Hospitals

Hospitals (NAICS 622) form the backbone of U.S. inpatient and emergency care delivery. The subsector covers general medical and surgical hospitals, psychiatric facilities, specialty hospitals, and rehabilitation centers. According to the American Hospital Association, roughly 6,120 hospitals operated in the U.S. as of 2023, with combined expenses exceeding $1.3 trillion. HCA Healthcare, the largest investor-owned system, runs over 180 hospitals across 20 states, while nonprofit giants like CommonSpirit Health and Kaiser Permanente anchor care delivery in California and other western states. Hospitals operate under CMS Conditions of Participation for Medicare, Joint Commission accreditation standards, and the 340B Drug Pricing Program, which allows eligible facilities to purchase outpatient drugs at reduced prices. The Affordable Care Act's Hospital Readmissions Reduction Program penalizes facilities with excess 30-day readmission rates, reshaping discharge planning across the sector. Texas, Florida, and California collectively account for the highest hospital bed counts in the nation. Workforce-wise, the subsector employs over 5.2 million people, though the Bureau of Labor Statistics projects a shortfall of over 200,000 registered nurses by 2030, concentrating recruitment pressure on rural and safety-net facilities.