Hundreds of hospitals in rural areas of the U.S. are at risk of closure, according to new data from Chartis, a Chicago health care advisory services firm.

A total of 141 rural hospitals have closed since 2010 — while another 453 are “at risk of closure,” according to a press release.

The seven states with the most hospitals vulnerable to closures include Texas (45), Kansas (38), Nebraska (29), Oklahoma (22), North Carolina (19), Georgia (18) and Mississippi (18), as listed in Becker’s Hospital Review.

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In Florida, Tennessee and Nebraska, more than 41% of rural hospitals are at risk of closure.

Between 31% to 40% of rural hospitals are at risk in Utah, South Dakota, Kansas, Oklahoma, Alabama, North Carolina and South Carolina.

In Wyoming, Texas, Louisiana, Arkansas, Mississippi and Georgia, between 26% and 30% of rural hospitals are in danger of closing, the report stated.

Factors impacting closure risk

The analysis identified seven factors that have the biggest impact on a hospital’s risk of closure.

Two of those were the number of years a hospital has been operating without a profit and the amount of net patient revenue.

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The study also looked at the hospital’s average number of inpatients during the year — and the average daily need for skilled nursing facilities.

The remaining three factors include the hospital’s reliance on inpatient revenue, its share of Medicare outpatient charges and each hospital’s case mix index.

Among the rural hospitals that are still operating, an increasing number are dropping essential health services, including cancer treatments and maternal care, the data showed.

An emergency department physician noted that rural hospitals are extremely important for the country’s health care system.  (iStock)

Approximately 43% of rural hospitals are operating at a financial deficit, Chartis found.

“As the urgency of the pandemic disappears, the return of policy-driven reimbursement cuts, population health disparities and the nurse staffing crisis will apply renewed pressure to the rural health safety net,” said Michael Topchik, national leader of The Chartis Center for Rural Health, in the release.

How closures impact patients

Dr. Kenneth Perry, an emergency department physician in South Carolina, was not involved in the Chartis analysis but noted that rural hospitals are extremely important for the country’s health care system. 

“There are many patients who do not have access to primary care, but are within close enough proximity to rural hospitals, and obtain most of their care within those hospital systems,” he told Fox News Digital.

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“As economic pressures have increased for hospitals in the last few years, it has become increasingly difficult for these hospitals to stay financially profitable.”

Between the Centers for Medicare and Medicaid and private insurers, hospitals have faced “ever smaller” reimbursement amounts, Perry noted.

“Even with lowering reimbursement, operating costs have skyrocketed,” he added. “This makes it very difficult for rural hospitals to be profitable enough to stay open.”

“As the urgency of the pandemic disappears, the return of policy-driven reimbursement cuts, population health disparities and the nurse staffing crisis will apply renewed pressure to the rural health safety net,” the study author said. (iStock)

In areas where hospitals are forced to shutter, Perry warned that many patients will lose not just hospital care, but also access to emergency departments. 

“Many patients, specifically low or under insured patients, use the emergency department as a source of primary care,” he said.

“As economic pressures have increased, it has become increasingly difficult for these hospitals to stay financially profitable.”

“With the closure of these hospitals, many patients will lose access to all of their medical care.”

Without a feasible solution, Perry said, many patients will be left without access to emergency services and primary care.

Impact of REH designation

Chartis’ new report aimed to determine the potential impact of the Rural Hospital Emergency (REH) designation. It was enacted by Congress in Dec. 2020 as a means of ensuring emergency medical services in rural hospitals that may lack the resources to offer them.

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When a hospital is designated as an REH, it is able to provide emergency department services, observation care and potentially some outpatient services as long as the patient’s stay doesn’t exceed an average of 24 hours, according to the Centers for Medicare & Medicaid Services website.

“With the closure of these hospitals, many patients will lose access to all of their medical care,” an emergency department physician warned. (Getty Images)

“For some hospitals, our data model suggests the REH designation will serve as a desperately needed relief valve to avoid closing and provide a significant reversal in fortune for the vulnerable communities they serve,” Topchik said in the release. 

“But the decision to convert is highly nuanced, and as a result, we expect to see a relatively small number of hospitals embrace REH.” 

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There are 389 rural hospitals that Chartis identified as “most likely” to consider converting to REH status, with 77 designated as “ideal candidates.”

Fox News Digital reached out to Chartis and the American Hospital Association requesting additional comment.

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February is American Heart Month — a good time to know what’s at stake in terms of your cardiovascular health.

For women over age 50, a few factors regarding heart health deserve a little more attention, according to experts.

