuralRedwood Memorial Hospital (Fortuna) — CAH, 19 beds, RuralSan Gorgonio Memorial (Banning) — PPS, 79 beds, RuralPacifica Hospital Of The Valley (Sun Valley) — PPS, 133 beds, RuralGarfield Medical Center (Monterey Park) — PPS, 182 beds, RuralGlenn Medical Center (Willows) — CAH, 25 beds, RuralMenifee Valley Medical Center (Sun City) — PPS, 84 beds, RuralShasta Regional Medical Center (Redding) — PPS, 118 beds, RuralAnaheim Global Medical Center (Anaheim) — PPS, 103 beds, RuralAdventist Health Glendale (Glendale) — RRC, 318 beds, RuralUC Davis Medical Center (Sacramento) — RRC, 661 beds, RuralProvidence Little Company of Mary Medical Center San Pedro (San Pedro) — PPS, 97 beds, RuralMethodist Hospital Of Sacramento (Sacramento) — PPS, 154 beds, RuralGarden Grove Hospital Medical Center (Garden Grove) — PPS, 167 beds, RuralSan Gabriel Valley Medical Center (San Gabriel) — PPS, 187 beds, RuralZuckerberg San Francisco General (San Francisco) — PPS, 284 beds, RuralRidgecrest Regional Hospital (Ridgecrest) — CAH, 25 beds, RuralProvidence St Joseph Medical Center (Burbank) — RRC, 368 beds, RuralProvidence Holy Cross Med. Center (Mission Hills) — RRC, 297 beds, RuralAnaheim Regional Medical Center (Anaheim) — PPS, 223 beds, RuralScripps Mercy Hospital (San Diego) — RRC, 550 beds, RuralWatsonville Community Hospital (Watsonville) — PPS, 106 beds, RuralBanner Lassen Medical Center (Susanville) — CAH, 25 beds, RuralCoast Plaza Hospital (Norwalk) — PPS, 117 beds, RuralAdventist Health Lodi Memorial (Lodi) — PPS, 186 beds, RuralAdventist Health Mendocino Coast (Ft. Bragg) — CAH, 25 beds, RuralSutter Solano Medical Center (Vallejo) — PPS, 106 beds, RuralLaguna Honda Hospital (San Francisco) — PPS, 6 beds, RuralCPMC - Mission Bernal Campus (San Francisco) — PPS, 120 beds, RuralAlta Bates Medical Center (Berkeley) — PPS, 315 beds, RuralHuntington Beach Hospital (Huntington Beach) — PPS, 82 beds, RuralBiggs-Gridley Memorial Hospital (Gridley) — CAH, 24 beds, RuralLoma Linda University Medical Center — Murrieta (Murrieta) — PPS, 111 beds, RuralSharp Chula Vista Medical Center (Chula Vista) — PPS, 349 beds, RuralProvidence Cedars-Sinai Tarzana Medical Center (Tarzana) — RRC, 204 beds, RuralVentura County Medical Center (Ventura) — PPS, 272 beds, RuralProvidence Little Company of Mary Medical Center Torrance (Torrance) — PPS, 360 beds, RuralEmanate Health Medical Center (Covina) — PPS, 481 beds, RuralNorthern Inyo Hospital (Bishop) — CAH, 25 beds, RuralSouth Coast Global Medical Center (Santa Ana) — PPS, 109 beds, RuralOrange County Global Medical Center (Santa Ana) — PPS, 254 beds, RuralUCSF Medical Center (San Francisco) — RRC, 887 beds, RuralChapman Global Medical Center (Orange) — PPS, 75 beds, RuralSutter Delta Medical Center (Antioch) — PPS, 119 beds, RuralEncino Hospital (Encino) — PPS, 82 beds, RuralSt. Joseph Hospital Of Orange (Orange) — PPS, 330 beds, RuralSt. Johns Regional Medical Center (Oxnard) — PPS, 298 beds, RuralSan Dimas Community Hospital (San Dimas) — PPS, 94 beds, RuralSanta Rosa Memorial Hospital (Santa Rosa) — RRC, 255 beds, RuralSt Rose Hospital (Hayward) — PPS, 171 beds, RuralQueen Of The Valley Medical Center (Napa) — RRC, 139 beds, RuralRegional Medical Center Of San Jose (San Jose) — PPS, 252 beds, RuralLa Palma Intercommunity Hospital (La Palma) — PPS, 115 beds, RuralTri-City Medical Center (Oceanside) — PPS, 263 beds, RuralHealdsburg Hospital (Healdsburg) — CAH, 25 