FORHP funded the National Academy for State Health Policy to learn from states who expressed early interest in the REH provider type and national experts and develop a guide. This guide allows states to follow their own regulatory processes in drafting and enacting legislation and covers various decision points to consider should they decide to move forward to allow the REH designation. The REH provider type is designed to address concerns that some rural hospitals would not be able to sustain operations and could be at risk of complete closure. So far, approximately 20 states have REH licensure or regulations in place so this guide can help the remaining states that are considering adding REH licensure or regulations.