Rural health · National baseline
A third of American hospitals serve a seventh of the population
1,847 of the 5,366 hospitals CMS lists sit in nonmetro counties, which hold 13.8% of US residents. Rural facilities are therefore about 2.5 times as numerous as population alone would suggest, because distance, not density, decides where a hospital has to be. That is the arithmetic behind every rural health program, and it is rarely stated. Click any state.
| State | Hospitals | In nonmetro counties | Rural share | Critical Access | Rural population |
|---|---|---|---|---|---|
| Vermont | 17 | 15 | 88.2% | 8 | 64.9% |
| Wyoming | 30 | 25 | 83.3% | 19 | 68.7% |
| North Dakota | 47 | 37 | 78.7% | 37 | 39.8% |
| Montana | 63 | 48 | 76.2% | 50 | 44.7% |
| South Dakota | 61 | 44 | 72.1% | 39 | 50.3% |
| Nebraska | 93 | 66 | 71% | 62 | 34.6% |
| Iowa | 118 | 81 | 68.6% | 82 | 38.6% |
| Kansas | 138 | 94 | 68.1% | 82 | 29.7% |
| Mississippi | 108 | 70 | 64.8% | 29 | 50.9% |
| Maine | 36 | 22 | 61.1% | 18 | 40.2% |
| New Hampshire | 28 | 17 | 60.7% | 13 | 37% |
| New Mexico | 45 | 27 | 60% | 13 | 33.3% |
| Minnesota | 136 | 79 | 58.1% | 73 | 22.1% |
| Kentucky | 103 | 59 | 57.3% | 29 | 38.2% |
| Arkansas | 91 | 50 | 54.9% | 29 | 39.6% |
| Idaho | 48 | 26 | 54.2% | 26 | 26.5% |
| West Virginia | 55 | 28 | 50.9% | 21 | 39.2% |
| Oklahoma | 135 | 68 | 50.4% | 39 | 32.6% |
| Missouri | 121 | 52 | 43% | 35 | 24.5% |
| Wisconsin | 141 | 60 | 42.6% | 58 | 25.5% |
| Alabama | 100 | 42 | 42% | 8 | 22.3% |
| Colorado | 97 | 40 | 41.2% | 32 | 12.3% |
| Oregon | 62 | 25 | 40.3% | 25 | 15.1% |
| Utah | 52 | 20 | 38.5% | 13 | 12% |
| North Carolina | 120 | 46 | 38.3% | 20 | 21% |
| Georgia | 149 | 56 | 37.6% | 31 | 16.7% |
| Hawaii | 24 | 9 | 37.5% | 9 | 18.8% |
| Michigan | 148 | 52 | 35.1% | 35 | 16.5% |
| Tennessee | 122 | 41 | 33.6% | 15 | 21.2% |
| Illinois | 194 | 65 | 33.5% | 55 | 12.8% |
| Washington | 100 | 32 | 32% | 39 | 10.1% |
| Indiana | 151 | 48 | 31.8% | 33 | 21.9% |
| Delaware | 13 | 4 | 30.8% | 0 | 24% |
| Ohio | 196 | 56 | 28.6% | 33 | 18.1% |
| Texas | 468 | 133 | 28.4% | 93 | 9.9% |
| Virginia | 96 | 26 | 27.1% | 8 | 12.4% |
| Pennsylvania | 187 | 43 | 23% | 17 | 13.7% |
| Nevada | 46 | 10 | 21.7% | 13 | 7.4% |
| New York | 191 | 38 | 19.9% | 20 | 6.9% |
| South Carolina | 66 | 13 | 19.7% | 3 | 14.2% |
| Arizona | 107 | 17 | 15.9% | 17 | 4.7% |
| Maryland | 56 | 7 | 12.5% | 0 | 4.4% |
| Alaska | 25 | 3 | 12% | 3 | 32.6% |
| California | 378 | 32 | 8.5% | 38 | 2.2% |
| Florida | 221 | 18 | 8.1% | 12 | 3.1% |
| Massachusetts | 84 | 3 | 3.6% | 4 | 1.5% |
| Connecticut | 36 | 0 | 0% | 0 | 5.8% |
| District of Columbia | 10 | 0 | 0% | 0 | 0% |
| Louisiana | 161 | 0 | 0% | 0 | 15.9% |
| New Jersey | 79 | 0 | 0% | 0 | 0% |
| Rhode Island | 13 | 0 | 0% | 0 | 0% |
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What the map shows
- Facility count and population diverge sharply. Nonmetro counties hold 13.8% of residents but 34.4% of hospitals. A funding formula weighted purely by population will under-serve the facilities; one weighted purely by facility count will over-serve them. Both numbers belong in the same sentence.
- Critical Access is concentrated. 1,338 hospitals carry the designation nationally, led by Texas (93), Iowa (82), Kansas (82). These are the facilities with 25 beds or fewer, remote from the next hospital, and they are where a closure removes access rather than shifting it.
- Rural share is not a proxy for rural population. Vermont leads on hospital share while holding a modest rural population; Texas has many rural hospitals and a large metro population. Sorting the table by different columns makes the two measures separate visibly.
Pennsylvania: the connectivity layer
Counting hospitals says where care is. It does not say whether those hospitals can be found by the software that routes patients, records and payment. We measured that for Pennsylvania: every hospital matched against the endpoint directories certified EHR vendors publish, which reveals both digital reachability and which EHR each facility runs.
The result inverts the usual assumption. Rural hospitals are more findable than metro ones, and the apparent gaps turn out to be publishing patterns at two health systems rather than missing technology. Open the Pennsylvania dashboard.
Method and limits
Rural means the hospital's county carries USDA ERS Rural-Urban Continuum Code 4 to 9 (nonmetro) for 2023. Critical Access is the CMS facility-level designation. 239 hospitals could not be matched to a county code and are counted in each state's unmatched field rather than assigned to either group. Territories are excluded because ERS publishes no continuum code for them.
Sources: CMS Hospital General Information (data.cms.gov provider-data catalog) · USDA ERS Rural-Urban Continuum Codes 2023. Rural classification is county-level, so a metro-county hospital may still serve a rural population and the Critical Access flag is the facility-level federal designation. Generated 2026-08-05T01:45:19+00:00. Methodology 0.7.2-draft. Compute script analysis/rural_health_national.py, which costs nothing to run. Payload: /api/v1/rural-health.json.