The news that the Bradford Regional Medical Center is going to downsize its operations from patient, emergency and long-term care services to an ambulatory and outpatient model is the latest in a long line of warnings about the state of rural health care in Pennsylvania. The closure notice primarily affects the 20-bed inpatient unit, where the average daily census is fewer than one patient per day in 2026 and inpatient utilization has declined by 73% since 2019.

Don Boyd, president and CEO of Kaleida Health, said federal funding cuts and longstanding financial issues across the health care industry forced the move. Bradford’s population – like many in this region of Pennsylvania and New York state – is declining to the point that the hospital isn’t seeing enough patients to merit remaining open. Financially the hospital has been losing an average of $10.1 million each year since 2021.

A report by the U.S. Department of Agriculture Economic Research Service, found that 146 hospitals in rural U.S. counties closed or were converted to non-acute care between 2005 and 2023. Of the 146, 81 shut down completely. The problem is becoming less of a “they” problem and more of a “we” problem.

In January Warren General Hospital announced it would suspend inpatient labor and delivery procedures. February 2025 brought news that UPMC Cole in Coudersport was closing its labor and delivery unit. As of May 2025, Crozer-Chester Medical Center in Delaware County ceased operations, following the closure of Taylor Hospital, marking the collapse of the county’s largest health system.

The state Office of Rural Health has tracked 36 rural hospital closures in Pennsylvania since 2020.

Access to health insurance has been one of the great political talking points of the past 20 years. It’s an important issue – but what good is health insurance if there is no hospital to accept the insurance? It’s time for our health care conversations to focus on providers as well as access.