This study examined the disaster preparedness plans within selected rural North Dakota hospitals. The ultimate goal was to explore rural North Dakota hospitals' disaster preparedness plans, gathering information that would provide answers to some key disaster preparedness questions. This study looked at the steps these hospitals have taken, but also what they have planned for in terms of surge capacity, plan activation, and implementation of the disaster plan and training that goes along with it. Several themes emerged from the data that brought new light to the research. These themes included reviewing and revising the disaster preparedness plans, memoranda of understanding, disaster preparedness plan activation, all-hazards planning, training and exercising the disaster preparedness plan, liability and insurance, community representation, and surge capacity. Specific thoughts about rural hospital disaster preparedness versus urban hospital disaster preparedness were also discussed. The significance of the study and suggestions for future research were also presented.