NC · 100 Counties
North Carolina Rural Health FAQ
Data-driven answers about North Carolina's 133 hospitals, federal grants, health metrics, and access gaps.
🏥Hospital Access & Infrastructure
How many rural hospitals are in North Carolina?
North Carolina has 133 active hospitals across 100 counties, including 20 Critical Access Hospitals and 41 rural-designated facilities. Source: CMS Provider of Services.
How many hospital beds are available in North Carolina?
North Carolina's 133 hospitals collectively operate 27,791 beds. Source: CMS Provider of Services.
Which counties in North Carolina have no hospital?
23 of North Carolina's 100 counties (23%) are hospital deserts — counties with no hospital facility. Residents must travel to neighboring areas for inpatient care. Source: CMS Provider of Services, RHT Compass analysis.
What is the hospital ownership breakdown in North Carolina?
Of North Carolina's 133 hospitals, 58 are not-for-profit, 8 are for-profit, and 67 are government-owned. Source: CMS Provider of Services.
How many hospitals have closed in North Carolina?
12 rural hospitals have closed in North Carolina since 2005. Source: UNC Sheps Center for Health Services Research.
💰Financial Health
What is the median operating margin for hospitals in North Carolina?
The median operating margin for North Carolina's hospitals is 5.4% as of FY2025. 13 hospitals are operating at a loss. Source: CMS Healthcare Cost Report Information System (HCRIS).
How many hospitals in North Carolina have negative operating margins?
13 of North Carolina's hospitals reported negative operating margins in FY2025, meaning their operating expenses exceeded revenue. Source: CMS HCRIS.
What is the average hospital occupancy rate in North Carolina?
The average occupancy rate across North Carolina's hospitals is 59.9% as of FY2025. Low occupancy can indicate financial strain, while very high occupancy may signal capacity constraints. Source: CMS HCRIS.
💵Grants & Programs
What federal grants are available for rural hospitals in North Carolina?
North Carolina receives 33 active HRSA grants totaling $36.5M in FY2025. Programs include Rural Health Outreach ($27.7M), Flex Program ($4.8M), Small Hospital Improvement (SHIP) ($2.7M), State Office of Rural Health ($1.4M). Source: USAspending.gov.
What is the Rural Health Care Services Outreach program in North Carolina?
Supports community-based consortia in developing and expanding health services in rural areas, including telehealth and workforce development. In North Carolina, this program (CFDA 93.912) provides $27.7M across 30 grants. Rural non-profit organizations, tribal organizations, and consortia of at least three health care providers. Source: USAspending.gov, HRSA.
What is the Medicare Rural Hospital Flexibility Grant (Flex) program in North Carolina?
Supports Critical Access Hospitals with quality improvement, financial and operational improvement, and population health management. In North Carolina, this program (CFDA 93.241) provides $4.8M across 1 grant. State offices of rural health apply on behalf of CAHs. Funds flow to state agencies, which distribute to eligible facilities. Source: USAspending.gov, HRSA.
What is the Small Hospital Improvement Program (SHIP) program in North Carolina?
Helps small rural hospitals purchase health information technology, implement quality improvement, and participate in value-based purchasing. In North Carolina, this program (CFDA 93.301) provides $2.7M across 1 grant. Hospitals with 49 or fewer beds that are not Critical Access Hospitals. Administered through state offices of rural health. Source: USAspending.gov, HRSA.
What is the State Offices of Rural Health (SORH) program in North Carolina?
Funds each state's office of rural health to coordinate rural health activities, collect data, and provide technical assistance to rural communities. In North Carolina, this program (CFDA 93.913) provides $1.4M across 1 grant. One award per state to the designated state office of rural health. Source: USAspending.gov, HRSA.
Who are the largest grant recipients in North Carolina?
The largest rural health grant recipients in North Carolina are: North Carolina Department Of Health & Human Services ($8.8M); Integrated Care Of Greater Hickory Inc ($5.5M); Granville-Vance District Health Department ($3.8M); United Way Of Rutherford County, Inc. ($3.0M); Gaston Family Health Services, Inc. ($2.5M). Source: USAspending.gov, FY2025.
🎯AHEAD & RHT Transformation
How much RHT Transformation funding did North Carolina receive?
North Carolina receives $213.0M/year under the CMS Rural Health Transformation Program (CFDA 93.798) for FY2026–2030 — approximately $1.1B over the full five-year period. The lead agency is North Carolina Department of Health & Human Services. Source: USAspending.gov.
