In rural communities, the need for hospice services is increasing as the number of rural hospice providers decreases and demand for hospice continues to increase. Receiving quality hospice care has been linked to improved outcomes, including greater patient and family care satisfaction and better quality of life. Given that Critical Access Hospitals (CAHs) are smaller in nature, tend to have fewer resources at their disposal, and often serve vast geographic areas, providing hospice services can be a challenge for CAHs. Because CAHs are often the sole health care provider in their communities, caring for patients across generations, their staff may be intimately familiar with the populations they serve and CAHs may be uniquely situated to provide quality end-of-life care for their patients. This policy brief identifies common characteristics of CAHs providing hospice services, explores the processes by which CAHs provide hospice care, and investigates the strengths and challenges of providing such care in communities served by CAHs.