In Appalachian Ohio, districts are 2.5 times more likely than other districts to earn "efficiency" ratings from the state education agency (SEA). District accountability performance is not adjusted for poverty or other structural threats, and affluent suburban districts are permitted to address the same standards as impoverished rural and urban districts. The SEA calls his "accepting no excuses." This study, arguing that poverty (and other threats) are not irrelevant temporizations but powerful threats, investigates the charge of deficiency in the case of district-level mathematics Performance, holding all else equal. The analysis theorizes the influence of 10 independent variables on three dependent measures (mathematics pass rates, mathematics achievement efficiency, and number of accountability indicators passed). All else equal, the results suggest that Appalachian locale and rural locale exert significant influences on the dependent variables, and that, most particularly, (a) the charge of deficiency is inapt and (b) Appalachian districts are more efficient in the production of mathematics achievement than other districts. In short, Appalachian districts do more with less in cultivating the mathematics learning of their students. One of several surprising results is that the proportion of expenditures devoted to instruction (i.e., teacher salaries), particularly among lower-spending districts, exerts a positive a positive influence on achievement. Recommendations include the need for (a) a value-added accountability model in Ohio and (b) resource levels adequate to sustain smaller schools and districts and to fund competitive teacher salaries in rural and Appalachian districts.