The Chartis Group


Since 2010, The Chartis Center for Rural Health has explored the stability of the rural health safety net. Despite continued downward pressure on rural hospital operating margins and health disparities, our research indicates that rural hospitals are successfully moving the needle on performance and delivering higher quality care. 

Data on this year’s Top 100 Critical Access Hospitals show performance levels at or exceeding the 80th percentile in areas such as Quality, Patient Perspective, and Charges. Iowa leads the nation with the most 2019 Top 100 CAHs with 15, followed by Nebraska (9), North Dakota (9), and Wisconsin (8). In all, 24 states are represented this year. 

Nearly 40 percent of this year’s Top 100 CAHs have received this honor more than five times, while 19 hospitals earned Top 100 status for the first time in 2019. These statistics demonstrate both an ability to sustain a higher level of performance and apply proven strategies for improvement to current financial and operational practices. Learn more at