OFFICE  OF 

INSPECTOR  GENERAL 

HOSPITAL  CLOSURE:  1989 
. 
Richard  P.  Kusserow 
INSPECTORGENERAL 
OEI-04-90-02440  EXECUTIVE  SUMMARY 
PURPOSE 
This report  describes  the phenomenon  of hospital  closure  in the United  States.  It examines  the 
characteristics  of, reasons for, and impact  of closures  in 1989. 
BACKGROUND 
The closure  of hospitals  in recent years has generated increasing  public  and congressional 
concern.  According  to a number  of recent studies, more hospitals  are expected  to close their 
doors in coming  years.  Numerous  questions  have been raised about the reasons for and the 
impact  of hospital  closure,  as well  as the implications  for public  policy. 
At the request of the Secretary  of the Department  of Health  and Human  Services, the Office  of 
Inspector  General  (OIG)  prepared  a report  in May  1989 describing  the nationwide  phenomenon 
of hospital  closure  in 1987.  The Secretary  then asked the Inspector  General  to continue  analysis 
of hospital  closure  to determine  trends and effects of the phenomenon.  A report  on 1988 hospital 
closures  was issued in April  1990. 
The findings  from  both the 1987 and 1988 studies were similar.  The hospitals  that closed were 
small and had low  occupancy  rates.  When the hospitals  closed, few patients  were affected. 
Most  could  get medical  care nearby. 
FINDINGS 
This  inspection  found  that in 1989: 
l 	 Seventy-six  general,  acute care hospitals  closed - 12 fewer  than in  1988.  They  were 
located  in 29 States.  Eleven  new hospitals  opened in 1989, and 3 of the 76 hospitals 
which  closed in  1989 have reopened  in  1990. 
l 	 Forty-three  of the closed hospitals  were rural;  33 were urban.  In relation  to their 
numbers  nationwide,  a higher  percentage  of rural  hospitals  (1.6%)  closed in  1989 
than urban hospitals  (1.2%). 
l 	 The closed hospitals  in both rural  and urban areas are significantly  smaller  than the 
national  averages.  Rural  hospitals  that closed were about half  the size of the average 
rural  hospital  nationwide.  Urban  hospitals  that closed were less than half the size of 
the average urban hospital  nationwide. 
i  l 	 No significant  difference  exists in the average Medicare  and Medicaid  utilization 
among rural  hospitals  that closed and all rural  hospitals  nationwide.  In urban  areas, 
the average Medicaid  utilization  among hospitals  that closed is higher  than the 
nationwide  average (13.5%  vs. lo%),  and the average Medicare  utilization  among 
hospitals  that closed is slightly  higher  than the nationwide  average (47.2%  vs. 44.4%). 
l 	 The reasons for hospitals  closing  in 1989 are similar  to those reported  for hospitals 
closing  in 1987 and 1988.  Hospitals  closed because of the interrelated  factors  of 
declining  occupancy,  lagging  revenues and rising  costs.  Hospital  viability  was said to 
depend on the stability  of all three factors.  The weakening  of one may begin a chain 
reaction  eventually  leading  to hospital  closure. 
l 	 Emergency  and inpatient  medical  care is available  within  20 miles for most 
communities  where  hospitals  closed. 
l 	 Forty-four  (58%)  of the closed hospital  facilities  are currently  being  used; plans are 
being made for  12 of the currently  vacant hospitals  to be used for other types of 
health care services. 
ii  TABLE  OF  CONTENTS 
EXECUTIVE  SUMMARY 

INTRODUCTION..  ....................................................................................................1 

FINDINGS  ..................................................................................................................3 

EXTENT  AND NATURE  OF HOSPITAL  CLOSURE  ..................................3 

How  Many  Closed?. ....................................................................................  .3 

Where Were They?. .....................................................................................  .3 

How  Many  Opened? ....................................................................................  . 

What Were the Closed Hospitals  Like?. ......................................................  .4 

Why  Did  They  Close?. .................................................................................  . 

