United States · Space

Hospitals added 19% more floor space from 2011 to 2024, and 3% more beds

In 2,155 general hospitals that reported every year, the building around each bed grew from 2,392 square feet to 2,756. Clinics, emergency rooms and intensive care grew fastest. Discharges barely moved; staff grew 19%.

Oct. 20, 2026· Medicare cost reports, fiscal years 2011 to 2024

Every hospital that bills Medicare files a cost report each year, and one worksheet in it lists the floor space of every department. Follow the same 2,155 general hospitals through all fourteen years from 2011 to 2024 and a pattern stands out: the buildings kept growing, the number of beds inside them barely changed, and the number of patients going home from them barely moved.

Together these hospitals had 1.09 billion square feet in 2011 and 1.30 billion in 2024, an average of 97,295 square feet more for each hospital. The whole building of the typical rural critical access hospital is 70,030 square feet.

Change since 2011, same 2,155 hospitals

Source: Medicare cost reports (HCRIS), Worksheets B-1 and S-3. General hospitals with a usable report in every year.

Floor space grew 19%.

The blue line is the total floor space of the 2,155 hospitals, as a change from 2011. It rose nearly every year, through the pandemic and after it.

Beds grew 3%.

The black line is beds: 457,649 in 2011, 473,314 in 2024. The beds a cost report counts are the ones set up and staffed for patients, not the larger number on a state license.

Patients discharged: +1%. Days in a bed: +11%.

The grey lines are patients, at the 1,915 hospitals whose counts are steady from year to year. About as many left these hospitals in 2024 as in 2011, but they stayed longer, so the days spent in a bed rose. Discharges dropped in 2020, when hospitals put off scheduled care; days in a bed jumped in 2021 and stayed up. On occupancy, that shows.

Staff grew 19%, about as fast as the building.

The orange line is employees, counted as full-time equivalents: 2.44 million in 2011, 2.91 million in 2024, at the 1,834 hospitals whose staff counts are steady.

Each bed now comes with 2,756 square feet of building, up from 2,392.

More space, more staff and about the same number of beds and patients. The rest of this page shows where the space went. How much building a bed comes with also differs widely from state to state.

Where the new space went

The cost report splits a hospital into departments. Outpatient clinics grew fastest, by 81%, followed by cardiac catheterization (43%) and recovery (39%). The emergency department grew 39% and intensive care 32%. Administration grew 3%.

Growth in floor space by department, 2011 to 2024

Departments that grew faster than the building as a whole (19%) are in blue. Same 2,155 hospitals.

Outpatient clinics +81%+28.1M sq ft

Cardiac catheterization +43%+3.5M sq ft

Recovery +39%+3.0M sq ft

Emergency department +39%+14.0M sq ft

Intensive care +32%+12.9M sq ft

Radiation therapy +31%+2.6M sq ft

Building operation and maintenance +27%+50.0M sq ft

Operating rooms +26%+18.3M sq ft

General inpatient rooms +19%+31.6M sq ft

Physicians' offices +16%+4.6M sq ft

Imaging (X-ray, CT, MRI, nuclear) +13%+6.7M sq ft

Labor and delivery +13%+2.1M sq ft

Laboratory +10%+2.2M sq ft

Kitchen and cafeteria +8%+2.3M sq ft

Psychiatric and rehabilitation units +4%+0.8M sq ft

Administration +3%+4.5M sq ft

Skilled nursing units −30%−1.7M sq ft

Source: Medicare cost reports, Worksheet B-1. Imaging combines diagnostic radiology, CT, MRI and nuclear medicine, because hospitals move space between those lines.

Patient rooms grew too, though not because there are more of them. The space in inpatient units, from general rooms to intensive care, grew from 524 square feet per bed to 599: each bed has more room around it.

The added space, counted out

All told the hospitals added 210 million square feet. The largest share went to support space: building operation and maintenance alone grew by 50 million square feet. The second largest went to outpatient care, which a decade ago was a small part of a hospital.

210 million square feet added, 2011 to 2024, by kind of space

Each square is 2 million square feet. The six groups are the cost report's own.

