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Due to COVID-19, CRH will continue working remotely until further notice.

Finance & Operations

The North Dakota Flex Program provides financial assistance to North Dakota's Critical Access Hospitals (CAHs) in their efforts to adapt to the changing rural healthcare environment. Learn more about these Flex funding programs:

"Peer Exchange" Rural Healthcare Exchange & Professional Development Program

Note: Applications and Outcomes Reports must be submitted through the online forms, they will not be accepted via mail or email.

Questions? Contact Jody Ward at (701) 858-6729 or by email at

2023 North Dakota CAH Subcontract

Sample Budget | Sample Budget Narrative

Application previews:
Use these to view the application form that you will be completing online. It is recommended that you prepare your responses, including attachments, in advance and then complete the online application. You will not be able to reenter the online application once you exit, so the full application must be completed in one session.

Submit your applications through these online forms:

Note: Applications must be submitted through the online forms, applications will not be accepted via mail or email.

Questions? Contact Holly Long at (701) 213-9985 or by email at

North Dakota Flex Program Critical Access Hospital Improvement Activity

Funding is available to support North Dakota CAHs in identifying potential opportunities for improvement through the areas of Quality, Outcomes, Patient Perspectives, or Financial Indicators. All North Dakota CAHs are eligible to apply for Flex subcontract funding. The North Dakota Flex Program anticipates funding up to $25,000 will be made available for awarded CAHs to select a vendor of choice and work on an identified area of improvement OR submit a project improvement plan for one of the identified areas.


Questions? Contact Nicole Threadgold at (701) 330-3264 or by email at

Rural Emergency Hospital Provider Designation

The new Rural Emergency Hospital (REH) provider designation is set to become an option for CAHs to consider converting to beginning January 1, 2023. The North Dakota Flex Program is partnering with the North Dakota Hospital Association to produce statewide education related to the new REH designation now through August 31, 2023.

For CAHs interested in assessing the feasibility of converting from CAH to REH, a national REH Technical Assistance Center (TAC) has been established and funded by the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

The REH-TAC services include:

  • Providing education and performing an initial assessment
  • Providing a rural-relevant subject-matter expert/coach to provide 1:1 guidance and support
  • Performing financial assessments where there is indication that the REH designation could be a viable option
  • Supporting strategic planning once a community identifies that REH is a viable path forward
  • Assisting with the application and providing ongoing support throughout the conversion process

Questions? For general questions and REH resources available through the North Dakota Flex Program, contact Nicole Threadgold at (701) 330-3264 or by email at For REH-TAC inquiries, email