HUNTSVILLE — A new Alabama Hospital Association survey shows that the majority of the state’s health care facilities are struggling to make ends meet.

The report shows that hospital executives are laying off workers, cutting back services and selling hospital equipment to get their budgets in the black. The survey talked to 84 of Alabama’s 106 hospitals.

Executives blamed the downturn on increasing charity and emergency care, rising interest rates on debt and declining patient admissions.

The survey says that nearly 70 percent of hospital CEOs have laid off workers. A third said they’ve cut back services or put hospital buildings and equipment up for sale.