The Federal Office of Rural Health Policy has created clear expectations and incentives for CAHs to engage with their communities, develop collaborative delivery systems of care, and undertake efforts with those in their community to address unmet community health and health system needs. Additionally, there has been a growing push in clarifying the “community benefit” provided by not-for-profit hospitals – including the development of community benefit reporting requirements in dozens of states. The Flex Monitoring Team worked to develop a set of community impact and benefit indicators for CAHs, which attempt to provide rural-relevant community impact indicators for CAHs to quantify their benefit to their communities. Through use of these indicators, CAHs can document their community impact activities and CAH progress in meeting community needs can be monitored. The indicators were pilot tested with approximately 25 CAHs across six states before finalization.