Health care workforce recruitment and retention challenges are pervasive throughout the U.S., driven by factors such as staff shortages, high rates of burnout and turnover, an aging population, and the lingering effects of the COVID-19 Public Health Emergency. Economic pressures, including employee cost of living, further exacerbate these issues. Critical Access Hospitals (CAHs) face unique difficulties in maintaining their workforce due to limited institutional resources, high turnover, and a shortage of essential support services like child care and housing in rural areas.

To help CAHs and other rural providers enhance their workforce efforts, we have created this toolkit, which provides background on health care workforce challenges in the U.S., describes common workforce challenges faced by CAHs, and provides examples of external resources that CAHs across the country may utilize to address their own workforce needs. The toolkit includes five modules, which discuss key workforce challenges and resources by topic:

• The Introduction module summarizes key challenges and barriers in recruitment and retention of rural health care workforce and offers general workforce resources. 
• The Organizational Culture and Leadership module explores the crucial role of effective CAH leadership and provides resources to foster leadership and improve organizational culture in CAHs in the context of workforce challenges. 
• The Leveraging Partnerships module demonstrates the immense potential CAHs have to collaborate with partners in their communities to address their workforce and other needs.
• The Emergency Medical Services Workforce module focuses on workforce issues specific to both paid and volunteer EMS personnel in rural communities. 
• The Administrative and Support Staff Workforce module examines current workforce challenges in recruitment and retention of administrative, support staff, and technicians in CAHs and provides resources to help CAHs address challenges with this segment of the workforce.