Rural hospital closures have become an epidemic in rural communities across the country. Appalachia has been hit particularly hard. More than 75 rural hospitals have closed since 2010 and the most recent projections from the National Rural Health Association indicate that 673 additional facilities are vulnerable to closure. The data also show that few reopen. But when one hospital closes its doors, the social and economic ripple effects are felt throughout the entire community. This paper will offer the case of one hospital closure in Lee County, Virginia and the efforts of community leaders working in concert with a hospital corporation to repopen the county's only hospital, which was closed by its former owner, Wellmont Health System, in October, 2014. Data will be presented gathered from interviews, secondary sources, and observations from community forums held in the wake of the closure. Information gleaned from the presentation can be instructive to leaders in other communities as they seek restore hospital services in there area. The impact of healthcare financing will also be explored as will the influence of future healhcare legislation.