beds, RuralPetaluma Valley Hospital (Petaluma) — PPS, 59 beds, RuralStanislaus Surgical (Modesto) — PPS, 23 beds, RuralNew York — 45 of 146 hospitals (30.8%) at riskMetropolitan Hospital Center (New York) — PPS, 196 beds, RuralHarlem Hospital Center (New York) — PPS, 217 beds, RuralBrookdale Hospital Medical Center (Brooklyn) — PPS, 450 beds, RuralWyckoff Heights Medical Center (Brooklyn) — PPS, 240 beds, RuralThe Mount Vernon Hospital (Mount Vernon) — PPS, 63 beds, RuralSchuyler Hospital (Montour Falls) — CAH, 25 beds, RuralThe Brooklyn Hospital Center (Brooklyn) — PPS, 236 beds, RuralMaimonides Medical Center (Brooklyn) — RRC, 641 beds, RuralNiagara Falls Memorial Medical Center (Niagara Falls) — PPS, 133 beds, RuralMount Sinai St. Lukes Roosevelt Hosp (New York) — RRC, 644 beds, RuralErie County Medical Center (Buffalo) — RRC, 410 beds, RuralMount Sinai Hospital (New York) — PPS, 1046 beds, RuralGarnet Health Medical Center - Catsk (Harris) — SCH/RRC, 76 beds, RuralSisters Of Charity Hospital (Buffalo) — RRC, 296 beds, RuralUHS Hospitals (Binghamton) — RRC, 428 beds, RuralArnot-Ogden Medical Center (Elmira) — PPS, 191 beds, RuralNathan Littauer Hospital & Nursing H (Gloversville) — MDH, 57 beds, RuralSt. Johns Riverside Hospital (Yonkers) — RRC, 319 beds, RuralClaxton Hepburn Medical Center (Ogdensburg) — SCH, 38 beds, RuralSt. James Hospital (Hornell) — SCH, 15 beds, RuralCarthage Area Hospital (Carthage) — CAH, 25 beds, RuralRichmond University Medical Center (Staten Island) — PPS, 209 beds, RuralRochester General Hospital (Rochester) — PPS, 470 beds, RuralSt. Marys Healthcare (Amsterdam) — MDH, 100 beds, RuralNewYork-Presbyterian/Queens (Flushing) — RRC, 480 beds, RuralRome Memorial Hospital Inc. (Rome) — PPS, 79 beds, RuralKaleida Health (Buffalo) — RRC, 954 beds, RuralGood Samaritan Hospital (Suffern) — PPS, 286 beds, RuralNewark Wayne Community Hospital (Newark) — MDH, 100 beds, RuralJamaica Hospital Medical Center (Jamaica) — RRC, 275 beds, RuralSt. Lukes Cornwall Hospital (Newburgh) — RRC, 193 beds, RuralColumbia Memorial Hospital (Hudson) — RRC, 192 beds, RuralAlbany Medical Center Hospital (Albany) — RRC, 719 beds, RuralThe Unity Hospital Of Rochester (Rochester) — RRC, 283 beds, RuralBon Secours Community Hospital (Port Jervis) — PPS, 62 beds, RuralBertrand Chaffee Hospital (Springville) — PPS, 23 beds, RuralStaten Island University Hospital (Staten Island) — PPS, 544 beds, RuralMontefiore Nyack Hospital (Nyack) — PPS, 235 beds, RuralMargaretville Hospital (Margaretville) — CAH, 15 beds, RuralMercy Medical Center (Rockville Centre) — PPS, 166 beds, RuralNassau University Medical Center (East Meadow) — PPS, 372 beds, RuralStony Brook University Hospital (Stony Brook) — RRC, 725 beds, RuralNew York Eye And Ear Infirmary (New York) — PPS, 12 beds, RuralClifton-Fine Hospital (Star Lake) — CAH, 20 beds, RuralCuba Memorial Hospital Inc (Cuba) — CAH, 20 beds, RuralIllinois — 28 of 166 hospitals (16.9%) at riskSt. Bernard Hospital (Chicago) — PPS, 114 beds, RuralProvident Hospital (Chicago) — PPS, 34 beds, RuralWest Suburban Hospital Med Center (Oak Park) — PPS, 135 beds, RuralMount Sinai Hospital Medical Center (Chicago) — PPS, 236 beds, RuralIroquois Memorial Hospital (Watseka) — CAH, 25 beds, RuralHoly Cross Hospital (Chicago) — PPS, 153 beds, RuralUnion County Hospital District (Anna) — CAH, 25 beds, RuralInsights Hospital And Medical Center (Chicago) — PPS, 72 beds, RuralIngalls Memorial