IMPACT  OF HOSPITAL  CLOSURE..  ............................................................8 

How  Many  Patients Were Affected?  ...........................................................  .9 

Are  Inpatient  Care and  Emergency  Services Available?.  ........................... .9 

What Is the Building  Used For Now?.  .......................................................  11 

SUMMARY  ......................................................................................................12 

ENDNOTES.. ............................................................................................................13 

APPENDICES 

APPENDIX  A:  Methodology  ......................................................................  A - 1 

APPENDIX  B:  1989 Hospital  Closure  Tables .............................................  B-l 
 INTRODUCTION 
PURPOSE 
This report  describes  the phenomenon  of hospital  closure  in the United  States.  It examines  the 
characteristics  of, reasons for, and impact  of closures in  1989. 
This report  is a follow-up  to the recent Office  of Inspector  General  (OIG)  studies entitled 
Hospital  Closure:  1987  (OAI-04-89-00740),  issued in May  1989, and Hospital  Closure: 
1988  (OEI-04-89-01810),  issued in April  1990. 
This  study has been requested  by the Secretary of the Department  of Health  and Human  Services. 
BACKGROUND 
In the past several years, the closure  of general acute care hospitals  has generated  increasing 
public  and congressional  concern.  According  to a number  of recent studies, more hospitals  are 
expected  to close their doors in coming  years.  Numerous  questions  have been raised about the 
reasons for and the impact  of hospital  closure,  as well  as the implications  for public  policy. 
The OIG  released an inspection  in May  1989 describing  the phenomenon  of  1987 hospital 
closure  in the United  States.  That study found  that 69 hospitals  closed in  1987.  That  study was 
presented  to the Secretary of the Department  of Health  and Human  Services (HHS),  the Assistant 
Secretaries of HHS,  and staff of the Health  Care Financing  Administration  (HCFA)  and the 
Public  Health  Service  (PHS).  The Inspector  General  testified  before the U.S. House Ways and 
Means  Subcommittee  on Health  regarding  the study findings.  Many  of those informed  of the 
study of  1987 hospital  closures encouraged  the Inspector  General  to continue  analysis  of the 
phenomenon  to detect differences  in the rate of hospital  closure  and in the characteristics  and 
circumstances  of hospitals  closing  their doors. 
A similar  inspection  of 1988 hospital  closures issued in April  1990 found  that 88 hospitals 
closed.  That  study also was presented  to the Secretary, the Assistant  Secretaries,  and staff of 
HCFA  and PHS. 
The findings  from  both the 1987 and 1988 studies were  similar.  The hospitals  that closed were 
small and had low  occupancy  rates.  When  the hospitals  closed, few patients  were affected. 
Most  could  get medical  care nearby. 
page1  SCOPE 
This  study examined  hospitals  that closed in calendar  year 1989. 
For purposes of this study, the following  definitions  were used: 
Hospital:  A facility  that provides  general,  short-term,  acute medical  and surgical  inpatient 
services. 
CZosed Hospital:  One that stopped providing  general,  short-term,  acute inpatient  services 
in  1989.  If a hospital  merged with  or was sold to another  hospital  and the physical  plant 
closed for inpatient  acute care, it was considered  a closure.  If a hospital  both closed and 
reopened  in  1989, it was not considered  a closure.  If a hospital  closed in  1988, reopened 
in  1989, and closed again in  1989, it was counted  as a closure  for  1988 but not again in 
1989. 
METHODS 
Information  for this study was obtained  from  contacts with  State hospital  associations,  State 
licensing  and certification  agencies, State health planning  agencies, officials  associated with 
closed hospitals  and hospitals  nearby, and local public  officials.  Information  which  describes the 
characteristics  of the hospitals  was obtained  from  HCFA  data bases. 
Appendix  A describes information  collection  methods in further  detail. 
pai9 2  FINDINGS 

