Fifty-eight, and where that comes from
A state-by-state table on the Center for Healthcare Quality and Payment Reform rural hospital site puts 58 of the 100 open rural inpatient hospitals in Kansas at risk of closing and 21 of them at immediate risk. The table's own source note dates the data to July 2026[1]. The same Kansas row records 72 rural hospitals with a loss on patient services in the most recent year available, which the table's footnote gives as 2024, seven rural hospital closures since 2015, and three hospitals that gave up inpatient services to become Rural Emergency Hospitals.
The national row of the same table counts 2,249 open rural inpatient hospitals in the United States, of which 700 are at risk and 264 at immediate risk, which it renders as 31 percent and 12 percent[3]. The Kansas shares are 58 percent and 21 percent.
None of this is in either of the organization's downloadable reports. The July 2026 report on rural hospital closures states the national totals in prose and draws the state figures as maps[4]. The state numbers live in the HTML table on the website, which is the version a reader can check line by line.
What at risk means to the body that publishes the number
Risk of closure is defined as financial losses on patient services during the most recent two years, combined with insufficient financial reserves to keep operating without grants, local taxes or other revenue not derived from services to patients[1]. The longer statement puts a figure on the reserves: net assets excluding buildings and equipment that would not offset losses on patient services for more than six or seven years[3].
Immediate risk is the same test tightened. The hospital has lost money on patient services over a multi-year period, excluding the first year of the pandemic, without enough revenue from elsewhere to cover it, and it either owes more than it owns or holds net assets that could absorb the losses for at most two or three years[3].
Two things follow. The category is a financial description rather than a prediction that any named hospital will shut. And it is sensitive to revenue that is not clinical. The organization's own data page says that many small rural hospitals have a positive total margin despite incurring losses on patient services because they receive local tax revenues or state grants that offset the losses[5].
The rows the count is built from
The hospital-level table is published alongside the state one, and Kansas has 112 rows in it, 103 open and nine closed, with closure years running from 2006 to 2023[5]. Counting the open rows, 82 of the 103 carry a negative two-year average margin on patient services and 53 carry a negative total margin. Both of those are counts made here over the cached rows of that table rather than figures the organization printed.
The companion table on assets is where the reserves half of the definition lives. It holds 104 Kansas rows, and 41 of them show negative total net assets once buildings and equipment are excluded, meaning current and long-term liabilities exceed current and other assets[6]. Twelve of the 41 also show negative current net assets. Again, counts made here from the rows.
The closed rows carry no ambiguity at all. Cedar Vale Community Hospital closed in 2006, Central Kansas Medical Center at Great Bend in 2011, Mercy Hospital Independence in 2015, Horton Community Hospital and Oswego Community Hospital in 2019, Saint Luke's Cushing Hospital at Leavenworth and Sumner Community Hospital at Wellington in 2020, Community Healthcare System St Marys in 2021 and Herington Hospital in 2023[5]. Closure status comes from the list kept by the Cecil G. Sheps Center for Health Services Research[7].
The designations, and what each one is paid
A designation is a Medicare payment method, not a size and not a service list. Five of the codes in the table's legend are in use among Kansas rural hospitals, and one row is typed Other, which the legend does not define[5].
Critical access is the one that carries the state, and two independent files agree on how many there are. Eighty-three of the 103 open Kansas rows are typed that way, and the federal certification dataset behind Care Compare types 83 Kansas hospitals as Critical Access Hospitals in the file last modified on July 22, 2026[2]. A critical access hospital is paid for Original Medicare patients on the basis of what its services cost rather than at standard Medicare fees. That rate began at 101 percent of eligible costs, and 100 percent for rural health clinics, and federal sequestration has held them at 99 and 98 percent since 2013, suspended during the pandemic and back in force from 2022[8].
Medicare Advantage plans are not required to pay a critical access hospital on either basis, which is the gap the payment-reform organization keeps pointing at[8]. The Inpatient Prospective Payment System, which most urban hospitals are paid under, pays predetermined case rates and was created by Congress in 1983[8]. The Rural Emergency Hospital payment category is far newer. Congress established it in 2021 and CMS issued regulations implementing it in 2022[3]. The condition attached is that the hospital stops providing inpatient services, which is why the state table counts a conversion as an inpatient service closure rather than as a rescue[1].
| Code | What the code means | Open Kansas rows |
|---|---|---|
| CAH | Critical Access Hospital | 83 |
| SCH | Sole Community Hospital | 10 |
| IPPS | Standard Inpatient Prospective Payment System payment | 4 |
| REH | Rural Emergency Hospital | 3 |
| RCH | Participant in the CMS Rural Community Hospital Demonstration | 2 |
| Other | Not defined in the legend beneath the table | 1 |
Where the counting organization starts arguing
The Center for Healthcare Quality and Payment Reform is not a neutral statistical office and does not present itself as one. Its pages state that payments from private insurance plans below the cost of care are the primary reason hundreds of rural hospitals are at risk, that standby capacity payments from both private and public payers are the remedy, and that the Rural Emergency Hospital program and wider Medicaid eligibility will not solve the problem[3]. Those are the positions of the organization that produced the counts.
The counts are usable because the method is published and the underlying rows can be downloaded and recounted, which is what happened here. The conclusions belong to the organization that drew them, and this publication draws none of its own, here or on any of the other pages listed on the front page.
What 58 does not settle
The at-risk table counts open rural inpatient hospitals, so the three Kansas Rural Emergency Hospitals sit outside its 100. The hospital-level table counts 103 open Kansas rural hospitals because it includes them[5]. Neither figure is a count of hospitals licensed by the state, which is a different question with a different answer.
The federal certification file lags, and the documents cached for this section show it. KDHE published a 2026 award list naming Freeman Fort Scott Hospital, at Fort Scott, and gave it $2,502,999 to establish the first MRI services in Bourbon County[9]. No hospital in Bourbon County appears among the 139 Kansas rows of the CMS file[2], and none appears among the 112 Kansas rows of the rural hospital table[5] either. A count of certified hospitals is not a count of hospitals, and the difference here is a whole county wide.