Cardiovascular disease (CVD) is the leading cause of death in women, according to Northwell Health cardiologist Dr. Stacey Rosen, who is based in New York.

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Nearly 45% of women over 20 years old are actually living with some form of CVD, Rosen told Fox News Digital.

Gender-specific risk factors include menstrual history and adverse pregnancy outcomes, she said. 

“Other sex-specific risk factors include anxiety and depression, increased risk due to certain treatments for breast cancer, and rheumatologic conditions,” she said.

Dr. John Whyte, chief medical officer of WebMD and based in Washington, D.C., also told Fox News Digital about some primary risk factors for women age 50 and older — starting with menopause.

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“The decrease in estrogen levels after menopause is linked to an increased risk of cardiovascular disease,” he said. “That’s one of the reasons [we see an] increase in heart attacks around this age.”

High blood pressure and high cholesterol also often increase with age and can become “more challenging to control,” Whyte said.

Gender-specific heart disease risk factors include menopause, menstrual history and adverse pregnancy outcomes, according to experts. (iStock)

“Changes in cholesterol levels, including increases in ‘bad’ LDL cholesterol and decreases in ‘good’ HDL cholesterol, can elevate heart disease risk,” he said.

Diabetes risk also increases with age, which significantly raises the chance of heart disease, Whyte said, as do other health factors such as obesity, smoking and a sedentary lifestyle.

“Lack of physical activity can increase the risk of heart disease and other co-morbid conditions,” he added.

Symptoms worth noticing

As women often experience different cardiac symptoms than men, the “classic chest pain that radiates down the left arm” may not occur, Whyte said.

Women may instead notice unusual or extreme fatigue, shortness of breath, dizziness, nausea and indigestion.

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Jaw, neck and upper back pain are often overlooked, as they often occur without the chest pain associated with heart attacks, according to experts.

“The symptoms women experience with heart disease can often be different,” Rosen of New York said. 

“Don’t ignore new symptoms like fatigue, breathlessness or indigestion.”

Symptoms of heart problems in women can appear as unusual or severe fatigue, shortness of breath, dizziness, nausea and indigestion. (iStock)

There are several routine exams to monitor heart health, Whyte noted.

Blood pressure screenings are “crucial,” the doctor said, as “hypertension is a silent killer.”

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An annual cholesterol profile check will monitor levels of HDL (“good” cholesterol), LDL (“bad” cholesterol) and triglyceride (lipid fats).

“The key is not just total cholesterol, but also LDL,” Whyte said.

An annual cholesterol profile check will help monitor HDL (“good” cholesterol), LDL (“bad” cholesterol) and triglyceride levels. (iStock)

Blood glucose tests can also be helpful in monitoring diabetes, which is a “significant risk factor for heart disease,” Whyte said, as well as a coronary calcium score to determine risk.

People with symptoms or significant risk factors can check for heart rhythm abnormalities through an electrocardiogram (EKG/ECG), experts recommend.

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It’s “important to have a primary care clinician who knows you well and can help determine the need for further evaluation,” Rosen added.

“Develop a trusting, longitudinal relationship with a primary care clinician,” she recommended. “This is the time to be a ‘good’ patient. Ask questions about prevention strategies and cardiovascular testing that is appropriate for you.”

Strategies to keep the heart happy

The majority of CVD is preventable through lifestyle changes, heightened awareness and education, Rosen said — which means that “your heart health is in your hands.”

“Know your numbers — cholesterol, weight, waist circumference, blood pressure, blood sugar — as all are important risk factors that can be modified,” she said.

Health factors such as obesity, smoking and a sedentary lifestyle increase heart disease risk, experts said. (iStock)

For day-to-day upkeep, Whyte listed several foods that are known to promote a healthy heart.

These include fruits and vegetables that are rich in vitamins, minerals, fiber and antioxidants; whole grains for fiber and nutrients; lean protein like fish and poultry; nuts and seeds for healthy fats; legumes for fiber and protein; and coffee and tea for antioxidants.

Limiting sugary foods and drinks will help prevent obesity and diabetes.

Among the foods to avoid are saturated and trans fats, which are found in red meat, butter, cheese and processed foods, experts said.

Steering clear of excess salt will also help avoid high blood pressure — while limiting sugary foods and drinks will help prevent obesity and diabetes.

Processed and junk foods are “generally high in unhealthy fats, sugars and salt” and therefore should also be avoided, Whyte added.