The Inspector  Generals  study of hospitals  closed in 1989 found  that: 
l 	 Seventy-six  general,  acute care hospitals  closed in 1989.  Twelve  fewer  hospitals 
closed in  1989 than in the previous  year. 
l  Size and occupancy  levels appear to be the major  factors  in hospital  viability. 
l 	 Because of the small size and low  occupancy  of hospitals  that closed, few patients 
were affected. 
l 	 Emergency  and inpatient  medical  care is available  within  20 miles for most 
communities  where  hospitals  closed. 
EXTENT  AND NATURE  OF HOSPITAL  CLOSURES 
How  many  closed? 
In  1989, there were more than 6,800 hospitals  in the United  States.  Of those, 5,396  were 
general,  short-term,  acute care hospitals  entered on HCFAs  data base as participating  in the 
Medicare  program.  Seventy-six  (76) hospitals  closed in 1989 - 1.4 percent  of all hospitals 
nationally.  Twelve  fewer  hospitals  closed in  1989 than in the previous  year. 
Hospitals in U.S.:  5,396 

Closed  in 1989:  76 (1.4%)  I 

When  they closed, the general, acute care inpatient  bed supply  was reduced  by 5,272 beds, or 0.6 
percent. 
Where  were they? 
The closed hospitals  were located  in 29 States.  The greatest number  of closures  was in Texas 
(13), followed  by Illinois  (7), Mississippi  (6), and Colorado  (5).  These four  States represented 
41 percent  of the closures.  Eleven  States had just one closure  each.  Appendix  B lists the 1989 
closures  by State. 
In relation  to their numbers  nationwide,  a higher  percentage  of rural  hospitals  closed than urban 
hospitals. 
page
3  How  many  opened? 
While  76 hospitals  closed in  1989,  11 new general, acute care hospitals  opened,  adding  744 beds 
to the national  supply  of beds. 
In addition  to the new openings  during  1989, two  hospitals  that closed prior  to 1989 reopened  in 
1989, adding  another  50 beds. 
Three of the 76 hospitals  which  closed in  1989 reopened  in  1990, adding  92 beds. 
What  Were the Closed Hospitals  Like? 
Size:  Hospitals  that closed in 1989 were small.  More  than three-quarters  had 
fewer  than 100 beds. 
SIZE  OF CLOSED  HOSPITALS 
Hospitals 
Number  of Beds 
Rural  Urban  Total  Percent 
Closed  hospitals  in both rural  and urban areas are significantly  smaller  than the national 
averages.  Rural  hospitals  that closed were about half the size of the average rural  hospital 
nationwide.  Urban  hospitals  that closed were less than half the size of the average urban hospital 
nationwide. 
page
4  HOSPITALS  THAT  CLOSED  WERE  SMALL 
#  of  beds 
300 
241.5 
250 
200 
150 
102.8 
100 
50 
0 
RURAL  HOSPITALS  URBAN  HOSPITALS 
Nattonal  Avg.  m  Closed  Hospital  Avg 
Occupancy:  Occupancy  rates for closed rural  and urban  hospitals  were  significantly 
lower  than the national  averages. 
OCCUPANCY  RATES  WERE  LOW 
80% 
69% 
70% 
60% 
50% 
40% 
30% 
20% 
10% 
0% 
RURAL 	 HOSPITALS  URBAN  HOSPITALS 
National  Avg.  m  Closed  Hospital  Avg  Medicare  and Medicaid  Utilization:  No  significant  difference  exists in the average Medi
care and Medicaid  utilization  among  rural  hospitals  that closed  and all rural  hospitals  na
tionwide.  In urban  areas, the average Medicaid  utilization  among  hospitals  that closed is 
higher  than the nationwide  average (13.5%  vs. lo%),  and the average Medicare  utilization 
among  hospitals  that closed  is slightly  higher  than the nationwide  average (47.2%  vs. 
MEDICARE  UTILIZATION 
50.2%  50.3% 
,  /  47.2% 
44  4% 
/  / 
O%JL(
RURAL  HOSPITALS  URBAN  HOSPITALS
National  Avg  m  Closed  Hospital  Avg 
MEDICAID  UTILIZATION 
60% 
N 
RURAL  HOSPITALS  URBAN  HOSPITALS 
NatIonal  Avg  m  Closed  Hospital  AW 
page
6  Why Did  They Close? 
As in the previous  1987 and 1988 hospital  closure  studies, the many health  care professionals 
interviewed  for  1989 closures reported  no single reason for hospital  closure.  Hospitals  closed in 
1987 and 1988 because of the interrelated  factors of declining  occupancy,  lagging  revenues and 
rising  costs.  Hospital  viability  was said to depend on the stability  of all three factors.  The 
weakening  of one may begin a chain reaction  eventually  leading  to hospital  closure. 
Although  the sequence and combination  of these factors  were not always  the same, generally  the 
scenario  was as follows: 
The hospitals  OCCUPANCY  begins to slide because a doctor  leaves town  or retires, or begins to 
