The NC Rural Health Research Program’s Findings Brief, Geographic Variation in the Profitability of Critical Access Hospitals, examines how the profitability of Critical Access Hospitals (CAHs) varies greatly across states and U.S. Census divisions. The decertification of CAHs and the loss of cost-based reimbursement are likely to reduce hospital profitability, with some states and regions being more adversely affected than others. At the present time, CAHs in Hawaii, Georgia, and Kansas had both the lowest total margin and lowest operating margin. CAHs in South Atlantic and East South Central had both the lowest total margin and the lowest operating margin. CAHs in East North Central had both the highest total and highest operating margins.