During the past decade, access to health care services provided by rural hospitals has changed in two major ways. First, there has been a substantial increase in the number of rural hospitals that have completely closed or converted (provide some health care services, but not inpatient care). Second, and less understood, many rural hospitals have reduced or terminated services historically considered to be essential hospital services. The purpose of this study is to gain a better understanding of (1) recent trends in hospital service provision and (2) whether there were disparities between rural and urban hospitals. In the brief, Changes in Provision of Selected Services by Rural and Urban Hospitals between 2009 and 2017, the NC Rural Health Research Program describes and compares the changes in service provision for rural and urban hospitals between 2009 and 2017.