Examines recent trends in the provision of both charity care and uncompensated care by rural hospitals in five states. Also identifies rural communities whose charity and uncompensated care may diminish if their hospitals face more intense financial pressures as a result of the Balanced Budget Act. Two major findings: 1) differences in hospitals' expenditures on charity and uncompensated care vary dramatically across states; and 2) hospital financial health may have a limited effect on charity and uncompensated care expenditures. Concludes that future access to hospital services in many rural communities will depend upon how the uncompensated care burden is shared between hospitals and the state. Report available on request by contacting the Center.