Saturated and trans fats found in red meat, butter, cheese and processed foods should be avoided to promote heart health, Whyte said. (iStock)

Women over age 50 should partake in regular physical activity, which involves at least 150 minutes of moderate aerobic activity or 75 minutes of “vigorous activity” each week, he recommended.

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“Start anywhere,” he advised. Do “10 [minutes] a day or 4,000 steps a day … and slowly increase. Don’t get discouraged thinking you can’t do 150 [minutes].”

Maintaining a healthy weight through a balanced diet and exercise will also help ward off heart complications, as well as quitting smoking, limiting alcohol intake and managing stress.

It’s crucial for women over age 50 to prioritize their sleep and stress management, one expert told Fox News Digital.  (iStock)

Whyte suggested women should try stress-reducing techniques such as mindfulness, yoga or deep breathing, and should also get adequate sleep.

“Aim for seven to nine hours per night, as poor sleep can cause chronic inflammation,” he said.

Rosen agreed that while being mindful of daily lifestyle choices like eating healthy foods and exercising is important, it’s also crucial for women over 50 to prioritize their sleep and stress management.

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“Speak to your clinician to learn of the advances that have been made to assist in adhering to a healthy lifestyle,” she said. 

“For example, we can manage issues with sleep disorders better than ever before. Don’t be afraid to ask.”

For more Health articles, visit www.foxnews.com/health.

Fox News Digital publishes an array of health pieces all week long to keep you in the know on a range of wellness topics: disease prevention, nutrition, medical research, health care and more — plus, personal stories of people and families overcoming great obstacles.

As you wind down your weekend, check out some of the top stories of the week in Health that you may have missed, or have been meaning to check out. 

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These are just a few of what’s new, of course. 

There are many more to see at http://www.foxnews/health. 

At-home testing for HPV

The National Cancer Institute announced a new program to study HPV testing via self-collection. Cancer experts discuss how this method could help prevent cervical cancer diagnoses. Click here to get the story.

Bubonic plague in Oregon

After a case of bubonic plague was confirmed in Oregon earlier this week, some people may wonder if there’s a danger of the disease spreading. Infectious disease experts share what to know about the animal-borne disease, which can be deadly if it goes untreated. Click here to get the story.

Since its introduction 120 years ago, the bubonic plague has become endemic in ground squirrels and rodents in the rural Southwestern U.S. (iStock)

‘Life-changing’ treatment for lupus

Researchers in Australia have discovered a new treatment for lupus that infuses healthy human cells into patients, triggering a protective mechanism that helps to prevent autoimmune reactions. Learn how it works and why it could extend to other disease treatments. Click here to get the story.

Common symptoms of lupus include joint pain, extreme fatigue, joint pain or a butterfly rash. (iStock)

Stopping frostbite in its tracks

The U.S. Food and Drug Administration (FDA) approved the first medication to treat severe frostbite, the agency announced this week. The drug, iloprost (brand name Aurlumyn), is intended to reduce the risk of finger and toe amputations due to dangerously cold extremities. Dr. Marc Siegel weighed in on this “very important approval.” Click here to get the story.

Frostbite occurs when cold temperatures cause parts of the body to freeze, primarily the fingers, toes, nose, cheeks and chin. (iStock)

State of COVID quarantines

Amid reports that the U.S. Centers for Disease Control and Prevention (CDC) may be considering a change to its COVID isolation guidelines, doctors are sharing their own recommendations. Click here to get the story.

The current CDC guidance, implemented in late 2021, calls for people who test positive for the virus to “stay home for at least five days and isolate from others in your home.” (iStock)

Lincoln’s depression struggles

The 16th president suffered from chronic “melancholy,” according to historians. Dr. Chris Tuell, a clinical psychotherapist and a chemical and behavioral addiction specialist at the University of Cincinnati College of Medicine, reflected on what caused Lincoln’s mental health struggles and how the illness was perceived in his time. Click here to get the story.

He is perhaps best known for his honesty — but a lesser-known fact about Abraham Lincoln is that the 16th president of the United States battled severe depression during his lifetime. (Painting by J.L.G. Ferris)

ADHD gender divide

Symptoms of ADHD in boys compared to girls can make a big difference in diagnosis and treatment, experts say. Fox News Digital spoke with two mental health professionals about how the disorder shows up in males versus females, and when to seek professional help. Click here to get the story.

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Viagra’s link to Alzheimer’s risk

Research from University College London indicated that 18% of men who were prescribed various erectile dysfunction medications were less likely to develop Alzheimer’s disease. An Alzheimer’s Association expert weighed the benefits and limitations of the findings. Click here to get the story.

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