Hospital (Harvey) — PPS, 165 beds, RuralAdvocate Southland Health Network (Chicago) — PPS, 438 beds, RuralOSF Sacred Heart Medical Center (Danville) — RRC, 100 beds, RuralLittle Company Of Mary (Evergreen Park) — RRC, 217 beds, RuralGateway Regional (Granite City) — PPS, 288 beds, RuralThomas H. Boyd Critical Acc Hospital (Carrollton) — CAH, 25 beds, RuralVista Medical Center - East (Waukegan) — PPS, 166 beds, RuralOSF Saint Anthonys Health Center (Alton) — PPS, 49 beds, RuralPresence Saint Francis Hospital (Evanston) — RRC, 146 beds, RuralSt. Johns Hospital (Springfield) — RRC, 442 beds, RuralDeaconess Illinois Crossroads (Mt Vernon) — MDH, 47 beds, RuralHoopeston Community Memorial Hospital (Hoopseton) — CAH, 22 beds, RuralSt. Marys Hospital (Decatur) — PPS, 131 beds, RuralCommunity First Medical Center (Chicago) — PPS, 213 beds, RuralGottlieb Memorial Hospital (Melrose Park) — RRC, 135 beds, RuralPresence St. Joseph Medical Center (Joliet) — PPS, 425 beds, RuralUChicago Medicine Adventhealth GlenOaks (Glendale Heights) — PPS, 134 beds, RuralSt. Alexius Medical Center (Hoffman Estates) — RRC, 313 beds, RuralRoseland Community Hospital (Chicago) — PPS, 134 beds, RuralFairfield Memorial Hospital (Fairfield) — CAH, 25 beds, RuralWashington — 22 of 84 hospitals (26.2%) at riskNorth Valley Hospital (Tonasket) — CAH, 18 beds, RuralMid-Valley Hospital (Omak) — CAH, 25 beds, RuralColumbia Basin Hospital (Ephrata) — CAH, 25 beds, RuralToppenish Community Hospital (Toppenish) — PPS, 45 beds, RuralCoulee Medical Center (Grand Coulee) — CAH, 25 beds, RuralGrays Harbor Community Hospital (Aberdeen) — SCH, 49 beds, RuralProvidence Holy Family Hospital (Spokane) — PPS, 187 beds, RuralSt. Clare Hospital (Lakewood) — PPS, 106 beds, RuralOthello Community Hospital (Othello) — CAH, 16 beds, RuralProvidence Sacred Heart Medical Center (Spokane) — RRC, 633 beds, RuralTrios Health (Kennewick) — PPS, 111 beds, RuralProvidence St Josephs Hospital (Chewelah) — CAH, 23 beds, RuralValley Hospital & Medical Center (Spokane) — PPS, 123 beds, RuralSt Joseph Medical Center (Tacoma) — PPS, 337 beds, RuralHighline Medical Center (Seattle) — PPS, 132 beds, RuralGarfield Memorial Hospital (Pomeroy) — CAH, 25 beds, RuralOdessa Memorial Hospital (Odessa) — CAH, 25 beds, RuralDayton General Hospital (Dayton) — CAH, 25 beds, RuralValley Medical Center (Renton) — PPS, 328 beds, RuralMulticare Auburn Medical Center (Auburn) — PPS, 91 beds, RuralGood Samaritan Hospital (Puyallup) — PPS, 314 beds, RuralFerry County Memorial Hospital (Republic) — CAH, 25 beds, RuralLouisiana — 20 of 101 hospitals (19.8%) at riskOchsner Lsu Health Monroe (Monroe) — PPS, 85 beds, RuralMinden Medical Center (Minden) — RRC, 129 beds, RuralNorth Louisiana Medical Center (Ruston) — RRC, 122 beds, RuralNew Orleans East Hospital (New Orleans) — PPS, 40 beds, RuralOur Lady Of The Angels Hospital Mc (Bogalusa) — PPS, 36 beds, RuralThe General (Baton Rouge) — PPS, 169 beds, RuralUniversity Hospital & Clinics (Lafayette) — PPS, 52 beds, RuralAcadian Medical Center (Eunice) — PPS, 49 beds, RuralMercy Regional Medical Center (Ville Platte) — MDH, 27 beds, RuralWinn Parish Medical Center (Winnfield) — MDH, 45 beds, RuralOakdale Community Hospital (Oakdale) — MDH, 49 beds, RuralTouro Infirmary (New Orleans) — PPS, 254 beds, RuralWest Jefferson Medical Center (Marrero) — PPS, 181 beds, RuralOchsner St. Mary (Morgan City) — SCH, 60 beds, RuralSouthern Regional