21.   It threatens to put rural hospitals and urban hospitals out of business.

22.   Legislators may push for loosening state certificate-of-need laws, so rural hospitals can branch into new businesses.

23.   Like many rural hospitals, his center, Saunders County Health Services, ministers to a population that is largely elderly and exceedingly dependent on Medicare.

24.   On the whole, though, federal reimbursements to rural hospitals are lower than those made to urban hospitals.

25.   Rural hospitals are spewing red ink.

26.   Rural hospitals have less competition when they negotiate for contract rates than those in urban areas.

27.   Rural hospitals play a critical role in assuring access to basic health care to underserved populations, he said.

28.   Rural hospitals are anyway in difficulties.

29.   Rural hospitals are being hit even harder on two other fronts.

30.   Rural hospitals are especially vulnerable because of the high cost of compliance.