COVID-19 has posed unique challenges to rural communities and rural hospitals, including Critical Access Hospitals (CAHs). The ability of CAHs to respond to COVID-19 challenges has been impacted by the resources available to the hospital, including whether or not hospitals are affiliated with a larger health care system. In this project, the Flex Monitoring Team will examine how being a system-affiliated or independent CAH impacted overall COVID-19 response. The project will include CAH COVID-19 responses as they pertain to three areas: workforce and staffing, emergency management planning and coordination, and patient transfers.