A key issue facing the United States is how to structure rural health care delivery. In research and policy discussions of this challenge, a core focus has been the appropriate role for rural hospitals. In rural areas, hospitals face structural barriers to delivering care: low patient volumes limit revenues and drive up the cost of care delivery, leading to closure and undermining surviving hospitals' capacity to provide high-quality care. 1 Yet, losing access to hospital care can be detrimental to the health of local residents. 2–4 Rural hospitals also provide important services in times of crisis, most recently during the COVID-19 pandemic, when there is an influx of patient needs. 5–7