From CAH to REH with Samuel Pennington, CEO

Sam Pennington, Chief Executive Officer of Garden County Health Services in Oshkosh, Nebraska, joins Stronger Together to talk through one of the hardest decisions a rural board can face. In February 2026, Garden County completed its conversion from a critical access hospital to a Rural Emergency Hospital, a designation that only became available to rural facilities in 2023 and that remains unfamiliar territory for most of the field. Sam describes the analysis that led his board to the decision, how the community responded to the loss of inpatient beds, what the REH model actually looks like in daily operation, and what he would tell any rural executive weighing the same path. The conversation is honest about both the opportunity and the tradeoffs.