How many U.S. hospitals are losing money?

Of the 6,968 hospitals with complete Medicare cost reports analyzed here, 2,453 (35.2%) reported a negative operating margin — i.e., they are operating at a loss. The median hospital operating margin is 4.5%.

What does it mean for a hospital to operate at a loss?

A hospital operates at a loss when its total costs exceed its total revenues — a negative operating margin (net income divided by total revenue). Sustained losses are a leading indicator of service-line cuts, mergers, or closure. Figures here come from each hospital's most recent Medicare cost report (HCRIS).

▸ DATA STUDY · 2025 EDITION

Hospitals Losing Money

35% of U.S. hospitals are operating at a loss. Of the 6,968 hospitals with complete Medicare cost reports (through FY2025), 2,453 reported a negative operating margin. Below: the hospitals with the deepest losses nationally, and how the loss rate breaks down by state. Drawn from each hospital's most recent HCRIS filing; updated annually.

35.2%

HOSPITALS OPERATING AT A LOSS

2,453

COUNT AT A LOSS

6,968

HOSPITALS ANALYZED

4.5%

MEDIAN OPERATING MARGIN

▸ STATES WITH THE HIGHEST LOSS RATE

Share of hospitals operating at a loss — top 12 states

▸ DEEPEST LOSSES NATIONALLY

The 50 hospitals with the worst operating margins

Ranked by operating margin (net income ÷ total revenue), worst first. Limited to hospitals reporting more than $10.0M in total revenue to exclude small-facility noise.

#	Hospital	Location	Operating margin	Net income	Revenue
1	William R Sharpe Jr Hospital	Weston, WV	-744.9%	−$119.2M	$16.0M
2	Center For Forensic Phychiatry	Ann Arbor, MI	-714.0%	−$95.6M	$13.4M
3	Co. Mental Health Inst. - Pueblo	Pueblo, CO	-515.6%	−$57.4M	$11.1M
4	Creek Nation Community Hospital	Okemah, OK	-419.0%	−$65.0M	$15.5M
5	Caro Center	Caro, MI	-377.5%	−$49.8M	$13.2M
6	Mildred Mitchell-Bateman Hospital	Huntington, WV	-349.6%	−$46.5M	$13.3M
7	Trinity Regional Hospital Sachse	Sachse, TX	-320.6%	−$33.9M	$10.6M
8	Southwestern State Hospital	Thomasville, GA	-315.6%	−$32.6M	$10.3M
9	Shriners Hospital For Children	Philadelphia, PA	-289.2%	−$39.0M	$13.5M
10	Herrick Medical Center	Tecumseh, MI	-288.6%	−$46.2M	$16.0M
11	Hcris Filer 453319	Austin, TX	-271.2%	−$168.9M	$62.3M
12	Rocky Mountain Medical Center	Salt Lake City, UT	-266.6%	−$42.3M	$15.9M
13	St. John Northeast Community Hosp	Detroit, MI	-249.5%	−$39.8M	$16.0M
14	N.w. Mo Psychiatric Rehab Ctr	St.joseph, MO	-219.3%	−$52.9M	$24.1M
15	Oregon State Hospital	Salem, OR	-209.7%	−$336.9M	$160.6M
16	Johnstown Heights Behavioral Health	Johnstown, CO	-203.6%	−$22.6M	$11.1M
17	Hcris Filer 060133	Colorado Springs, CO	-203.1%	−$21.3M	$10.5M
18	Stuart Circle Hospital	Richmond, VA	-199.2%	−$29.4M	$14.8M
19	Baptist Med Ctr-Downtown	Montgomery, AL	-199.1%	−$37.2M	$18.7M
20	Center For Behavioral Medicine	Kansas City, MO	-195.4%	−$30.1M	$15.4M
21	Phc Regional Hospital & Medical Ctr	Salt Lake City, UT	-192.6%	−$26.6M	$13.8M
22	San Juan Municipal Hospital	San Juan, PR	-192.1%	−$90.9M	$47.3M
23	Austin State Hospital	Austin, TX	-185.4%	−$97.1M	$52.4M
24	Medical College Of Pennsylvania	Philadelphia, PA	-184.3%	−$78.1M	$42.4M
25	Ntsh - Witchita Falls	Wichita Falls, TX	-182.9%	−$198.4M	$108.5M
26	Columbus Community Hospital	Columbus, TX	-177.5%	−$61.7M	$34.7M
27	Northern Virginia Community Hospital	Arlington, VA	-169.8%	−$18.8M	$11.1M
28	Lifecare Hospitals Of South Texas	Mcallen, TX	-168.3%	−$21.6M	$12.8M
29	Elkins Park	Elkins Park, PA	-162.8%	−$21.6M	$13.3M
30	Aspirus Riverview Hospital & Clinics	Wisconsin Rapids, WI	-162.0%	−$100.1M	$61.8M
31	Dakota Hospital	Fargo, ND	-160.6%	−$50.9M	$31.7M
32	Baptist Orange Hospital	Orange, TX	-160.5%	−$19.5M	$12.1M
33	Rio Grande State Center	Harlingen, TX	-160.4%	−$27.0M	$16.8M
34	Terrell State Hospital	Terrell, TX	-160.3%	−$92.6M	$57.7M
35	Compton Heights Hospital	St. Louis, MO	-158.8%	−$43.9M	$27.6M
36	Bucks County Hospital	Bensalem, PA	-158.5%	−$20.2M	$12.7M
37	Franklin Regional Medical Center	Louisburg, NC	-153.4%	−$23.7M	$15.5M
38	Marshfield Medical Center Weston	Weston, WI	-148.2%	−$137.4M	$92.7M
39	Cabrini Medical Center	New York, NY	-146.0%	−$19.2M	$13.2M
40	Sharon Regional Health System	Sharon, PA	-145.6%	−$32.0M	$22.0M
41	Denver Springs	Englewood, CO	-145.0%	−$19.9M	$13.7M
42	Cleveland Emergency Hospital	Cleveland, TX	-143.2%	−$31.6M	$22.1M
43	Covenant Specialty Hospital	Lubbock, TX	-142.1%	−$14.4M	$10.2M
44	Woman S Medical Hospital	Philadelphia, PA	-140.2%	−$14.3M	$10.2M
45	Chalmette Medical Center	New Orleans, LA	-135.6%	−$67.3M	$49.6M
46	Nix Health Care System	San Antonio, TX	-135.0%	−$68.8M	$51.0M
47	Salt Lake Regional Medical Center	Salt Lake City, UT	-134.0%	−$60.6M	$45.2M
48	Welch Community Hospital	Welch, WV	-132.6%	−$17.6M	$13.3M
49	Pbi Regional Medical Center	Passaic, NJ	-130.2%	−$24.8M	$19.0M
50	Rusk State Hospital	Rusk, TX	-129.4%	−$100.7M	$77.8M

