Department of Health and Human Services 
OFFICE OF 
INSPECTOR GENERAL 
HOSPITAL CLOSURE: 1999 
MARCH 2001 
OEI-04-01-00020  OFFICE OF INSPECTOR GENERAL 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as 
amended by Public Law 100-504, is to protect the integrity of the Department of Health and Human 
Services programs as well as the health and welfare of beneficiaries served by them. This statutory 
mission is carried out through a nationwide program of audits, investigations, inspections, sanctions, and 
fraud alerts. The Inspector General informs the Secretary of program and management problems and 
recommends legislative, regulatory, and operational approaches to correct them. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) is one of several components of the Office of Inspector 
General. It conducts short-term management and program evaluations (called inspections) that focus 
on issues of concern to the Department, the Congress, and the public.  The inspection reports provide 
findings and recommendations on the efficiency, vulnerability, and effectiveness of departmental 
programs. 
OEI's Atlanta Regional Office prepared this report under the direction of Jesse J. Flowers, Regional 
Inspector General, and Christopher H. Koehler, Deputy Regional Inspector General.  Principal OEI 
staff included: 
Kristy Williams, Program Analyst 
Tricia Davis, Program Specialist 
Scott Horning, Program Analyst 
Linda Moscoe, Program Analyst 
Graham Rawsthorn, Team Leader 
To obtain copies of this report, please call the Atlanta Regional Office at 404-562-7723.  Reports are 
also available on the World Wide Web at our home page address: 
http://www.dhhs.gov/progorg/oei  TABLE  OF  CONTENTS 
PAGE

EXECUTIVE SUMMARY  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1

INTRODUCTION  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  4

FINDINGS

Extent and Characteristics of Closed Hospitals .................................6

How Many Closed .................................................6

The Effect on Bed Supply  ...........................................6

Where They Were  .................................................7

What They Were Like  ..............................................7

Reasons for Hospital Closure .............................................. 11

Impact of Hospital Closure  ...............................................11

How Many Patients Were Affected ...................................11

What Inpatient Care and Emergency Services Are Available ............... 12

What the Building Is Used for Now ................................... 14

APPENDICES 
A. Methodology ........................................................15

