By Andrew Cass of Becker's Hosptial Review

With the end of pandemic-era relief programs, the rural health safety net is under renewed pressure, according to a Feb. 7 report from healthcare advisory firm Chartis Group. 

Six things to know: 

1. Forty-three percent of rural hospitals have negative operating margins. More than half (51 percent) of rural hospitals in non-Medicaid expansion states have negative operating margins, compared with 39 percent in expansion states. 

2. There have been 143 rural hospital closures in the past 13 years, and Chartis research shows another 453 are vulnerable for closure. 

3. Rural hospital closures fell from 19 in 2020 to two in 2021, but crept up to seven in 2022.  

4. Between 2011 and 2019, 198 hospitals ceased to provide obstetrics. That number has since increased to 217 as of the time of the report's release. 

5. Between 2014 and 2019, 311 hospitals stopped providing chemotherapy. That number has since increased to 353. 

6. Conversion requirements and other considerations make it unlikely the new rural emergency hospital designation that went into effect Jan. 1 will deliver widespread relief to the rural safety net. Of the 389 hospitals most likely to consider conversion, a Chartis data model identified 77 that are ideal candidates.