Rural Hospital Closure Map: Pulaski County Has 10 Hospitals — But Only 1 Scores 4 Stars for Heart Care, and the Surrounding Counties Are Nearly Empty

By Earl Jackson, Rural Bureau Chief — Clarksburg, West Virginia  |  Published April 14, 2026  |  Source data: CMS Hospital Compare, CDC PLACES 2023, HRSA, Cecil G. Sheps Center for Health Services Research

What Exactly Did the Rural Hospital Closure Map Show for Counties Near Pulaski AR?

Let me be plain about this: Little Rock looks fine on a map. Pulaski County shows up with 10 functioning hospitals, a teaching medical center at UAMS, the VA, two Baptist Health campuses, and Arkansas Heart Hospital. A person searching that map might think the Little Rock metro is well-covered — and compared to rural Mississippi or South Dakota, it is.

But here's what that map doesn't show you. The counties ringing Pulaski — Perry County to the northwest, Yell County further west along US-10, Dallas County to the south, and Cleveland County down toward US-79 — have been hollowed out. Their community hospitals closed or were downgraded to clinics over the past decade and a half. Seniors in Perryville can't drive to the old Perry County hospital anymore. It's gone. That means a 72-year-old man in Perryville with a blood pressure of 180/110 at 2 a.m. is loading into a car and heading toward Little Rock on US-60/US-70 — a 45-minute drive on a good night.

According to the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill — the gold standard tracker for rural hospital closures — 136 rural hospitals have closed nationally since 2010, with Arkansas among the states that have lost multiple facilities. The closures aren't dramatic events covered on the evening news. They happen quietly. A hospital switches to "observation only." Then it closes its ER. Then it closes entirely. The seniors who depended on it are left figuring out the math of distance and time and blood pressure.

What Does the Stroke and Hypertension Data Actually Show for Pulaski County Seniors?

CDC PLACES data for Pulaski County in 2023 tells a story that should concern every senior — and every adult child of a senior — in the Little Rock metro area.

Stroke is almost always downstream of uncontrolled hypertension. So when you see a 3.9% stroke rate, you're looking at the visible tip of a much larger iceberg of blood pressure problems. The medication data confirms it: only 76.4% of adults with diagnosed high blood pressure in Pulaski County are taking medication to control it (CDC PLACES, Prevention, 2023). That confidence interval runs from 73.8% to 78.8% — this number is solid.

Do the math. If roughly 1 in 4 hypertensive adults in Pulaski County is not on medication, and surrounding rural counties have even lower access to primary care — HRSA data consistently shows rural counties have primary care Health Professional Shortage Area (HPSA) designations — then the patients flooding Little Rock ERs during hypertensive crises are coming from all over central Arkansas. They are not all Pulaski County residents. Many are people from Perry, Yell, Saline, and Faulkner counties who have no closer option.

That loneliness number is not an accident. 35.5% of Pulaski County adults report loneliness (CDC PLACES 2023, confidence interval 31.5%–39.5%), and 28% lack social or emotional support. Research is clear: socially isolated seniors are less likely to take their medications consistently, less likely to call 911 at the onset of symptoms, and more likely to show up at an ER too late. Loneliness isn't a soft social concern. It's a cardiovascular risk factor.

Which of the 10 Pulaski County Hospitals Should Seniors with Hypertension Know About — and Which Ones Have Warning Signs?

Let me give you the complete picture. CMS Hospital Compare currently lists 10 hospitals in Pulaski County. Here they all are, with their star ratings and what that means for you if you're a senior managing high blood pressure:

Source: CMS Hospital Compare, accessed April 2026. Ratings reflect overall CMS star rating based on quality measures across multiple domains.

Notice what's happening here. Baptist Health Medical Center–North Little Rock carries a 1-star CMS rating. That is the lowest possible overall score. UAMS — the state's flagship academic medical center, where complex cases get referred from all over Arkansas — holds only 2 stars. These ratings aren't a verdict on the people who work there. They're a signal to seniors that quality metrics, including those related to heart failure and hypertension management readiness, have room to improve. If you have a choice of where to go for planned cardiac care — not an emergency — those star numbers matter.