B. Number of Hospital Closures by State ....................................16

C. Hospital Closures by Hospital Name and Location ..........................17

D. Hospital Openings by Hospital Name and Location  .........................19
 EXECUTIVE  SUMMARY 
PURPOSE 
To describe the extent, characteristics, reasons for, and impact of hospital closure in 1999. 
BACKGROUND 
The closure of hospitals in past years has generated public and congressional concern. We 
released a report in May 1989 describing the nationwide phenomenon of hospital closure in 
1987. Subsequently, we issued annual reports for hospital closures from 1988 through 1998. 
The findings from all the OIG studies of hospital closures are similar. The hospitals that closed 
were small and had low occupancy rates. When the hospitals closed, few patients were 
affected. Most patients could get medical care nearby. 
FINDINGS 
Our inspection of hospital closures in 1999 produced findings similar to those previously 
reported for 1987-1998. 
!	 Sixty-four general, short-term, acute care hospitals closed in 1999 -- 1.3 percent of all 
hospitals. 
!	 Twenty-one more hospitals closed in 1999 than closed in 1998, however, the 
additional closings were offset by the twenty-two hospitals that opened or reopened in 
1999, eight more than in 1998. 
!	 Twenty-one of the closed hospitals were rural and 43 were urban.  This is 
proportionate to the total number of hospitals in each category. 
!	 Closed hospitals in both rural and urban areas were smaller on average than the 
national averages. 
Rural hospitals that closed had an average of 42 beds as compared to an 
average of 67 beds for all rural hospitals nationally. 
Urban hospitals that closed had an average of 106 beds as compared to an 
average of 223 beds for all urban hospitals nationally. 
1 
Hospital Closure: 1999  OEI-04-01-00020  !	 Occupancy rates for closed rural and urban hospitals were lower on average than the 
national averages. 
Rural hospitals that closed had an average occupancy rate of 31 percent as 
compared to an average of 38 percent for all rural hospitals nationally. The 
average daily census in the year prior to closure was about 13 patients. 
Urban hospitals that closed had an average occupancy rate of 38 percent as 
compared to an average of 57 percent for all urban hospitals nationally. The 
average daily census in the year prior to closure was about 40 patients. 
!	 Medicare utilization in closed hospitals was about the same as the national average for 
rural and urban hospitals. 
In rural areas, the average Medicare utilization among hospitals that closed was 
58 percent compared to an average of 56 percent for all rural hospitals 
nationally.  About eight Medicare patients were in the hospital on an average 
day in the year prior to closure. 
In urban areas, the average Medicare utilization among hospitals that closed 
was 44 percent compared to an average of 41 percent for all urban hospitals 
nationally. About 18 Medicare patients were in the hospital on an average day 
in the year prior to closure. 
!	 Medicaid utilization in closed hospitals was about the same as the national average for 
rural and urban hospitals. 
In rural areas, the average Medicaid utilization among hospitals that closed was 
14 percent as compared to an average of 13 percent for all hospitals nationally. 
About two Medicaid patients were in the hospital on an average day in the year 
prior to closure. 
In urban areas, the average Medicaid utilization among hospitals that closed 
was 16 percent as compared to an average of 14 percent for all urban hospitals 
nationally. About seven Medicaid patients were in the hospital on an average 
day in the year prior to closure. 
!	 Many factors caused hospitals to close. The reasons most often reported for closure, 
in order, were financial problems, low occupancy, reorganizations, mergers, 
bankruptcies and competition. Hospital administrators, former owners, general 
counsel, city managers, and others provided the reasons for closure. 
!	 Officials in only eight of the 64 hospitals that closed included Medicare and Medicaid 
reimbursement reductions as a reason for closure.  However, only one claimed it to be 
the sole reason. In this instance, the hospitals occupancy was significantly lower than 
2 
Hospital Closure: 1999  OEI-04-01-00020  the national average. However, Medicare and Medicaid utilization accounted for over 