admit  patients  to a more modern  hospital  not far away.  Also,  the Peer Review  Organization 
(PRO)  is said to be scrutinizing  admissions  more closely,  and local  physicians  are cautious  about 
admitting  patients  whose  claims  may be disallowed  later by the PRO.  Lengths  of stay are down 
because of prospective  payment  pressures and more effective  treatment  methods.  A new 
ambulatory  surgical  center has opened and is also drawing  away  some of the hospitals  surgical 
cases. 
While  occupancy  is declining,  the hospitals  COSTS  continue  to rise.  Competition  with  other 
hospitals  means that new, high  technology  equipment  is needed.  Nurses and technicians  are 
demanding  higher  salaries - and theyre  getting  them from  other hospitals  nearby.  The building 
may be deteriorating  but the hospital  hasnt  been able to fully  fund  its capital  reserves for several 
years. 
On the other hand, patient  care REVENUE  is down  because of lower  occupancy  and more 
uninsured  or inadequately  insured  patients.  For those who  do have coverage,  either public  or 
private,  insurers  are holding  down  their costs and squeezing  the hospitals  bottom  line. 
Soon the hospital  administrator  is unable to manage the situation,  and the Board  examines  its 
options:  sell the hospital;  merge with  another, more stable hospital;  or close. 
The smaller  the hospital,  the less able it is to resist this downward  spiral.  As noted earlier,  the 
average size of the 76 hospitals  that closed in 1989 was only  44 beds for rural  hospitals,  and 103 
beds for urban  hospitals.  They  are significantly  smaller than the nationwide  averages. 
Planned Closures 
Some hospital  administrations  and communities  have long realized  the possibility  of their 
hospitals  closing.  They  planned  to use the closing  as an opportunity  to reassess and improve 
community  health  care. 
page7  Three  hospitals  closed in  1989 as part of a plan to upgrade  community  hospital  care: 
l 	 In Lam-ens County,  South Carolina,  the community  decided  not to upgrade  the two 
existing  hospitals  located  12 miles  apart, but instead to build  a new hospital  in the 
County.  Bailey  Memorial  Hospital  and Laurens  District  Hospital  both closed in 
1989, and the new centrally  located Laurens  Hospital  opened. 
l 	 Wheeler  Hospital,  in Gilroy,  California  had no room  to expand and upgrade.  The 
hospital  closed after a new hospital,  South Valley  Hospital,  was constructed  3 miles 
away. 
Other  hospitals  closed  as acute care facilities  as part of a plan to better meet the needs of the 
community.  For example: 
l 	 In Meridian,  Mississippi,  Physicians  Hospital  closed as an acute care hospital,  but 
was reopened  by community  physicians  as a psychiatric  hospital  with  a chemical 
dependency  unit.  These services had been previously  unavailable  in the community. 
l 	 In Michigan  City,  Indiana,  a community  needs assessment showed  an excess of acute 
care beds but a shortage of psychiatric  inpatient  services.  Kingwood  Hospital  was 
converted  from  an acute care general hospital  to a psychiatric  hospital. 
l 	 In Darlington,  South Carolina,  the community  needed a nursing  home, but had an 
excess of acute care beds. Southland  Medical  Center was closed as an acute care 
hospital  and opened as a nursing  home. 
In a few  cases, the hospital  closed to reduce competition  with  an affiliated  hospital.  For 
example,  White  River  Medical  Center, in Batesville,  Arkansas  bought  Grays  Hospital,  only  2 
,miles away.  The hospitals  administration  saw no reason for two  hospitals  owned  by the same 
company  to compete  directly  with  each other, and closed the acute care service at Grays 
Hospital. 
IMPACT  OF HOSPITAL  CLOSURE 
In communities  where  hospitals  closed in  1989, this study assessed: 
l  the number  of patients  affected  by the closure  of the hospital; 
l 	 the availability  of inpatient  care and emergency  medical  services to communities  in 
which  hospitals  closed;  and 
l  the current  use of the closed hospital  facility. 
page8  How  Many  Patients  Were Affected? 
Few patients  were affected  by hospital  closure.  For rural  hospitals  that closed in 1989, the 
average daily  census in the year prior  to closure  was 10 patients.  The urban hospitals  had an 
average daily  census of 31 patients. 
WHEN  HOSPITALS  CLOSED, 

