In states where Medicaid was not expanded, small rural hospitals were forced to take drastic measures to stay afloat. In rural Georgia, a rookie CEO, Angela Ammons who had worked herself up from a homeless immigrant to registered nurse managing a team, convinced the hospital system to give her a chance as CEO, citing her life experience of struggle and resiliency for making her a great candidate. In 2017 Ammons learned of some policies that were helping another rural facility stay afloat. She reached out, adopted and implemented the policies at her hospital, and they worked! She has been able to keep her 25-bed hospital open, an imperative in states struggling to care for Covid-19 overflow patients.