82 percent of the hospitals total utilization. 
!	 Emergency and inpatient medical care was generally available within 10 miles of a 
closed hospital. 
!	 At the time of our inspection, 32 of the 64 closed hospital facilities (50 percent) were 
being used for health-related services such as outpatient facilities, health clinics or long-
term care facilities. Also, plans were being made to use 7 of the remaining 32 closed 
hospitals for health-related services. 
3 
Hospital Closure: 1999  OEI-04-01-00020  INTRODUCTION 
PURPOSE 
To describe the extent, characteristics, reasons for, and impact of hospital closure in 1999. 
BACKGROUND 
In the late 1980s, closure of general, acute care hospitals generated public and congressional

concern. Numerous questions were raised about the impact of hospital closure in the United

States, as well as implications for public policy. A number of studies predicted that more

hospitals would close in coming years. 

In response to these concerns, the Office of Inspector General released a report in May 1989

describing the phenomenon of hospital closure during 1987 in the United States. We found that

the hospitals that closed were small and their closing did not severely affect access to care. 

Many users of our 1987 hospital closure study encouraged us to continue year-by-year

analyses of the phenomenon to detect differences in the rate of hospital closure, and in the

characteristics and circumstances of hospitals that close.

Similar inspections on hospital closures in 1988 through 1994 showed a downward trend in the

number of closures. Hospital closures in 1995, 1996, 1997, and 1998 more than doubled

those of 1994, but were still less than in most other years since we began this series of reports. 

4 
Hospital Closure: 1999  OEI-04-01-00020  The findings from the 1987 through 1998 inspections 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. 
METHODOLOGY 
We examined hospitals that closed in calendar year 1999.  For purposes of this study, we use 
the following definitions. 
Hospital: A facility that provides general, short-term, acute medical and surgical 
inpatient care. 
Closed Hospital: A facility that stopped providing general, short-term, acute inpatient 
care in 1999.  We did not consider a hospital a closure if it: 
C  Merged with or was sold to another hospital but the physical plant 
continued to provide inpatient acute care, 
C  Converted to critical access status, or 
C  Both closed and reopened in 1999 in the same physical plant. 
To determine the extent, reasons for, and impact of hospital closures, we obtained information 
from State licensing and certification agencies, State health planning agencies, State hospital 
associations, Health Care Financing Administration (HCFA) data bases, officials associated 
with closed and nearby hospitals, and local public officials. 
We obtained information on the characteristics of all hospitals, including those that closed in 
1999 from the Hospital Cost Report Information System (HCRIS) maintained by HCFA. 
Appendix A describes our methodology in further detail. 
____  ____  ____  ____ 
We conducted our inspection between October 2000 and February 2001.  We conducted this 
inspection in accordance with the Quality Standards for Inspections issued by the Presidents 
Council on Integrity and Efficiency. 
5 
Hospital Closure: 1999  OEI-04-01-00020  FINDINGS 
Our analysis shows that: 
!	 Sixty-four general, short-term, acute care hospitals closed in 1999 -- 1.3 percent of all 
hospitals. 
!	 Twenty-one more hospitals closed in 1999 than closed in 1998, however, the 
additional closings were offset by the 22 hospitals that opened or reopened in 1999, 
eight more than in 1998. 
!  Most hospitals that closed were small and had low occupancy rates. 
!	 The characteristics, reasons for, and impact of 1999 closures were similar to the 1998 
closures. 
!	 Although residents of a few communities had to travel greater distances for hospital 
care, most had emergency and inpatient medical care available within 10 miles of a 
closed hospital. 
Extent and characteristics of closed hospitals 
How many closed 
In 1999, there were 4,818 general, short-term, acute care hospitals in the United States entered 
on HCFA's HCRIS data base as participating in the Medicare program.  Sixty-four hospitals 
closed in 1999 -- 1.3 percent of all hospitals nationally. 
Number of hospitals in the U.S.  4,818