= 2 million square feet

Support and overhead +61 million sq ft administration, building operation, housekeeping, kitchen, records

Outpatient +46 million sq ft clinics, emergency department, observation beds

Diagnosis and treatment +45 million sq ft surgery, imaging, laboratory, therapy, pharmacy supplies

Patient rooms +44 million sq ft general, intensive care, psychiatric and other units, nursery

Not billed as patient care +14 million sq ft physicians' offices, research, gift shops

Other services −0 million sq ft home health, hospice, ambulance and the like

Source: Medicare cost reports, Worksheet B-1, the same 2,155 general hospitals.

How these figures were made

General (short-term acute) hospitals with a usable Medicare cost report in every fiscal year from 2011 to 2024: 2,155 hospitals. Hospitals that opened, closed or filed an unusable report in any year are left out, so the change is not a matter of which hospitals happen to be counted.
A report is usable when its square feet passed the database's checks and its bed count agrees with its bed-days. Some reports put patient days in the beds field; one counts six million beds.
Discharges, patient days and staff are not checked by those tests, and a few reports carry hours or misplaced figures (one hospital reports 1.4 million staff in a year). Their lines use the hospitals whose figures never jump by more than 60% from one year to the next, and, for staff, between 0.5 and 30 per bed: 1,915 hospitals for patients, 1,834 for staff. Discharges and patient days are scaled to a full year when a report covers part of one.
Square feet are what each hospital reports for spreading its building costs. For the national picture in one year, see the benchmark; for what that space costs, see construction cost and operating cost. Sources and checks: methods.

Totals for the same 2,155 hospitals by year
Year	Floor space	Beds	Patients discharged	Patient days	Staff (full-time equivalent)
2011	1,094,557,957	457,649	22,068,450	102,138,374	2,444,784
2012	1,111,196,637	458,253	21,795,594	101,163,703	2,460,403
2013	1,126,520,135	458,777	21,377,880	100,034,913	2,466,559
2014	1,144,831,040	459,383	21,327,629	101,225,537	2,484,231
2015	1,169,471,410	459,678	21,560,653	102,573,831	2,546,193
2016	1,177,461,354	460,935	21,667,024	102,777,352	2,601,304
2017	1,193,679,857	462,972	21,867,482	103,151,145	2,632,255
2018	1,212,729,586	463,560	21,894,300	104,076,503	2,666,486
2019	1,232,932,641	465,727	21,516,497	103,405,641	2,694,696
2020	1,250,925,679	469,982	20,329,006	103,317,070	2,667,212
2021	1,264,973,159	471,349	20,891,687	110,651,163	2,680,195
2022	1,273,510,675	470,968	20,883,038	109,856,427	2,704,512
2023	1,291,137,679	471,767	21,647,942	110,323,651	2,800,926
2024	1,304,227,957	473,314	22,395,190	113,162,577	2,907,947

Floor space by department
Department	2011	2024	Change
Outpatient clinics	34,509,399	62,620,453	+81%
Cardiac catheterization	8,063,219	11,522,097	+43%
Recovery	7,628,321	10,632,881	+39%
Emergency department	36,222,272	50,208,849	+39%
Intensive care	40,179,465	53,037,708	+32%
Radiation therapy	8,557,833	11,173,560	+31%
Building operation and maintenance	181,948,211	231,947,017	+27%
Operating rooms	70,817,609	89,153,192	+26%
General inpatient rooms	169,458,279	201,080,100	+19%
Physicians' offices	27,935,818	32,511,788	+16%
Imaging (X-ray, CT, MRI, nuclear)	51,385,599	58,100,343	+13%
Labor and delivery	16,814,668	18,958,868	+13%
Laboratory	23,162,409	25,382,809	+10%
Kitchen and cafeteria	30,369,270	32,710,206	+8%
Psychiatric and rehabilitation units	18,640,769	19,451,265	+4%
Administration	137,461,722	141,963,333	+3%
Skilled nursing units	5,794,763	4,074,810	−30%