Medical Corp (Houma) — PPS, 64 beds, RuralEast Jefferson General Hospial (Metairie) — PPS, 516 beds, RuralLane Regional Medical Center (Zachary) — PPS, 109 beds, RuralOchsner Lsu Health - St Mary Med Ctr (Shreveport) — PPS, 110 beds, RuralWest Ascension Parish Hospital (Donaldsonville) — CAH, 25 beds, RuralLallie Kemp Regional Medical Center (Independence) — CAH, 24 beds, RuralOklahoma — 19 of 106 hospitals (17.9%) at riskElkview General Hospital (Hobart) — SCH, 25 beds, RuralSequoyah County City Of Sallisaw Hos (Sallisaw) — PPS, 41 beds, RuralGreat Plains Regional Medical Center (Elk City) — SCH, 42 beds, RuralHillcrest Hospital Henryetta (Henryetta) — PPS, 15 beds, RuralHillcrest Hospital Cushing (Cushing) — MDH, 28 beds, RuralDrumright Regional Hospital (Drumright) — CAH, 15 beds, RuralIntegris Miami Hospital (Miami) — SCH, 36 beds, RuralIntegris Southwest Medical Center (Oklahoma City) — PPS, 177 beds, RuralSouthwestern Medical Center (Lawton) — RRC, 126 beds, RuralMcAlester Regional Health Center (McAlester) — SCH/RRC, 103 beds, RuralNowata Health Center (Nowata) — CAH, 25 beds, RuralWeatherford Regional Hospital (Weatherford) — CAH, 25 beds, RuralHaskell Regional Hospital (Stigler) — CAH, 25 beds, RuralWagoner Hospital Authority (Wagoner) — PPS, 100 beds, RuralAllianceHealth Madill (Madill) — CAH, 25 beds, RuralSSM Health St. Anthony Hospital - Mid (Midwest City) — PPS, 164 beds, RuralBass Baptist Health Center (Enid) — PPS, 110 beds, RuralSt John Sapulpa (Sapulpa) — CAH, 25 beds, RuralIntegris Community Hospital (Oklahoma City) — PPS, 32 beds, RuralMassachusetts — 15 of 55 hospitals (27.3%) at riskHolyoke Medical Center (Holyoke) — PPS, 201 beds, RuralBoston Medical Center (Boston) — RRC, 412 beds, RuralThe Mercy Hospital (Springfield) — PPS, 150 beds, RuralNorth Adams Regional Hospital (North Adams) — PPS, 18 beds, RuralBaystate Medical Center (Springfield) — RRC, 740 beds, RuralCambridge Health Alliance (Malden) — PPS, 225 beds, RuralBaystate Franklin Medical Center (Greenfield) — PPS, 89 beds, RuralLawrence General Hospital (Lawrence) — RRC, 186 beds, RuralUMass Memorial Medical Center (Worcester) — RRC, 700 beds, RuralTufts Medical Center (Boston) — RRC, 369 beds, RuralMorton Hospital (Taunton) — PPS, 125 beds, RuralNorth Shore Medical Center (Salem) — PPS, 281 beds, RuralBaystate Wing Hospital & Medical Center (Palmer) — PPS, 41 beds, RuralSteward Holy Family Hospital (Methuen) — RRC, 293 beds, RuralMetroWest Medical Center (Natick) — RRC, 134 beds, RuralIndiana — 13 of 115 hospitals (11.3%) at riskMethodist Hospitals Inc (Gary) — PPS, 405 beds, RuralLutheran Downtown Hospital (Fort Wayne) — PPS, 32 beds, RuralEskenazi Health (Indianapolis) — RRC, 314 beds, RuralMarion General Hospital (Marion) — SCH/RRC, 95 beds, RuralIu Health Jay Hospital (Portland) — CAH, 21 beds, RuralGreene County General Hospital (Linton) — CAH, 25 beds, RuralDaviess Community Hospital (Washington) — PPS, 36 beds, RuralHarrison County Hospital (Corydon) — CAH, 25 beds, RuralClark Memorial Hospital (Jeffersonville) — PPS, 153 beds, RuralDecatur Co. Memorial Hospital (Greensburg) — CAH, 25 beds, RuralIu Health Frankfort Hospital (Frankfort) — CAH, 12 beds, RuralPutnam County Hospital (Greencastle) — CAH, 25 beds, RuralFairbanks Hospital (Indianapolis) — PPS, 52 beds, RuralOregon — 12 of 54 hospitals (22.2%) at riskThree Rivers Medical Center (Grants Pass) — PPS, 126 beds, RuralMckenzie-Willamette Hospital (Springfield) — PPS, 113 beds, RuralBay Area Hospital (Coos Bay) — SCH/RRC, 144 beds, RuralAdventist Medical Center-Portland (Portland) — PPS, 168 beds, RuralSalem Hospital (Salem) — SCH/RRC, 537 beds, RuralWillamette Valley Medical Center (McMinnville) — PPS, 50 beds, RuralSilverton Hospital (Silverton) — PPS, 29 beds, RuralSamaritan Albany General Hospital (Albany) — PPS, 67 beds, RuralHarney District Hospital (Burns) — CAH, 24 beds, RuralLegacy Mount Hood Medical Center (Gresham) — PPS, 99 beds, RuralLegacy Emanuel Hospital & Health Ctr (Portland) — PPS, 388 beds, RuralProvidence Willamette Falls Med Ctr (Oregon City) — PPS, 108 beds, RuralPennsylvania — 12 of 146 hospitals (8.2%) at riskRoxborough Memorial Hospital (Philadelphia) — PPS, 48 beds, RuralUPMC Mckeesport (Mckeesport) — PPS, 145 beds, RuralNazareth Hospital-Philadelphia (Philadelphia) — PPS, 132 beds, RuralMercy Catholic Medical Center (Darby) — PPS, 153 beds, RuralMillcreek Community Hospital (Erie) — PPS, 124 beds, RuralHighlands Hospital (Connellsville) — PPS, 61 beds, RuralUPMC Mercy Hospital (Pittsburgh) — PPS, 336 beds, RuralUPMC Greene (Waynesburg) — MDH, 18 beds, RuralSuburban Community Hospital (Norristown) — PPS, 60 beds, RuralLower Bucks Hospital (Bristol) — PPS, 105 beds, RuralValley Forge Medical Center (Norristown) — PPS, 70 beds, RuralBucktail Medical Center (Renovo) — CAH, 16 beds, RuralMichigan — 12 of 125 hospitals (9.6%) at riskHarper- Hutzel Hospital (Detroit) — RRC, 251 beds, RuralSinai-Grace Hospital (Detroit) — RRC, 242 beds, RuralHurley Medical Center (Flint) — PPS, 362 beds, RuralAscension Borgess-Lee Hospital (Dowagiac) — CAH, 25 beds, RuralAspirus Iron River Hopsital & Clinic (Iron River) — CAH, 25 beds, RuralCorewell Health Wayne (Wayne) — PPS, 99 beds, RuralHillsdale Hospital (Hillsdale) — RRC, 44 beds, RuralAscension Macomb-Oakland Hospital (Warren) — RRC, 422 beds, RuralLake Huron Medical Center (Port Huron) — PPS, 129 beds, RuralInsight Surgical Hospital (Warren) — PPS, 13 beds, RuralHealthsource Saginaw Inc. (Saginaw) — PPS, 7 beds, RuralCorewell Health- Dearborn (Dearborn) — RRC, 498 beds, RuralNew Jersey — 12 of 59 hospitals (20.3%) at riskSt. Michaels Medical Center (Newark) — PPS, 110 beds, RuralEast Orange General Hospital (East Orange) — PPS, 157 beds, RuralPalisades Medical Center (North Bergen) — PPS, 186 beds, RuralBayonne Medical Center (Bayonne) — PPS, 131 beds, RuralClara Maass Medical Center (Belleville) — PPS, 267 beds, RuralCapital Health Regional Medical Ctr (Trenton) — PPS, 179 beds, RuralInspira Medical Center Vineland (Vineland) — PPS, 280 beds, RuralMonmouth Medical Center Southern Cam (Lakewood) — PPS, 201 beds, RuralTrinitas Hospital (Elizabeth) — PPS, 182 beds, RuralHoboken University Medical Center (Hoboken) — PPS, 114 beds, RuralRobert Wood Johnson University Hospital (New Brunswick) — PPS, 625 beds, RuralNewark Beth Israel Medical Center (Newark) — PPS, 419 beds, RuralKentucky — 11 of 88 hospitals (12.5%) at riskCumberland County Hospital (Burkesville) — CAH, 25 beds, RuralTug Valley Arh (South Williamson) — RRC, 37 beds, RuralOur Lady Of The Way (Martin) — CAH, 25 beds, RuralMarcum & Wallace Memorial Hospital (Irvine) — CAH, 25 beds, RuralPineville Community Health Center (Pineville) — PPS, 45 beds, RuralSt. Claire Medical Center (Morehead) — SCH/RRC, 100 beds, RuralJennie Stuart Medical Center (Hopkinsville) — SCH, 106 beds, RuralTaylor Regional Hospital (Campbellsville) — MDH, 90 beds, RuralLogan Memorial Hospital (Russellville) — MDH, 37 beds, RuralUofL Health-Shelbyville (Shelbyville) — MDH, 32 beds, RuralJane Todd Crawford Hospital (Greensburg) — CAH, 25 beds, RuralVirginia — 10 of 78 hospitals (12.8%) at riskBuchanan General Hospital (Grundy) — SCH, 111 beds, RuralTwin County Regional Hospital (Galax) — SCH, 141 beds, RuralSouthside Community Hospital (Farmville) — SCH, 77 beds, RuralCommunity Memorial Hospital (South Hill) — SCH, 70 beds, RuralHalifax Regional Hospital (South Boston) — SCH/RRC, 44 beds, RuralCarilion Tazewell Community Hospital (Tazewell) — MDH, 23 beds, RuralSouthern Virginia Regional Med. Ctr. (Emporia) — MDH, 39 beds, RuralVCU Health Tappahannock Hospital (Tappahannock) — SCH, 66 beds, RuralSentara Northern Virginia Med Ctr (Woodbridge) — RRC, 147 beds, RuralDickenson Community Hospital (Clintwood) — CAH, 2 beds, RuralConnecticut — 9 of 25 hospitals (36.0%) at riskWaterbury Hospital (Waterbury) — PPS, 212 beds, RuralCharlotte Hungerford Hospital (Torrington) — RRC, 96 beds, RuralSt. Vincents Medical Center (Bridgeport) — RRC, 222 beds, RuralBridgeport Hospital (Bridgeport) — RRC, 397 beds, RuralDay Kimball Hospital (Putnam) — PPS, 60 beds, RuralManchester Memorial Hospital (Manchester) — PPS, 123 beds, RuralJohn Dempsey Hospital (Farmington) — RRC, 165 beds, RuralJohnson Memorial Hospital Inc. (Stafford Springs) — PPS, 44 beds, RuralRockville General Hospital Inc. (Vernon) — PPS, 102 beds, RuralColorado — 9 of 81 hospitals (11.1%) at riskProwers Medical Center (Lamar) — CAH, 23 beds, RuralSt. Mary - Corwin Hospital (Pueblo) — PPS, 42 beds, RuralDenver Health Medical Center (Denver) — RRC, 387 beds, RuralSt. Elizabeth Hospital (Fort Morgan) — SCH, 33 beds, RuralNorth Colorado Medical Center (Greeley) — PPS, 182 beds, RuralPlatte Valley Medical Center (Brighton) — PPS, 89 beds, RuralUCHealth Grandview Hospital (Colorado Springs) — PPS, 22 beds, RuralLongmont United Hospital (Longmont) — PPS, 127 beds, RuralSt. Vincent General Hospital (Leadville) — CAH, 8 beds, RuralMissouri — 9 of 97 hospitals (9.3%) at riskTexas County Memorial Hospital (Houston) — SCH, 47 beds, RuralChristian Hospital Northeast (St. Louis) — RRC, 256 beds, RuralMissouri Delta Medical Center (Sikeston) — SCH/RRC, 98 beds, RuralSSM Saint Louis University Hospital (St. Louis) — RRC, 382 beds, RuralResearch Medical Center (Kansas City) — PPS, 300 beds, RuralNevada Regional Medical Center (Nevada) — SCH, 41 beds, RuralUniversity Health Lakewood Med Ctr (Kansas City) — PPS, 117 beds, RuralMissouri Baptist Sullivan Hospital (Sullivan) — CAH, 25 beds, RuralLafayette Regional Health Center (Lexington) — CAH, 25 beds, RuralOhio — 9 of 148 hospitals (6.1%) at riskCoshocton Regional Medical Center (Coshocton) — SCH, 56 beds, RuralEuclid Hospital (Euclid) — PPS, 90 beds, RuralUh Conneaut Medical Center (Conneaut) — CAH, 25 beds, RuralTwin City Hospital (Dennison) — CAH, 25 beds, RuralSouth Pointe Hospital (Warrensville Heights) — PPS, 172 beds, RuralMercy Regional Medical Center (Lorain) — PPS, 145 beds, RuralMarymount Hospital (Garfield Heights) — PPS, 188 beds, RuralMary Rutan Hospital (Bellefontaine) — SCH, 39 beds, RuralGreene Memorial Hospital Inc. (Xenia) — PPS, 13 beds, RuralWest Virginia — 8 of 46 hospitals (17.4%) at riskWelch Community Hospital (Welch) — SCH, 49 beds, RuralRoane General Hospital (Spencer) — CAH, 25 beds, RuralSummers County Arh (Hinton) — CAH, 