Number of hospitals that closed in 1999  64  1.3%

While 64 hospitals closed in 1999, 20 new hospitals opened and 2 previously closed hospitals 
reopened. In comparison, 43 hospitals closed in 1998, 12 new hospitals opened and 2 
previously closed hospitals reopened. The net effect was an increase in 1999 hospital closures 
(42 hospitals) over the 1998 closures (29 hospitals). 
The effect on bed supply 
Closure of the 64 general, acute care hospitals reduced 1999 inpatient bed supply by 5,414 
beds, or 0.7 percent. 
6 
Hospital Closure: 1999  OEI-04-01-00020  Number of inpatient beds in the U.S.  738,377 
Inpatient beds in hospitals that closed in 1999  5,414  0.7% 
The 22 hospital openings and reopenings, however, added 1,916 beds and 122 beds 
respectively.  Therefore, the net reduction to the 1999 inpatient bed supply was 3,376 beds.  In 
comparison, the net reduction to the 1998 inpatient bed supply was 2,615 beds. 
Where they were 
The closed hospitals were located in 28 States.  Texas had the greatest number of closures (7), 
followed by California (6), Georgia (4), Alabama (3), Arizona (3), Louisiana (3), 
Massachusetts (3), Michigan (3), and Oklahoma (3). The remaining 21 States had 1 or 2 
closures each. Appendix B lists the number of hospital closures by State. Appendix C lists the 
closures by location. 
Twenty-one of the closed hospitals were rural and 43 were urban. This is proportionate to the 
total number of hospitals in each category. 
RURAL  URBAN 
Hospitals in the U.S.:  2,155  2,663 
Closed in 1999  21  1.0%  43  1.6% 
What the closed hospitals were like 
Size: Both rural and urban hospitals that closed in 1999 were smaller, on average, than the 
national average size. The average number of beds for hospitals nationwide is 153. About 84 
percent of the hospitals that closed had fewer beds than the national average. Furthermore, 
over half (67 percent) of the hospitals that closed had 100 beds or less. In contrast, 16 percent 
of the closed hospitals had more beds than the national average. 
7 
Hospital Closure: 1999  OEI-04-01-00020  SIZE OF CLOSED HOSPITALS 
Number of Closed Hospitals 
Rural  Urban  Total  Percent 
Number of Beds 
0 - 30  10  9  19  30% 
31 - 50  8  7  15  23% 
51 - 100  1  8  9  14% 
101 - 150  1  10  11  17% 
151 - 200  1  3  4  6% 
201 - 300  0  5  5  8% 
301 >  0  1  1  2% 
Totals  21  43  64  100% 
Rural hospitals that closed had an average of 42 beds as compared to an average of 67 beds 
for all rural hospitals nationally. Urban hospitals that closed had an average of 106 beds as 
compared to an average of 223 beds for all urban hospitals nationally. 
Occupancy: Occupancy rates for closed rural and urban hospitals were lower on average 
than the national averages.1 
1 Hospital occupancy rate is defined as the actual number of patient days divided by the total bed days 
available. National average occupancy rate is defined as the sum of all hospitals occupancy rates, divided by the 
number of hospitals. 
8 
Hospital Closure: 1999  OEI-04-01-00020  Rural hospitals that closed had an average occupancy rate of 31 percent as compared to an 
average of 37.7 percent for all rural hospitals nationally. The average daily census in the year 
prior to closure was about 13 patients versus the national average of 25 patients. 
Urban hospitals that closed had an average occupancy rate of 38.1 percent as compared to an 
average of 57 percent for all urban hospitals nationally.  The average daily census in the year 
prior to closure was about 40 patients versus the national average of 127 patients. 
Medicare Utilization: The average Medicare utilization among rural and urban hospitals that 
closed was about the same as the national average.2 
In rural areas, the average Medicare utilization among hospitals that closed was 58.5 percent 
compared to an average of 56.1 percent for all rural hospitals nationally.  About eight Medicare 
patients were in the hospital on an average day in the year prior to closure. 
In urban areas, the average Medicare utilization among hospitals that closed was 44.3 percent 
compared to an average of 40.9 percent for all urban hospitals nationally.  About 18 Medicare 
patients were in the hospital on an average day in the year prior to closure. 
2 Average Medicare utilization in closed 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. 
9 
Hospital Closure: 1999  OEI-04-01-00020  Medicaid Utilization: The average Medicaid utilization among rural and urban hospitals that 
closed was about the same as the national average.3 
In rural areas, the average Medicaid utilization among hospitals that closed was 13.8 percent as 
compared to an average of 13 percent for all hospitals nationally. About two Medicaid patients 
