Since 2005, 64 of the 182 total rural hospital closures were Critical Access Hospitals (CAHs). Considering the unique challenges that exist in small rural hospitals that may lead to increased risk of closure, there is a need to identify promising interventions for improving financial and operational performance. This study will build upon prior work from the Flex Monitoring Team on high performing CAHs to identify hospital-level factors and interventions that may present opportunities for improving the financial performance of CAHs.