Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. Proactive adoption of telehealth is essential to stake a value-added position in delivery of healthcare. Creating a regional ecosystem that both supports, and receives support from, local businesses and potential workforce members is vital to building and maintaining a thriving organization. Rural healthcare providers must consider these strategies to ensure that they are able to continue delivering their mission of improving the health of the populations they serve.