HOW MANY  PATIENTS  WERE  AFFECTED? 

Medicare  utilization  data were analyzed  to determine  the number  of elderly  patients  affected by 
hospital  closure  in  1989.  In rural  hospitals  that closed, five Medicare  patients  were in the 
hospital  on an average day in the year prior  to closure.  In the urban hospitals  that closed, there 
were  15 Medicare  patients. 
WHEN  HOSPITALS  CLOSED, 

HOW MANY  MEDICARE  PATIENTS  WERE  AFFECTED? 

Are  Inpatient  Care  and Emergency  Services Available? 
Availability  of inpatient  and emergency  medical  care was measured in miles from  the closed 
hospital  to the nearest inpatient  and emergency  facilities. 
Inpatient  Care:  In most communities  where  a hospital  closed in  1989, inpatient  hospital  care is 
available  nearby. 
Rural: 	 Residents  in 82 percent of the rural  communities  where  a hospital  closed  can get 
inpatient  care within  20 miles of the closed hospital. 
Residents  of only  one rural  community  must travel more than 30 miles for inpatient 
care.  Since the closure  of Sterling  County  Hospital,  residents  of Sterling  City, Texas 
must travel 40 miles for inpatient  care.  Sterling  City  has emergency  care services, 
page9  located  in the former  hospital,  to stabilize  patients  prior  to transporting  them to an 
acute care hospital. 
Urban: 	 In all but two  of the 33 urban communities  where  a hospital  closed in  1989, inpatient 
care is available  within  10 miles of the closed hospital.  Twenty-three  of the closed 
hospitals  are within  3 miles of an inpatient  hospital. 
AVAILABILITY  OF INPATIENT  CARE 
11 - 20 Miles  17 (40%)  1(3%) 
21 - 30 Miles  7 (16%)  1(3%) 
Emergency  Services:  When  a hospital  closes, the community  loses not only  inpatient  beds, but 
also emergency  services. 
Rural: 	 In all 43 cases of closed rural  hospitals,  emergency  care facilities  are available  within 
30 miles of the closed hospital. 
In eight of the 43 rural  communities  where  hospitals  closed, residents  had to travel 
more than 20 miles for emergency  care.  In those communities,  ambulance  services 
and physician  services are available. 
NEAREST  EMERGENCY  SERVICES  TO CLOSED  RURAL  HOSPITALS 
Urban: 	 In all but six urban communities  where  a hospital  closed, emergency  care facilities  are 
less than 3 miles from  the closed hospital. 
Emergency  care facilities  in five of the remaining  six communities  are within  11 miles 
from  the closed hospital.  Residents  of Granville,  New  York  must travel 23 miles for 
emergency  care.  Granville  has a health clinic,  physicians,  and ambulance  service 
available. 
page10  What Is the Building  Used For  Now? 
Forty-four  (58%)  of the closed hospital  facilities  are currently  being  used.  Three of the hospitals 
reopened  in 1990.  The other facilities,  while  ceasing to operate as acute care hospitals,  continue 
to provide  services to the community.  For example: 
l 	 Caney  Clinic  which  opened in the former  hospital  facility  in Caney,  Kansas provides 
outpatient  and 24-hour  emergency  services; 
l  Malheur  Memorial  Hospital  in Nyssa, Oregon  is now  a rural  health clinic; 
l 	 George  Ade Memorial  Hospital  in Brook,  Indiana  has been converted  to a nursing 
home;  and 
l 	 St. Josephs  Hospital  in Alton,  Illinois  now renamed  St. Clares;offers  substance 
abuse, psychiatric,  occupational  health and extended  care services as well  as radiation 
therapy  for cancer patients. 
The following  chart illustrates  the current  use of all 76 hospitals  closed in  1989. 
CURRENT  USE OF CLOSED  HOSPITALS 
Number  of Former  Hospitals* 
Current  Use of Building 
Rmml  1 Jrhsan  a 
Reopened Hospital  2  1 
Specialty Treatment  Facility 
2  4 
(e.g. chemical dependency) 
Long-Term  Care Facility  14  5 
Outpatient  Services/Clinic  9  9 
Offices  4  2 
Other  2  0 
*Duplicate count. In eight of the 76 former hospitals more than bne service is now offered. 
Plans are being  made for  12 of the currently  vacant hospitals  to be used for other types of health 
care services.  For example,  Mauritz  Hospital  in Ganado,  Texas has plans to be converted  to an 
alcohol  and drug  treatment  hospital. 
Plans are also being  made for  several of the closed facilities  to reopen  as acute care hospitals. 
page 11  SUMMARY 
Seventy-six  hospitals  closed in  1989.  Their  characteristics  were similar  to hospitals  that closed 
in  1987 and 1988.  Most  hospitals  that closed in  1989 were small and had low  occupancy.  When 
a hospital  closed, few patients  were affected.  Most  had emergency  and inpatient  medical  care 
available  within  20 miles. 
page12  ENDNOTES 