25 beds, RuralLogan Regional Medical Center (Logan) — SCH, 132 beds, RuralBeckley ARH (Beckley) — MDH/RRC, 57 beds, RuralRaleigh General Hospital (Beckley) — RRC, 300 beds, RuralGreenbrier Valley Medical Center (Ronceverte) — SCH/RRC, 66 beds, RuralMon Health Marion Neighborhood Hospital (White Hall) — PPS, 10 beds, RuralArizona — 8 of 70 hospitals (11.4%) at riskExceptional Healthcare Bullhead City (Bullhead City) — PPS, 8 beds, RuralAbrazo Central Campus (Phoenix) — RRC, 149 beds, RuralValleywise Health Medical Center (Phoenix) — RRC, 298 beds, RuralTempe St. Lukes Hospital (Tempe) — RRC, 74 beds, RuralCarondelet St. Marys Hospital (Tucson) — RRC, 357 beds, RuralBanner Goldfield Medical Center (Apache Junction) — PPS, 20 beds, RuralMountain Vista Medical Center (Mesa) — RRC, 138 beds, RuralArizona General Hospital (Mesa) — PPS, 50 beds, RuralNew Mexico — 7 of 35 hospitals (20.0%) at riskSierra Vista Hospital (Truth Or Consequences) — CAH, 11 beds, RuralUnion County Gen. Hospital (Clayton) — CAH, 25 beds, RuralRoosevelt General Hospital (Portales) — PPS, 12 beds, RuralCovenant Health Hobbs Hospital (Hobbs) — SCH/RRC, 25 beds, RuralPresbyterian Hospital (Albuquerque) — RRC, 772 beds, RuralSanta Fe Medical Center (Santa Fe) — PPS, 36 beds, RuralArtesia General Hospital (Artesia) — SCH, 25 beds, RuralMinnesota — 7 of 121 hospitals (5.8%) at riskHennepin County Medical Center (Minneapolis) — PPS, 347 beds, RuralRange Regional Health Services (Hibbing) — PPS, 73 beds, RuralLakewood Health System (Staples) — CAH, 25 beds, RuralMayo Clinic Health System -Albert Lea Austin (Austin) — SCH, 79 beds, RuralSt. Gabriels Hospital (Little Falls) — CAH, 25 beds, RuralLakewood Health Center (Baudette) — CAH, 15 beds, RuralMahnomen Health Center (Mahnomen) — PPS, RuralMississippi — 6 of 86 hospitals (7.0%) at riskNorthwest Mississippi Regional Medical Center (Clarksdale) — SCH/RRC, 181 beds, UrbanBolivar Medical Center (Cleveland) — SCH, 152 beds, UrbanBaptist Medical Center - Yazoo (Yazoo City) — CAH, 25 beds, UrbanCentral Mississippi Medical Center (Jackson) — PPS, 238 beds, UrbanBiloxi Regional Medical Center (Biloxi) — PPS, 121 beds, UrbanMonroe Regional Hospital (Aberdeen) — CAH, 25 beds, UrbanTennessee — 5 of 94 hospitals (5.3%) at riskRegional One Health (Memphis) — PPS, 291 beds, UrbanHaywood County Community Hospital (Brownsville) — PPS, 9 beds, UrbanMethodist H/C Memphis Hospital (Memphis) — PPS, 1368 beds, UrbanWest Tn Healthcare Volunteer Hospital (Martin) — MDH, 38 beds, UrbanHawkins County Memorial Hospital (Rogersville) — PPS, 6 beds, UrbanWisconsin — 5 of 124 hospitals (4.0%) at riskAscension St. Francis Hospital (Milwaukee) — PPS, 88 beds, UrbanAscension Columbia St. Marys Milwaukee (Milwaukee) — RRC, 374 beds, UrbanWheaton Franciscan Healthcare - All (Racine) — RRC, 269 beds, UrbanSt. Josephs Hospital (Chippewa Falls) — PPS, 102 beds, UrbanAscension Wisconsin Emerus Menomonee (Menomonee Falls) — PPS, 24 beds, UrbanMaryland (see note) — 5 of 14 hospitals (35.7%) at riskNote: 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, RuralSt. Agnes Hospital (Baltimore) — PPS, 190 beds, RuralGood Samaritan Hospital (Baltimore) — PPS, 200 beds, RuralMedstar Franklin Square Medical Ctr (Baltimore) — PPS, 357 beds, RuralMedstar Southern Maryland Hospital C (Clinton) — PPS, 197 beds, RuralHawaii — 4 of 17 hospitals (23.5%) at riskMolokai General Hospital (Kaunakakai) — CAH, 15 beds, RuralKona