were in the hospital on an average day in the year prior to closure. 
In urban areas, the average Medicaid utilization among hospitals that closed was 16 percent as 
compared to an average of 14 percent for all urban hospitals nationally. About 7 Medicaid 
patients were in the hospital on an average day in the year prior to closure. 
3 Medicaid utilization is calculated in the same way as Medicare utilization. 
10 
Hospital Closure: 1999  OEI-04-01-00020 Reasons for hospital closure 
The officials we interviewed reported many reasons for hospital closure. The most often 
reported reasons for closures, in order, were financial problems, low occupancy, 
reorganizations, mergers, bankruptcies and competition.  These reasons for closure were 
interrelated. 
Officials in only eight of the 64 hospitals that closed included Medicare and Medicaid 
reimbursement reductions as a reason for closure. However, only one claimed it to be the sole 
reason.  In this instance, the hospitals occupancy was significantly lower than the national 
average. However, Medicare and Medicaid utilization accounted for over 82 percent of the 
hospitals total utilization. 
The other seven hospitals claimed mismanagement, competition, and private business decisions 
as contributing reasons for closure.  For example, a hospital that closed in Georgia faced 
competition from a nearby hospital (12 miles) that had about 7 times the number of hospital 
beds available. 
Eleven hospitals closed in order to open ten new facilities. For example, two hospitals in 
California did not meet earthquake standards.  Hospital management determined that it would 
be more cost effective to build new facilities rather than renovate the existing facilities. In North 
Carolina, two local hospitals closed and were replaced by one new regional hospital located 
about midway between the two closed facilities. 
Impact of hospital closure 
In communities where hospitals closed in 1999, we determined the 
!  number of patients affected by closure of hospitals, 
!  availability of inpatient care and emergency medical services, and 
!  current use of closed hospital facilities. 
How many patients were affected 
For rural hospitals that closed in 1999, the average daily census in the year prior to closure was 
about 13 patients. The urban hospitals that closed had an average daily census of about 40 
patients. 
11 
Hospital Closure: 1999  OEI-04-01-00020  WHEN HOSPITALS CLOSED, 
HOW MANY PATIENTS WERE AFFECTED DAILY? 
Rural Hospitals  Urban Hospitals 
Average Number of Beds  41.6  105.6 
Average Occupancy Rate  x 31%  x 38.1% 
Average Number of Patients  12.9  40.2 
We analyzed Medicare utilization data to determine the number of elderly patients affected by 
hospital closure in 1999. In rural hospitals that closed, about eight Medicare patients were in 
the hospital on an average day in the year prior to closure. In the urban hospitals that closed, 
about 18 Medicare patients were in the hospital on an average day. 
WHEN HOSPITALS CLOSED, 
HOW MANY MEDICARE PATIENTS WERE AFFECTED DAILY? 
Rural Hospitals  Urban Hospitals 
Average Number of Patients  12.9  40.2 
Average Medicare Utilization Rate  x 58.5%  x 44.3% 
Average Number Medicare Patients  7.5  17.8 
What inpatient care and emergency services are available 
Inpatient Care: In most communities where a hospital closed in 1999, inpatient hospital care 
was available nearby.4 
4 We assessed availability of inpatient medical care in miles from a closed hospital to the nearest inpatient 
facility. 
12 
Hospital Closure: 1999  OEI-04-01-00020  NEAREST INPATIENT CARE TO CLOSED HOSPITALS 
NUMBER OF CLOSED 
HOSPITALS 
DISTANCE  RURAL  URBAN 
Within 3 Miles  6  28.6%  18  41.9% 
4-10 Miles  4  19.0%  19  44.2% 
11-20 Miles  4  19.0%  5  11.6% 
21-30 Miles  6  28.6%  1  2.3% 
More than 30 Miles  1  4.8%  0  0.0% 
Totals  21  100.0%  43  100.0% 
Rural Areas: Residents in 14 of the 21 rural communities (67 percent) where a hospital closed 
could get inpatient hospital care within 20 miles of the closed hospital. Residents of only one 
community had to travel in excess of 30 miles to receive inpatient care. The residents of 
Wiggins, Mississippi had to travel 33 miles. 
Urban Areas: In 37 of the 43 urban communities (86 percent) where a hospital closed in 
1999, residents could get inpatient hospital care within 10 miles of the closed hospital. 
Residents in all 43 urban communities where a hospital closed could get inpatient care within 30 
miles of the closed hospital. 
Emergency Services: When a hospital closed, the community lost not only inpatient beds, 
but also 24-hour emergency services.5 
Rural Areas: In 12 of the 21 rural communities (57 percent) where a hospital closed in 1999, 
emergency care facilities were available within 20 miles of the closed hospital. Of the remaining 
