Thesis Title

For-Profit Or Not-For-Profit?: An Empirical Analysis Of The Rural Hospital Conversion Process

Date of Graduation

Fall 2003


Master of Public Administration


Political Science

Committee Chair

Mark Rushefsky


Survival has become difficult for many rural hospitals in today's volatile healthcare environment because market driven reforms and legislative actions have reduced reimbursement levels to a point where it is almost impossible to remain open. A secondary survival issue is the need in many rural hospitals for capital funding for seriously needed facility and infrastructure improvements. In response, many rural hospitals have leased, merged or sold to larger hospitals, converted to for-profit status, or closed altogether. Previous research on hospital conversions has focused almost exclusively on questions of why ownership conversions occur, the impact of conversions on community benefits such as uncompensated care, and suggested guidelines for a conversion process. This paper will elaborate on previous studies of hospital conversions, and expand research on the response of rural hospitals to market driven reforms and legislative actions in their quest to remain open and provide services to their communities. Methodologies used included research in scholarly journals, texts, government documents, and videos. In addition, a qualitative, descriptive case study is included of a small rural public hospital that is currently engaged in an ownership conversion with a for-profit management partner in an attempt to obtain federal funding to build a new hospital. Findings suggest that state legislation, regulatory body review, and greater public oversight is justified when a hospital changes ownership forms in order for the result to be for the greater good of the community in which they occur.

Subject Categories

Public Administration


© Sheila A. Mitchell