I. 	 Hospital  occupancy  rate is defined  as the actual number  of patient  days divided  by the total 
bed days available.  National  occupancy  rate is defined  as the sum of all hospitals 
occupancy  rates, divided  by the number  of hospitals. 
i3.  Average  Medicare  utilization  of closed urban and rural  hospitals  is defined  as the percent  of 
Medicare  patient  days compared  to the total patient  days for each hospital,  summed and 
divided  by the number  of hospitals.  National  average Medicare  utilization  is the percent of 
Medicare  utilization  of each hospital,  summed and divided  by the total number  of hospitals. 
Medicaid  utilization  is calculated  in the same way. 
page13  APPENDIX  A 

METHODOLOGY 
Phenomenon  of closure 
To determine  how  many  hospitals  closed in  1989, we contacted  all 50 State licensing  and 
certification  agencies.  We also contacted  State hospital  associations  and State health planning 
agencies.  When  a closed hospital  met the studys  definition  or when  there were questions,  we 
made contact  with  officials  associated with  the closed hospitals  and officials  associated with 
hospitals  nearest to the closed hospital. 
To determine  the number  of hospitals  in the United  States, we used the Hospital  Cost Report 
Information  System (HCRIS)  maintained  by the Health  Care Financing  Administration  (HCFA). 
 We included  only  the general,short-term,  acute care hospitals  under Medicares  Prospective 
Payment  System (PPS) in the universe.  There were 5,396 hospitals  listed.  This  was the current 
universe,  at the time of inquiry,  of short-term,  acute care, general hospitals  on HCRIS  for the 
fifth  year of PPS (PPS 5). 
Characteristics  of closed hospitals 
To analyze characteristics  of closed hospitals,  we used HCFAs  HCRIS  data.  Cost reports  were 
not available  for 2 of the 76 closed hospitals  because they reported  to Medicare  as part of a 
corporate  system, rather  than as an individual  hospital,  in the years prior  to closure.  For the 
remaining  74 hospitals,  we used the latest pre-closure  cost reports  containing  sufficient  data.  For 
example,  if a hospital  closed in May  1989 and its accounting  year was on a January-December 
cycle,  we used the providers  January  1, 1988 to December  31, 1988 report. 
Reasons for  hospital  closure 
We contacted  officials  of the following  organizations  to determine  the reasons for  1989 hospital 
closure: 
l  State hospital  associations; 
l  State health planning  agencies; 
l  State certification  and licensing  agencies; 
l  closed hospitals;  and 
l  nearest hospitals  to closed hospitals. 
A-l  Impact  of hospital  closure 
We limited  the impact  issues to distance from  the closed hospital  to the nearest still-operating 
hospitals  and to emergency  services.  To determine  this, we contacted  many of the following: 
l  former  hospital  administrators,  board members,  and/or  staff; 
l  hospital  administrators  and/or  staff at the nearest hospitals; 
l  local police  and health officials; 
l  local  government  officials; 
l  State health planning  agencies; 
. 
l  State certification  and licensing  agencies; and 
l  State hospital  associations. 
A-2 
 APPENDIX  B 
1989 HOSPITAL  CLOSURES 
Number  of  Number  of 
Number  of  Closures  by State  Rural  Urban 
Texas 
 13 
 10  3 