nine rural communities where a hospital closed, emergency care for eight was available within 
30 miles.  For Wiggins, Mississippi, 24-hour emergency care was available 33 miles from the 
closed hospital. 
Urban Areas: Emergency care facilities were available within 10 miles of the closed hospital in 
37 of the 43 urban communities where a hospital closed in 1999. Five other urban communities 
had emergency care within 20 miles while only one community had to travel 30 miles for 24-
hour emergency care. 
5 We assessed availability of emergency medical care in miles from a closed hospital to the nearest 
emergency facility. 
13 
Hospital Closure: 1999  OEI-04-01-00020  NEAREST EMERGENCY SERVICES TO CLOSED HOSPITALS 
NUMBER OF CLOSED 
HOSPITALS 
DISTANCE  Rural  Urban 
Within 3 Miles  5  23.8%  19  44.2% 
4-10 Miles  4  19.0%  18  41.9% 
11-20 Miles  3  14.3%  5  11.6% 
21-30 Miles  8  38.1%  1  2.3% 
More than 30 Miles  1  4.8%  0  0.0% 
Totals  21  100.0%  43  100.0% 
What the building is used for now 
At the time of our inspection, 32 of the 64 closed hospital facilities (50 percent) were being 
used for health-related services. For example: 
!	 Liberty Medical Center in Baltimore, Maryland along with five other closed hospitals 
became outpatient facilities. 
!	 Lindsay Municipal Hospital in Lindsay, Oklahoma along with five other closed hospitals 
became health clinics. 
!  Princeton Hospital in Orlando, Florida became a Psychiatric Hospital 
!	 Lakeland Medical Center- Berrien Center in Berrien Center, Michigan, Saratoga 
Hospital in Detroit, Michigan and Shannon Medical Center in San Angelo, Texas are 
now long-term care facilities. 
Of the closed hospital facilities that were not being used for health-related services, plans were 
being made to use 7 for health-related services. In addition, one facility was destroyed by a 
tornado and was in the process of being rebuilt. 
14 
Hospital Closure: 1999  OEI-04-01-00020  APPENDIX A 
METHODOLOGY 
Extent of Hospital Closure 
To determine how many hospitals closed in 1999, we contacted State licensing and certification 
agencies, State hospital associations, and State health planning agencies. We also compiled Health 
Care Financing Administration (HCFA) data on terminated hospitals in 1999.  When a closed hospital 
met the study definition or when questions arose, we surveyed officials associated with the closed 
hospitals, officials associated with hospitals nearest to the closed hospital, and local public officials. 
To quantify the number of hospitals in the United States, we used the Hospital Cost Report Information 
System (HCRIS) maintained by HCFA. We included only general, short-term, acute care hospitals 
under Medicare's Prospective Payment System (PPS) in the universe. There were 4,818 hospitals 
listed on HCRIS as short-term, acute care, general hospitals for 1999. 
Characteristics of Hospital Closure 
To analyze characteristics of closed hospitals, we used HCRIS data. We used the latest pre-closure 
cost reports. For example, if a hospital closed in May 1999 and its accounting year was on a January-
December cycle, we used the hospital's January 1, 1998 to December 31, 1998 report. 
Reasons for and Impact of Hospital Closure 
We determined the reasons for hospital closure by interviewing knowledgeable officials related to the 
closed hospitals.  Such officials included: 
!  Former hospital administrators, board members, and/or staff of closed hospitals, 
!  Hospital administrators and/or staff at the nearest hospitals, 
!  Local fire, health, and government officials, and 
!  Officials associated with closed hospital parent corporations. 
We determined the impact of hospital closures by identifying the distance from a closed hospital to 
the nearest still-operating hospital and to 24-hour emergency services. In addition we used the HCRIS 
to determine how many patients, including Medicare and Medicaid, were displaced by the closures. 
15 
Hospital Closure: 1999  OEI-04-01-00020  AAPPPPEENNDDIIXX  BC 
1999 HOSPITAL CLOSURES - RANKED BY STATE 
State  Total Closures  Rural Closures  Urban Closures 
Texas  7  3  4 
California  6  0  6 
Georgia  4  1  3 
Alabama  3  1  2 
Arizona  3  0  3 
Louisiana  3  0  3 
Massachusetts  3  0  3 
Michigan  3  0  3 
Oklahoma  3  2  1 
Florida  2  0  2 
Kansas  2  2  0 
Maryland  2  0  2 
Minnesota  2  2  0 
Missouri  2  1  1 
Mississippi  2  2  0 
North Carolina  2  2  0 
New Jersey  2  0  2 
Ohio  2  0  2 
Virginia  2  1  1 
Arkansas  1  0  1 
Colorado  1  0  1 
Illinois  1  0  1 
Kentucky  1  0  1 
Maine  1  0  1 
Nebraska  1  1  0 
South Carolina  1  1  0 
Tennessee  1  1  0 
Utah  1  1  0 
28 States  64  21  43 
16 
Hospital Closure: 1999  OEI-04-01-00020  1999 HOSPITAL CLOSURES BY NAME AND LOCATION 
