Critical Access Hospital Recognition Nomination Form

Do you know of a critical access hospital (CAH) that has implemented an innovative approach to Collaboration through Telehealth to minimize barriers by connecting rural populations to needed health care in order to address clinical issues and patient needs, as well as provide support, resources, and education? If so, please consider nominating them for Critical Access Hospital Recognition, an initiative of the Technical Assistance and Service Center (TASC), a program of the National Rural Health Resource Center (The Center), and the Federal Office of Rural Health Policy (FORHP).

The purpose of the Critical Access Hospital Recognition initiative is to capture best practices and recognize the innovative work being done in CAHs across the country. It is also an opportunity for state Flex Coordinators to highlight the support state Flex Programs are providing to CAHs.

Based on the scoring criteria listed below, chosen CAHs will each receive a Certificate of Recognition. They will also be profiled in TASC’s electronic newsletter, Rural Route, and on the TASC website. The Center will also promote chosen CAHs via our social media platforms. Visit the CAH Recognition Awardee Spotlights page to see previous awardees. A press release template will be sent to the selected CAHs to assist them in promoting their recognition to communities in their service area.

The deadline to submit a nomination is Friday, February 19, 2021.

CAH Nominee
Hospital Administrator
Flex Coordinator
Supporting documentation may be emailed to Andy Naslund at
(0-3 points)
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This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.