Rural hospitals across Ohio face financial straits worse than their urban counterparts as expenses rise and health care reimbursements decline. A January snapshot by iVantage Health Analytics found hospitals in the state's metropolitan counties were running slightly in the black, while those in non-metro counties — often the largest employers — showed narrow losses, The Columbus Dispatch reported Sunday. Four years ago, struggling hospitals in Washington Court House and Logan closed their maternity units. More recently, hospitals in Chillicothe and Zanesville saw their bond ratings downgraded. Hospital workers in Gallipolis face possible layoffs later this year, while OhioHealth announced this week it will close its inpatient hospital in Nelsonville before 2015.