In 2020, Congress acted to prevent any more loss of essential health care services in rural areas by creating a new designation: Rural Emergency Hospitals (REHs). REHs became official on January 1, 2023. Since then, a growing number of rural care providers have voluntarily converted to this category. In this discussion, two rural health care leaders assess how the conversion to Rural Emergency Hospital is proceeding, and how to build trust and buy-in from patients and communities.