▸ BY STATE

Share of hospitals operating at a loss, by state

Puerto Rico56% (35/62)Alabama51% (56/110)Kansas50% (70/139)Arkansas47% (50/107)Connecticut46% (19/41)North Dakota46% (21/46)New York46% (109/239)Oregon45% (35/77)Massachusetts44% (56/126)Missouri44% (78/178)Pennsylvania44% (137/313)District of Columbia43% (6/14)California42% (211/506)Illinois41% (105/256)Rhode Island38% (5/13)Mississippi38% (43/113)New Jersey38% (43/113)Wyoming38% (14/37)Montana38% (23/61)Tennessee37% (57/153)Louisiana35% (70/201)Texas35% (228/656)Maine35% (19/55)Washington34% (41/120)Oklahoma34% (46/135)Idaho34% (20/59)Indiana33% (69/206)Vermont33% (7/21)Georgia33% (63/190)North Carolina33% (50/153)Colorado32% (37/114)West Virginia31% (23/75)Ohio30% (79/262)Michigan30% (62/206)South Carolina30% (27/91)Virginia28% (35/124)Florida28% (83/295)New Hampshire28% (11/40)Maryland27% (17/63)Nebraska26% (27/104)Minnesota26% (40/156)Wisconsin24% (45/184)Alaska24% (5/21)Arizona24% (29/123)South Dakota23% (12/52)Hawaii23% (6/26)Utah20% (12/59)Delaware19% (3/16)New Mexico18% (10/56)Nevada18% (10/57)Iowa17% (25/145)

Methodology

Operating margin is net income divided by total revenue, taken from each hospital's most recent Medicare Healthcare Cost Report Information System (HCRIS) filing. We include only hospitals reporting more than $10.0M in total revenue with complete revenue and net-income figures, to avoid distortions from very small or partially-reported facilities. A negative operating margin means the hospital spent more than it took in for that fiscal year. State rates include only states with at least five qualifying hospitals.

Want the underlying numbers for any hospital? Every facility links to its full HCRIS profile — multi-year financials, peer benchmarks, and a distress radar. Browse hospitals by state or search a specific hospital.

▸ USE THIS RESEARCH

Cite or embed this study

This research is free to reference. Journalists and researchers are welcome to cite the figures with a link back to HCRIS.

CITATION

HCRIS. (2025). Hospitals Losing Money. Retrieved from https://hcris.io/hospitals-losing-money

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<a href="https://hcris.io/hospitals-losing-money" style="display:inline-block;border-left:4px solid #84cc16;padding:10px 14px;font:14px/1.4 system-ui,sans-serif;color:#0f172a;text-decoration:none;background:#f8fafc;border-radius:4px;max-width:520px"><strong>35% of U.S. hospitals are operating at a loss</strong><br>Source: HCRIS — Hospitals Losing Money (2025)</a>

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35% of U.S. hospitals are operating at a loss
Source: HCRIS — Hospitals Losing Money (2025)