Illinois 
 7 
 2  5 

Mississippi 
 6 
 6  0 
Colorado 
 5 
 2  3 

Michigan 
 4 
 3  1 

Minnesota 
 3 
 3  0 
Nebraska 
 3  . 
 3  .O 

New  York 
 3 
 1  2 

South Carolina 
 3 
 3  0 
Arkansas 
 2 
 1  1 

California 
 2 
 0  2 

Indiana 
 2 
 2  0 
Kansas 
 2 
 1  1 

Louisiana 
 2 
 0  2 

Maine 
 2 
 1  1 

Massachusetts 
 2 
 0  2 

Oklahoma 
 2 
 1  1 

Oregon 
 2 
 2  0 
Arizona 
 1 
 0  1 

Florida 
 1 
 0  1 

Maryland 
 1 
 0  1 

New  Jersey 
 1 
 0  1 

North  Carolina 
 1 
 1  0 
Ohio 
 1 
 0  1 

Pennsylvania 
 1 
 0  1 

Rhode  Island 
 1 
 0  1 

South Dakota 
 1 
 1  0 
Tennessee 
 1 
 0  1 

Washington 
 1 
 0  1 

29 States 
 76 Closures  43 Rural  33 Urban 
B-l  1989 HOSPITAL  CLOSURES  BY NAME  AND  LOCATION 
Rural/ 
Hospital  Name  City  State  Urban 
Central  Ozarks  Medical  Center  Yellville  AR  rural 
Grays  Hospital  Batesville  AR  urban 
Scottsdale  Community  Hospital  Scottsdale  AZ  urban 
Channel  Islands  Community  Hospital  Oxnard  CA  urban 
Wheeler  Hospital  Gilroy  CA  urban 
Rocky  Mountain  Hospital  Denver  co  urban 
Doctors  Hospital  Colorado  Springs  co  urban 
AMC  Cancer Research Center  Lakewood  co  urban 
Monte  Vista Community  Hospital  Monte  Vista  co  rural 
Walsh District  Hospital  Walsh  co  rural 
AM1  Southeastern  Medical  Center  North  Miami  Beach  FL  urban 
Lutheran  General  Hospital  Park Ridge  .  IL  urban 
St. Josephs Hospital  Alton  IL  I  urban 
Mount  Sinai North  Hospital  Chicago  IL  urban 
Sheridan  Road Hospital  Chicago  IL  urban 
La Harpe Hospital  La Harpe  IL  rural 
Pearce Hospital  Eldorado  IL  rural 
Gateway  Community  Hospital  East St. Louis  IL  urban 
George Ade Memorial  Hospital  Brook  IN  rural 
Kingwood  Hospital  Michigan  City  IN  rural 
Caney Municipal  Hospital  Caney  KS  rural 
Memorial  Hospital  Corporation  of Topeka  Topeka  KS  urban 
Montelepre  Memorial  Hospital  New  Orleans  LA  urban 
Our Lady  of Lourdes  of St. Martinsville  St. Martinsville  LA  urban 
Van Buren  Community  Hospital  Van Buren  ME  rural 
Taylor  Hospital  Bangor  ME  urban 
Parkwood  Hospital  Clinton  MD  urban 
Choate Hospital  Woburn  MA  urban 
Sancta Maria  Hospital  Cambridge  MA  urban 
Redford  Community  Hospital  Redford  MI  urban 
Thorn  Hospital  Hudson  MI  rural 
