Although chronic respiratory diseases, including COPD, are a leading cause of death in the U.S., treatments such as pulmonary rehabilitation can improve the quality of life and prevent or delay death. Access to respiratory care services is especially important for rural populations, which are more likely to suffer from chronic respiratory diseases. We examined the availability of respiratory care services and respiratory therapists in different types of hospitals and found that Critical Access Hospitals (CAHs) are significantly less likely than rural and urban Prospective Payment System (PPS) hospitals to provide respiratory care services or to employ respiratory therapists.