Hospitals are a vital part of a nation’s social infrastructure, but they are also businesses that grapple with operational stresses, including staffing shortages and rising costs.

According to the American Hospital Association, the U.S. had 6,093 hospitals in 2022, led by more than 5,000 nonfederal, short-term general, and other special hospitals – like facilities dedicated to obstetrics, gynecology, and orthopedics. These hospitals contain a total of about 789,000 staffed beds, and last year reported 31.4 million admissions and $1.1 trillion in expenses – or roughly $35,000 per admission.

However, nearly one out of five U.S. hospitals were facing “critical” staffing shortages last year, according to the Department of Health and Human Services. States experiencing the largest share of hospitals with serious staffing shortages include small states like Vermont, where 52% of hospitals have insufficient hospital staff, and the nation’s most populous state, California, where 35% of hospitals say they don’t have enough staff. (These are the 16 states where hospitals are experiencing the worst workforce shortages.) 

Staffing shortages can be a problem in both urban and rural America. Rural hospitals struggle to maintain their services because of a low pool of medical care recruits and limited financial resources. In large cities, hospitals can be well-funded but struggle with the large quantity of admissions relative to the number of available staff despite the larger number of qualified medical care candidates.

To identify the cities with the most hospitals, 24/7 Tempo reviewed statistics on non-federal short-term acute-care hospitals by the American Hospital Directory. Data is based on each hospital’s most recent cost report and is up to date as of early May 2023. The AHD collects data on thousands of hospitals nationwide, drawing on both public and private sources, including Medicare claims data, hospital cost reports, and commercial licensors. Gross patient revenue (inpatient and outpatient) is taken from each hospital’s most recent Medicare Cost Report.

Click here to see the American cities with the most hospitals

Fifteen hospitals on this list have more than 1,000 staffed beds. Two hospital networks, New York-Presbyterian and Cedars-Sinai Medical Center in Los Angeles reported the highest annual gross patient revenue at $25 billion and $24 billion, respectively. (See this list of America’s best health care systems.)