Mackinac  Straits Hospital 
and Health  Center  St. Ignace  MI  rural 
Russell  Memorial  Hospital  Onaway  MI  rural 
St. Marys  Hospital  Wins ted  MN  rural 
Caledonia  Health  Care Center  Caledonia  MN  rural 
Gaylord  Community  Hospital  Gaylord  MN  rural 
Physicians  Hospital  Meridian  MS  rural 
South Washington  County  Hospital  Hollandale  MS  rural 
South Mississippi  State Hospital  Laurel  MS  rural 
Kuhn  Memorial  State Hospital  Vicksburg  MS  rural 
B-2 
 Rurull 
Hospital  Name  City  State  Urban 
Matty  Hersee Hospital  Meridian  MS  rural 
West Scott Baptist  Hospital  Morton  MS  rural 
Wakefield  Healthcare  Center  Wakefield  NE  rural 
Fritzer  Memorial  Hospital  Oxford  NE  rural 
Community  Memorial  Hospital  B urwell  NE  rural 
St. Marys  Hospital  Orange  NJ  urban 
Arnold  Gregory  Memorial  Hospital  Albion  NY  urban 
Emma Laing  Stevens Hospital  Granville  NY  urban 
Community  Hospital  Stamford  NY  rural 
Robersonville  Community  Hospital  Robersonville  NC  rural 
Wellington  Community  Hospital  Wellington  OH  urban 
Moots  Osteopathic  Hospital  Pry or  OK  rural 
City  of Faith Hospital  Tulsa  OK  urban 
Harvey  E. Rinehart  Memorial  Hospital  Wheeler  OR  rural 
Malheur  Memorial  Hospital  District  Nyssa  OR  rural 
St. Johns Health  and Hospital  Center  Pittsburgh  PA  urban 
Notre  Dame Hospital  Central  Falls  RI  urban 
Laurens  District  Hospital  Laurens  SC  rural 
Bailey  Memorial  Hospital  Clinton  SC  rural 
Southland  Medical  Center  Darlington  SC  rural 
Kingsbury  County  Memorial  Hospital  Lake Preston  SD  rural 
Northwest  General  Hospital  Knoxville  TN  urban 
St. Edward  Hospital  Cameron  TX  rural 
Seton Holy  Cross  Austin  TX  urban 
South Plains Hospital  Clinic  Amherst  TX  rural 
Hall-Bennett  Memorial  Hospital  Big  Spring  TX  rural 
Archer  County  Hospital  Archer  City  TX  rural 
Sterling  County  Hospital  Sterling  City  TX  rural 
San Saba Hospital  San Saba  TX  rural 
Menard  Hospital  Menard  TX  rural 
Newton  County  Memorial  HospitaI  Newton  TX  rural 
Leon  Memorial  Hospital  Buffalo  TX  rural 
Pioneer  Park Hospital  Irving  TX  urban 
HCA  Mansfield  Hospital  Mansfield  TX  urban 
Mauri&  Memorial  Hospital  Ganado  TX  rural 
Medical  Dental  Hospital  Seattle  WA  urban 
B-3