United States · Closures
One in seven hospitals that filed Medicare cost reports in 2011 had stopped by 2022. For most, no later report says what happened
Of 974 hospitals that stopped filing, 191 carried on under a new number, 91 of them as critical access hospitals. For 690, no later record shows a successor. Meanwhile 700 new hospitals began filing, 418 of them psychiatric or rehabilitation hospitals.
· Medicare cost reports, fiscal years 2011 to 2024
Every hospital paid by Medicare files a cost report each year under its CMS certification number. When the reports for a number stop, something changed: the hospital closed, merged into another, took a new number or stopped taking Medicare. The reports do not say which. What they can show is whether the same place kept filing under another number, or whether another hospital took over its address.
Of the 6,035 hospitals that filed for fiscal year 2011, 836, or 14%, filed no report after 2022. Counting hospitals that started later and stopped too, 974 numbers went quiet.
974 hospitals that stopped filing Medicare cost reports, 2011 to 2022
One square per hospital, by what later reports show. Hover or tap a square for its name.
Loading 974 hospitals…
Source: Medicare cost reports (HCRIS), fiscal years 2011 to 2024; Delgam's matching of later reports by address and name.
A new number, the same hospital
191 of them kept going at the same place under a new number, 150 with the same name. The most common change: 91 general hospitals that became critical access hospitals, a designation for small rural hospitals with its own number range and payment rules. Another 30 were long-term care hospitals moving from a start-up number to a permanent one. 20 are now counted as part of another hospital, and at 73 addresses a different hospital later filed.
That leaves 690, 71%, with no later report at the same place. Some closed. Others merged into a hospital in the same city whose report now covers them, which the reports cannot show, or stopped billing Medicare.
Hospitals by the fiscal year of their last cost report
The 974 that stopped by 2022, by what later reports show.
- Same place, new number
- Now part of another hospital
- Another hospital later at the address
- No later report found
Source: Medicare cost reports (HCRIS).
Long-term care hospitals went first
By type, long-term care hospitals, which care for patients who need weeks of hospital treatment, were the most likely to stop: 133 of the 443 filing in 2011. Critical access hospitals were the least likely, 53 of 1,323. For-profit hospitals stopped at 2.2 times the rate of nonprofit ones.
Share of hospitals filing in 2011 that had stopped by 2022
By type of hospital and by owner.
Source: Medicare cost reports (HCRIS). Ownership as each hospital reported it.
Where they stopped
Among states with 100 or more hospitals, the highest shares were in Texas (25%), Louisiana (22%), Pennsylvania (21%), Tennessee (21%). Texas lost 143 of its 575 hospitals, yet 576 were filing in 2024: new ones took their place.
Share of each state's 2011 hospitals that had stopped filing by 2022
All hospital types.
- Under 8%
- 8% to 12%
- 12% to 16%
- 16% to 20%
- 20% or more
Source: Medicare cost reports (HCRIS).
What opened instead
700 hospitals began filing after 2012 that do not continue an older number, and 418 of them, 60%, are psychiatric or rehabilitation hospitals. Psychiatric hospitals went from 494 to 644, rehabilitation hospitals from 228 to 388. Long-term care hospitals fell from 443 to 328.
Hospitals filing cost reports, 2011 and 2024, by type
Hollow: 2011. Filled: 2024.
- 2011
- 2024
Source: Medicare cost reports (HCRIS).
How these figures were made
- Medicare-certified hospitals in the 50 states and DC whose last cost report was for fiscal year 2022 or earlier (none for 2023 or 2024), counted by CMS Certification Number (CCN), with what later reports show about each one.
- Stopped: Last report for fiscal year 2022 or earlier: no report for 2023 or 2024.
- Same place, new number: Another CCN first files, from the year before the old number's last report to the year after, at the same street address, or in the same ZIP code or city under a near-identical name
- Now part of another hospital: A general or critical access hospital already filing, and still filing afterwards, moved its reported address to the old general hospital's; or a hospital of the same type has a near-identical name at the same address or ZIP code; or a hospital lists the old one as a campus on its fiscal year 2023 report.
- Another hospital later at the address: A new CCN first files at the same street address two or more fiscal years later, or another hospital already filing moved its reported address there afterwards (other than a general hospital taking over a general hospital's address).
- No later report found: None of the above: closed, merged without a trace in these fields, or stopped billing Medicare
- 118 hospitals whose last report is for fiscal year 2023 are not counted, because a late report may still come. Rural emergency hospitals, a type created in 2023, could not be picked out.
- The occupancy of the hospitals that kept filing: fewer hospitals, fuller beds. Rural hospitals that stayed open: critical access hospitals.
| State | Filing in 2011 | Stopped by 2022 | No later report |
|---|---|---|---|
| Alaska | 21 | 2 | 1 |
| Alabama | 126 | 24 | 21 |
| Arkansas | 101 | 8 | 5 |
| Arizona | 103 | 17 | 12 |
| California | 419 | 50 | 34 |
| Colorado | 97 | 8 | 4 |
| Connecticut | 42 | 4 | 1 |
| the District of Columbia | 13 | 1 | 1 |
| Delaware | 12 | 1 | 1 |
| Florida | 244 | 24 | 20 |
| Georgia | 175 | 29 | 26 |
| Hawaii | 26 | 0 | 0 |
| Iowa | 122 | 6 | 6 |
| Idaho | 49 | 4 | 3 |
| Illinois | 209 | 16 | 12 |
| Indiana | 164 | 23 | 18 |
| Kansas | 153 | 19 | 14 |
| Kentucky | 115 | 7 | 5 |
| Louisiana | 221 | 48 | 37 |
| Massachusetts | 109 | 16 | 15 |
| Maryland | 61 | 9 | 5 |
| Maine | 41 | 4 | 3 |
| Michigan | 169 | 20 | 12 |
| Minnesota | 144 | 10 | 8 |
| Missouri | 147 | 24 | 20 |
| Mississippi | 112 | 16 | 8 |
| Montana | 62 | 3 | 2 |
| North Carolina | 131 | 18 | 13 |
| North Dakota | 49 | 2 | 1 |
| Nebraska | 96 | 4 | 4 |
| New Hampshire | 30 | 0 | 0 |
| New Jersey | 98 | 6 | 6 |
| New Mexico | 45 | 8 | 3 |
| Nevada | 52 | 7 | 4 |
| New York | 218 | 43 | 34 |
| Ohio | 224 | 36 | 28 |
| Oklahoma | 145 | 25 | 14 |
| Oregon | 63 | 2 | 2 |
| Pennsylvania | 234 | 50 | 38 |
| Rhode Island | 15 | 1 | 1 |
| South Carolina | 82 | 13 | 9 |
| South Dakota | 60 | 6 | 3 |
| Tennessee | 145 | 31 | 23 |
| Texas | 575 | 143 | 97 |
| Utah | 54 | 4 | 2 |
| Virginia | 113 | 19 | 13 |
| Vermont | 15 | 0 | 0 |
| Washington | 99 | 5 | 5 |
| Wisconsin | 144 | 8 | 7 |
| West Virginia | 61 | 10 | 3 |
| Wyoming | 30 | 2 | 2 |