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Abstract

Rural hospital closings in the United States continue to be a major concern for rural development stakeholders. Numerous studies have shown that the primary cause of rural hospital closures is severe financial stress. The Federal Government, through various agencies, administers multiple programs that provide financial support for rural hospitals. The Community Facilities (CF) Program administered by USDA Rural Development is one of the major Federal programs that provides financial assistance to rural hospitals. The authors studied the impact of the CF Program on rural hospital closures. They combined program data obtained from USDA and National Establishment Time-Series data that identifies rural hospitals, the hospitals’ existence over time, closures, several hospital-related characteristics, and location information. Before conducting the statistical analysis, the authors created a synthetic experiment by matching rural hospitals that received program funding to those that did not, in terms of several hospital-level and area characteristics. The study found a statistically significant association between CF Program funding and a reduced likelihood of rural hospital closure.

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