The County also faces a challenge because the Medicare and Medicaid payments are often not enough to cover expenses. Due to the fact that many of the residents of the county have blue collar construction type jobs, residents that actually have health insurance are few and far between. It is also true that a large part of the community is unemployed or is amongst the senior population. Ashe County has a larger senior population that even many of the other rural communities. All these factors have left Ashe County with a very precarious health care situation. With the situation in Ashe County, many of the traditional strategic planning concepts will not work as well as they would in larger communities. For example as a Health Care manager I would perform a service area competitor analysis in larger communities. This would be necessary in order to gain an understanding of the current competitor environment. The service area competitor analysis would also help our organization to see where our competitors may have weaknesses and help us to gain a competitive