What Care-Proximity Data Found Across 765 U.S. Retirement Destinations
We compared four registry-based measures around 765 U.S. destinations. The results show where no qualifying hospital, primary-care, emergency-service hospital, or nursing-home record fell within each defined radius, and where further local research matters most.
Research extraction tested August 5, 2026
Independently researched using government, academic, and other authoritative sources.
The key findings
The two narrower measures produced the largest zero sets. The analysis found 96 destinations with no qualifying FEMA hospital point within 12 straight-line kilometers and 99 destinations with no qualifying HRSA adult-primary-care-likely site within 15 straight-line miles.
The two CMS measures produced much smaller sets: 2 destinations had no qualifying emergency-service hospital record within 30 straight-line miles, and 9 destinations had no qualifying active nursing-home record within 15 straight-line miles.
| Measure | Exact radius | Destinations with exactly zero available qualifying records |
|---|---|---|
| Open FEMA RAPT/HIFLD hospital points | 12 straight-line km | 96 |
| Qualifying permanent HRSA adult-primary-care-likely sites | 15 straight-line miles | 99 |
| Medicare-registered hospitals reporting Emergency Services=Yes | 30 straight-line miles | 2 |
| Currently active CMS-certified nursing homes | 15 straight-line miles | 9 |
These counts identify places that deserve more investigation. They do not determine whether local care is adequate, available to an individual, or better than care in another destination.
Download the 206-row CSVWhat a zero tells you
A zero has one narrow meaning:
No qualifying record from the named registry and source contract fell within the specified straight-line radius from the destination coordinate in this frozen release.
It does not establish:
- that the destination is a care desert or that healthcare is absent
- that the registry contains every local provider or facility
- that a nearby facility has capacity, appointments, or the services a person needs
- that a provider accepts a particular insurance plan
- that care quality is good or poor
- that straight-line distance represents a road route, travel time, or emergency-response time
A nearby record has limits too. It does not establish access, capacity, suitability, insurance acceptance, or quality.
Why there is no combined care score
The four measures answer different questions. They cover different facility types, draw from different registries, apply different qualification rules, and use different radii.
A FEMA hospital point within 12 kilometers is not equivalent to a qualifying HRSA primary care site within 15 miles, an emergency-service hospital record within 30 miles, or an active nursing-home record within 15 miles. Combining them would hide those differences and imply a conclusion the evidence does not support.
Where the results overlap
18 destination slugs appeared in both the FEMA hospital-point zero set and the HRSA primary-care-site zero set. This is a set intersection, not a combined finding.
To avoid selecting examples for effect, the report uses fixed rules. The first three names alphabetically in the 18-destination overlap are Bethany Beach, Delaware; Colonial Beach, Virginia; and Ellijay, Georgia.
The emergency-service hospital zero set contains exactly two destinations: St. Simons Island, Georgia, and Truth or Consequences, New Mexico. The first three names alphabetically in the nine-destination nursing-home zero set are Bar Harbor, Maine; Bisbee, Arizona; and Cape Charles, Virginia.
These examples report source-specific results only. They are not city care assessments and do not establish access, availability, suitability, or quality.
How to use this research
Use a zero as a prompt for closer investigation, not as a verdict about a destination.
- Start with a potential home address, not the destination coordinate, and check real road routes and travel times.
- Confirm current services, appointment availability, capacity, and insurance participation directly with providers.
- Consider the types of care you may need, transportation options, support networks, and how far you are willing to travel.
- Review care proximity alongside housing and household finances rather than treating it as a stand-alone destination score.
For a broader decision process, use the guide to comparing healthcare access in retirement cities. When the next question is financial, compare a city estimate with your plan in the Retirement City Budget Calculator.
How the research was produced
The complete locked release contains 987 destinations and 93,532 measures. This analysis is limited to the frozen U.S. cohort of 765 destinations.
A destination counted as zero only when:
- the metric was present
- availability was recorded as available
- the value was finite and nonnegative
- the value was exactly zero
- the source key matched the required source contract
Missing, unavailable, null, suppressed, negative, nonnumeric, duplicate, and wrong-source records never became zero. The extraction test passed on August 5, 2026 and fails closed if the locked release identifier changes.
View the locked release identifier
metric-release-2026-08-05T23:02:43.942Z-4d008d4ca3a5fb81bacde2929101e46dd3f5cebe5686fd5f6d620dea65c39cb2
Source and coverage details
FEMA hospital points
The hospital-point measure used open records from the FEMA RAPT/HIFLD hospital item and its hospital feature layer. It counted qualifying points within 12 straight-line kilometers of each destination coordinate.
HRSA primary care sites
The primary-care measure used the HRSA Primary Health Care Facilities query, interpreted with HRSA’s GIS developer documentation and health-center background information. The research contract included qualifying permanent adult-primary-care-likely sites within 15 straight-line miles. It excluded locations reported under 20 weekly hours and site types not specific to adult primary care.
View the HRSA exclusion details
The contract excluded dental-only, school-based, mobile, pediatric, behavioral-only, WIC, pharmacy, vision, recovery, and similar sites not specific to adult primary care.
CMS emergency-service hospitals
The CMS hospital dataset contained 4,498 records, with coordinates for 4,454, or 99.02%. A record qualified only when CMS reported Emergency Services=Yes. HIFLD and Census were used only to assign coordinates where applicable, not to infer emergency-service availability.
CMS-certified nursing homes
The CMS nursing-home dataset was modified June 1, 2026. It provided 14,695 currently active rows after deduplication by CMS Certification Number, with valid coordinates for every included row.
Important limitations
A zero means only that no qualifying record from the named registry and source contract fell within the stated straight-line radius of the destination coordinate in this frozen release.
Destination coordinates are place reference points, not home addresses. Straight-line distance is not a road route, travel time, transit time, or emergency-response time.
A registry record does not establish that a facility is open when needed, accepting patients, offering appointments, operating at sufficient capacity, accepting a particular insurance plan, suitable for an individual, or providing high-quality care.
The registries may not contain every local service. Their definitions, reporting practices, update schedules, and facility categories differ, so the four results cannot be combined or treated as equivalent.
The findings apply only to the identified release and frozen U.S. cohort. They do not account for an individual’s health needs, mobility, transportation, finances, insurance, support network, preferred providers, or willingness to travel. They do not rank destinations or determine whether any place is a good retirement choice.
This research is a screening resource, not medical advice or a personalized recommendation. Review the Retirement Lists editorial policy for the site’s evidence and publishing standards.
Sources
Explore with better questions
Use the findings to identify what needs verification, then review destinations in the context of your address, health needs, transportation, finances, and preferred providers.
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