Rural/ 
Hospital Name  City  State  Urban 
Baptist Medical Center- Downtown  Montgomery  AL  Urban 
Florence Hospital  Florence  AL  Urban 
Vaughan Perry Hospital  Marion  AL  Rural 
Baptist Memorial Medical Center  North Little Rock  AR  Urban 
Central Arizona Medical Center  Florence  AZ  Urban 
Community Hospital Medical Center  Phoenix  AZ  Urban 
Phoenix Regional Medical Center  Phoenix  AZ  Urban 
Natividad Medical Center  Salinas  CA  Urban 
San Bernardino County Medical Center  San Bernardino  CA  Urban 
St. Louise Hospital  Morgan Hill  CA  Urban 
UCSF- Mount Zion Medical Center  San Francisco  CA  Urban 
Valley Community Hospital  Santa Maria  CA  Urban 
Washington Medical Center  Culver City  CA  Urban 
Precedent Health Center  Denver  CO  Urban 
Clearwater Community Hospital  Clearwater  FL  Urban 
Princeton Hospital  Orlando  FL  Urban 
Baptist North Hospital  Cumming  GA  Urban 
Bowdon Area Hospital  Bowdon  GA  Urban 
Ridgecrest Hospital  Clayton  GA  Rural 
West Paces Medical Center  Atlanta  GA  Urban 
St. Joseph Hospital- Belvidere  Belvidere  IL  Urban 
Dechairo Hospital  Westmoreland  KS  Rural 
Ellsworth County Medical Center  Ellsworth  KS  Rural 
Woodford County Hospital  Versailles  KY  Urban 
Concord Hospital  Baton Rouge  LA  Urban 
Jo Ellen Smith Medical Center  New Orleans  LA  Urban 
Sterlington Hospital Inc.  Sterlington  LA  Urban 
Boston Regional Medical Center  Stoneham  MA  Urban 
The Malden Hospital  Malden  MA  Urban 
Medical Center at Symmes  Arlington  MA  Urban 
Church Hospital  Baltimore  MD  Urban 
Liberty Medical Center  Baltimore  MD  Urban 
Westbrook Community Hospital  Westbrook  ME  Urban 
Lakeland Medical Center- Berrien Center  Berrien Center  MI  Urban 
Saratoga Hospital  Detroit  MI  Urban 
Sinai Hospital  Detroit  MI  Urban 
Harmony Community Hospital  Harmony  MN  Rural 
Lake City Hospital  Lake City  MN  Rural 
Arcadia Hospital  Pilot Knob  MO  Rural 
Park Lake Medical Center  Kansas City  MO  Urban 
Smith County Hospital  Raleigh  MS  Rural 
Stone County Hospital  Wiggins  MS  Rural 
Charles A. Cannon Jr. Memorial Hospital  Banner Elk  NC  Rural 
Sloop Memorial Hospital Inc.  Crossnore  NC  Rural 
17 
Hospital Closure: 1999  OEI-04-01-00020  APPENDIX C 
CONTINUED 
1999 HOSPITAL CLOSURES BY NAME AND LOCATION - CONTINUED 
Rural/ 
Hospital Name  City  State  Urban 
Goli Medical Center  Sargent  NE  Rural 
Memorial Medical Center at South Amboy  South Amboy  NJ  Urban 
Montclair Community Hospital  Montclair  NJ  Urban 
MedCenter Hospital  Marion  OH  Urban 
St. Lukes Medical Center  Cleveland  OH  Urban 
Integris Bethany Hospital  Bethany  OK  Urban 
Lindsay Municipal Hospital  Lindsay  OK  Rural 
Stroud Municipal Hospital  Stroud  OK  Rural 
Byerly Hospital  Hartsville  SC  Rural 
Cumberland River Hospital South  Gainesboro  TN  Rural 
Columbia Surgicare Specialty Hospital  Corpus Christi  TX  Urban 
East Texas Medical Center- Rusk  Rusk  TX  Rural 
Memorial Hospital Pasadena  Pasadena  TX  Urban 
Presbyterian Medical Center of Wylie  Wylie  TX  Urban 
Shannon Medical Center- St. Johns Campus  San Angelo  TX  Urban 
Silsbee Doctors Hospital  Silsbee  TX  Rural 
Starlite Village Hospital  Center Point  TX  Rural 
Wasatch County Hospital  Heber City  UT  Rural 
Carilion Radford Community Hospital  Radford  VA  Rural 
Columbia Pentagon City Hospital  Arlington  VA  Urban 
18 
Hospital Closure: 1999  OEI-04-01-00020  APPENDIX D 
1999 HOSPITAL OPENINGS AND REOPENINGS BY NAME AND LOCATION 
Rural/ 
Hospital Name  City  State  Urban 
Baptist Memorial Medical Center  North Little Rock  AR  Urban 
St. Vincent Medical Center- Sherwood  Sherwood  AR  Urban 
Arrowhead Regional Medical Center  Colton  CA  Urban 
Bakersfield Heart Hospital  Bakersfield  CA  Urban 
City of Angels Medical Center  Los Angeles  CA  Urban 
Natividad Medical Center  Salinas  CA  Urban 
Baptist Medical Center  Cumming  GA  Urban 
Ellsworth County Medical Center  Ellsworth  KS  Rural 
Lake City Medical Center  Lake City  MN  Rural 
Doctors Hospital of Springfield  Springfield  MO  Urban 
Charles A. Cannon Jr. Medical Center  Linville  NC  Rural 
Physicians Hospital  Oklahoma City  OK  Urban 
Southcrest Hospital  Tulsa  OK  Urban 
Wetumka General Hospital  Wetumka  OK  Urban 
Carolina Pines Regional Medical Center  Hartsville  SC  Rural 
Providence Hospital Northeast  Columbia  SC  Urban 
Baptist Memorial Hospital- Collierville  Collierville  TN  Urban 
Kell West Regional Hospital, L.L.C  Wichita Falls  TX  Urban 
Vista Medical Center Hospital  Pasadena  TX  Urban 
Heber Valley Medical Center  Heber City  UT  Rural 
Carilion New River Valley Medical Center  Christiansburg  VA  Rural 
Aurora Medical Center  Kenosha  WI  Urban 
19 
Hospital Closure: 1999  OEI-04-01-00020