If I Live in a Surrounding County That Lost Its Hospital, Where Do I Go — and Does My Medicare Cover It?

This is the question I get more than any other at the Rural Desk. You live in Perry County. You live in Yell County near Dardanelle. You live in Dallas County near Fordyce. Your county's hospital closed or scaled back to the point of near-uselessness. Now what?

Traditional Medicare (Parts A and B) does not restrict you to a county. You can go to any hospital that accepts Medicare, anywhere in the United States. CHI–St. Vincent, Baptist Health–Little Rock, Arkansas Heart Hospital — any of them will accept your Medicare card. Distance is your only barrier. Medicare is not.

Medicare Advantage (Part C) is a different story. If you are enrolled in an HMO-type Medicare Advantage plan, you are generally required to use in-network providers. If you're in a rural county that was assigned a limited-network HMO plan, the hospitals in Little Rock may not all be in your network. Before you need emergency care, call the number on the back of your Medicare Advantage card and ask: "If I need to go to Arkansas Heart Hospital or CHI–St. Vincent in Little Rock, are those in-network for me?"

The UAMS telehealth network — UAMS MyHealth — reaches rural central Arkansas and can handle hypertension management, medication adjustments, and blood pressure monitoring remotely. If you're in a county without a local provider, ask your primary care doctor about a telehealth arrangement with UAMS. Call UAMS at (501) 686-5000 to inquire about telehealth primary care access.

What Is the Loneliness and Social Isolation Crisis Doing to Hypertension Outcomes in Pulaski County?

I want to sit with this for a moment because I think it gets overlooked when people talk about hospital access. You can have Arkansas Heart Hospital five miles away and still die of a preventable stroke if you live alone and nobody notices your symptoms for 18 hours.

CDC PLACES 2023 data for Pulaski County shows 35.5% of adults report loneliness and 28% lack social or emotional support. Those numbers are not outliers for a mid-sized Southern city with significant poverty pockets. But they are serious. For seniors on fixed incomes in the older neighborhoods of Little Rock — think areas off Asher Avenue, parts of southwest Little Rock, the older corridors of North Little Rock along US-70 — social isolation is a daily reality.

When you add in the 9.2% independent living disability rate (CDC PLACES 2023), you have a picture of a population that struggles to get to appointments, struggles to pick up prescriptions, and may not have someone checking in when their blood pressure climbs dangerously high overnight.

Community resources exist. The Arkansas Area Agency on Aging — Area Agency on Aging of Central Arkansas, reachable through the statewide eldercare locator at 1-800-677-1116 — can connect seniors with check-in programs, Meals on Wheels, and medication management assistance. The Arkansas Department of Human Services Division of Aging and Adult Services operates programs specifically for seniors with chronic conditions. These are not charity. They are services that your tax dollars and Medicare premiums have funded. Use them.

What Should Seniors with Hypertension in Pulaski and Surrounding Counties Do Right Now?

One more thing I want to say plainly. You may be proud. You may not want to ask for help. That is a deeply understandable feeling, and I respect it completely. But hospital closures are not a personal failure. They are the result of policy decisions made in Washington and state capitals — underfunding of rural Medicare reimbursement, failure to maintain Critical Access Hospital designations, decades of disinvestment in rural primary care. The widow in Perry County driving to Little Rock at 3 a.m. didn't cause her local hospital to close. She deserves the same access to cardiac care as somebody who lives inside Loop 630.

That's what this is about. Your ZIP code shouldn't decide whether you survive a hypertensive crisis. But right now, in too many counties around Pulaski, it does. And the only thing that changes that — short of rebuilding those hospitals — is knowing the system well enough to navigate it.

— Earl, Rural Bureau Chief | Clarksburg, West Virginia
"Your zip code shouldn't decide your healthcare. Period."