Using a novel integration of spatial analysis, multi-level modeling, and difference-in-difference tests, we propose to 1) investigate whether safety-net providers were more likely to defray the demand for services due to their proximity to hospitals that closed and 2) quantify the impact of hospital closures on rural mortality rates. The proposal aims to fill gaps in prior work by providing national estimates of impacts of hospital closures for rural populations due to changes to potential demand for services as well as in changes in health outcomes. Our study findings will provide new information on the cascading effect of increasing transportation times, social and economic conditions, and reduced access to healthcare providers on population health outcomes within rural communities.