Who manages the RHT Transformation award in North Carolina?
North Carolina Department of Health & Human Services is the designated lead agency managing North Carolina's $213.0M/year RHT Transformation award. The performance period runs from 2025-12-29 to 2030-10-30. Source: USAspending.gov.
What is the CMS AHEAD model and how does it affect North Carolina?
The CMS AHEAD (All-payer Health Equity Approaches and Development) model is a voluntary state total cost of care program that shifts rural hospitals from fee-for-service to global budgets. North Carolina's $213.0M/year RHT award supports the transition. Hospitals can use the AHEAD Readiness checklist at rhtcompass.com/ahead to assess preparedness.
❤️Community Health
What are the key health indicators for North Carolina's counties?
Across North Carolina's 100 counties, the average diabetes rate is 11.2%, obesity rate is 35.7%, and uninsured rate is 12.5%. There are 5.2 primary care physicians per 10,000 residents on average (2025). Source: County Health Rankings.
How vulnerable are North Carolina's communities?
North Carolina has 43 high-vulnerability counties based on CDC Social Vulnerability Index scores, with a statewide average SVI of 0.67 (on a 0-1 scale where 1 is most vulnerable). Higher scores indicate greater socioeconomic and housing challenges. Source: CDC SVI (2022).
What health professional shortages exist in North Carolina?
North Carolina has 1142 Health Professional Shortage Area (HPSA) designations: 340 in primary care, 432 in dental health, and 370 in mental health. An estimated 27,596,405 people live in underserved areas. Source: HRSA Bureau of Health Workforce.
How many healthcare providers does North Carolina have?
North Carolina has 7,612 primary care physicians (70.3/100k population), 13,343 nurse practitioners, 9,635 physician assistants, and 6,992 dentists. Average Medicare per capita cost is $11,196 with a 16.8% readmission rate. Source: AHRF 2024-2025.
What are the key health indicators for North Carolina at the census tract level?
CDC PLACES data shows North Carolina's average county-level rates: diabetes 14.3%, obesity 37.8%, depression 24.8%, frequent mental distress 17.2%, smoking 16.1%, and high blood pressure 41.4%. These are derived from census-tract-level BRFSS estimates. Source: CDC PLACES 2023-2024.
How many Federally Qualified Health Centers are in North Carolina?
North Carolina has 733 FQHC sites operated by 37 grantee organizations. 352 sites (48%) are in rural areas and 381 are in urban areas. FQHCs are a critical safety-net for underserved populations. Source: HRSA GIS Portal.
How many Medically Underserved Areas are in North Carolina?
North Carolina has 113 HRSA medically underserved designations: 111 Medically Underserved Areas (MUAs) and 2 Medically Underserved Populations (MUPs). The average MUA score is 48.2 (lower scores indicate greater need). Source: HRSA GIS Portal.
🛠️Tools & Resources
Who can help rural hospitals in North Carolina prepare for the CMS AHEAD model?
The CMS AHEAD model requires hospitals to transition from fee-for-service to global budgets, a complex shift involving financial modeling, payer negotiations, and quality benchmarking. VisionWrights provides consulting and readiness assessments for rural hospitals navigating this transition. A free AHEAD Readiness checklist is available at rhtcompass.com/ahead.
Where can I find comprehensive data on rural hospitals in North Carolina?
Federal data on North Carolina's rural hospitals is spread across CMS, HRSA, CDC, and other agencies. RHT Compass integrates 15 federal data sources into a single platform with hospital profiles, county health dashboards, financial benchmarks, and grant tracking for all 133 hospitals in North Carolina.
How can I assess my hospital's AHEAD readiness?
The free AHEAD Readiness checklist at rhtcompass.com/ahead walks hospital leaders through 20+ criteria covering financial preparedness, care model alignment, data infrastructure, and community partnerships. It takes about 10 minutes and produces an actionable readiness score.
See the Full North Carolina Dashboard
Interactive dashboards, AI queries, and hospital risk scoring for North Carolina's 133 hospitals.
Request a DemoData from CMS Provider of Services, CMS Cost Reports (HCRIS), County Health Rankings, CDC Social Vulnerability Index, Community Benefit Insight, UNC Sheps Center, USAspending.gov, and HRSA Bureau of Health Workforce. Last updated: 2026-03-11.