The data reported here provide a starting point for understanding Critical Access Hospital (CAH) community involvement. Data were collected and analyzed from a national telephone survey of CAH administrators conducted in 2004. Survey respondents were asked about community involvement activities including community needs assessment, outreach and formal health promotion programs, relationships with other community organizations, free or reduced cost healthcare, and hospital activities in support of special populations. Most CAHs are engaged in activities that offer benefit to their community beyond hospital-based acute care services. Administrators recognize the importance of being responsive to community needs and seek the financial support necessary to maintain outreach activities. The outreach programs reported by CAH administrators resemble typical community activities for a healthcare facility, with a particular emphasis on health promotion and management of chronic conditions. Report produced by the Flex Monitoring Project, funded by the Office of Rural Health Policy.