In 2007, the Flex Monitoring Team conducted a national telephone survey of 381 critical access hospital administrators covering a wide variety of questions concerning hospitals’ community benefit and impact activities. This Briefing Paper reports on the community benefit and impact findings of this survey. The results indicate that critical access hospitals are active in monitoring the health and health system needs of their communities, are engaged with other community rganizations and stakeholders to address those needs, and provide services (often free) for patients and other provider organizations in the community that enhance access to care and help build the local rural health system. Nearly all CAHs offer financial assistance to patients in the form of both charity care and discounted charges. In addition to free and discounted care provided to patients, CAHs are engaged in community needs assessments, gap-filling service development, and other activities that demonstrate their attention and responsiveness to community and rural health system needs.