Community Hospital (Kealakekua) — SCH, 83 beds, RuralWahiawa General Hospital (Wahiawa) — PPS, 66 beds, RuralKau Hospital (Pahala) — CAH, 21 beds, RuralIdaho — 4 of 43 hospitals (9.3%) at riskSt. Lukes Jerome Ltd (Jerome) — CAH, 16 beds, RuralCassia Regional Hospital (Burley) — CAH, 25 beds, RuralSt Lukes Magic Valley Reg Med Center (Twin Falls) — SCH/RRC, 175 beds, RuralGrove Creek Medical Center (Blackfoot) — PPS, 8 beds, RuralNevada — 4 of 34 hospitals (11.8%) at riskSt. Rose Dominican - Delima (Henderson) — PPS, 10 beds, RuralHumboldt General Hospital (Winnemucca) — CAH, 25 beds, RuralPershing General Hospital (Lovelock) — CAH, 13 beds, RuralGrover C. Dils Medical Center (Caliente) — CAH, 4 beds, RuralTexas — 4 of 347 hospitals (1.2%) at riskUniversity Medical Center Of El Paso (El Paso) — RRC, 333 beds, UrbanSt Joseph Medical Center (Houston) — PPS, 156 beds, UrbanCovenant Hospital Levelland (Levelland) — PPS, 21 beds, UrbanSanta Rosa Healthcare (San Antonio) — RRC, 387 beds, UrbanAlabama — 3 of 84 hospitals (3.6%) at riskHale County Hospital (Greensboro) — PPS, 28 beds, UrbanGrove Hill Memorial Hospital (Grove Hill) — PPS, 21 beds, UrbanHill Hospital Of Sumter County (York) — PPS, 33 beds, UrbanMontana — 3 of 58 hospitals (5.2%) at riskBig Horn Hospital (Hardin) — CAH, 18 beds, RuralGranite County Medical Center (Philipsburg) — CAH, 25 beds, RuralGarfield Co. Health Center (Jordan) — CAH, 25 beds, RuralNorth Carolina — 3 of 98 hospitals (3.1%) at riskS.E. Regional Medical Center (Lumberton) — SCH/RRC, 186 beds, RuralCentral Carolina Hospital (Sanford) — PPS, 127 beds, RuralThe McDowell Hospital (Marion) — PPS, 33 beds, RuralIowa — 3 of 111 hospitals (2.7%) at riskOttumwa Regional Health Center (Ottumwa) — SCH/RRC, 76 beds, RuralMercyone Oelwein Medical Center (Oelwein) — CAH, 17 beds, RuralChi Health Mercy Council Bluffs (Council Bluffs) — PPS, 141 beds, RuralFlorida — 3 of 176 hospitals (1.7%) at riskLakeside Medical Center (Belle Glade) — PPS, 70 beds, UrbanHomestead Hospital (Homestead) — PPS, 146 beds, UrbanMiami Jewish Health Systems Inc. (Miami) — PPS, 32 beds, UrbanMaine — 2 of 31 hospitals (6.5%) at riskSt. Marys Regional Medical Center (Lewiston) — PPS, 140 beds, RuralPenobscot Bay Medical Center (Rockport) — SCH, 81 beds, RuralRhode Island — 2 of 10 hospitals (20.0%) at riskRoger Williams Medical Center (Providence) — PPS, 148 beds, RuralOur Lady Of Fatima Hospital (North Providence) — PPS, 185 beds, RuralAlaska — 2 of 15 hospitals (13.3%) at riskKetchikan Medical Center (Ketchikan) — CAH, 25 beds, RuralFairbanks Memorial (Fairbanks) — SCH/RRC, 122 beds, RuralArkansas — 2 of 73 hospitals (2.7%) at riskForrest City Medical Center (Forrest City) — SCH, 48 beds, RuralBaptist Health Medical Center - Vb (Van Buren) — PPS, 74 beds, RuralKansas — 1 of 128 hospitals (0.8%) at riskStanton County Hospital (Johnson) — CAH, 16 beds, UrbanSouth Carolina — 1 of 53 hospitals (1.9%) at riskPrisma Health Richland Hospital (Columbia) — RRC, 603 beds, UrbanSouth Dakota — 1 of 55 hospitals (1.8%) at riskBennett County Hospital (Martin) — CAH, 14 beds, RuralVermont — 1 of 14 hospitals (7.1%) at riskNorth Country Hospital & Health Ctr (Newport) — CAH, 25 beds, RuralDelaware — 1 of 6 hospitals (16.7%) at riskNanticoke Memorial Hospital (Seaford) — MDH/RRC, 92 beds, RuralWashington D.C. — 1 of 5 hospitals (20.0%) at riskGeorge Washington University Hospital (Washington) — PPS, 339 beds, Rural