As part of the monitoring efforts for the Medicare Rural Hospital Flexibility Program (Flex Program), the Flex Monitoring Team conducted a national telephone survey of 500 CAH administrators between January and April 2004. The purpose of the survey was to document the program-related experiences of CAHs over the past two years, in order to help shape public policy to improve the effectiveness of the Flex Program and CAHs. The CAH survey was developed by the Flex Monitoring Team members at the Universities of Minnesota, North Carolina, and Southern Maine and fielded by the Survey Research Center in the Division of Health Services Research and Policy at the University of Minnesota. Report produced by the Flex Monitoring Project, funded by the Office of Rural Health Policy.