In a survey, Critical Access Hospital (CAH) CEOs in eight states identified that their most common innovations during the COVID-19 pandemic were related to hospital processes (e.g. patient transfers, testing) and clinical care (e.g. telehealth, separate clinical teams to treat COVID-19 patients). Regarding hospital workforces, the most commonly reported challenges were staff illness and layoffs or furloughs. When asked how they have overcome these challenges, the most common responses among participants mentioned changing the scope of work for employees and providing employee support.