National Rural Health Association

What it reported doing in 2025

Nrha is a national nonprofit membership organization that brings together thousands of members across the us to tackle the vastly different obstacles faced by patients and health care providers in rural areas. Nrha members participate in in-depth analysis, assistance, discussion, advocacy, programming, and policy production with stakeholders across the country. They participate in national conferences and symposiums, engage in education and assistance, and seek to improve access to healthcare in their rural communities. Nrha works to improve access to care for those living in rural communities. One of the most pertinent issues is the health care workforce shortage and its significant impact on patients' access to care. To address this concern, nrha began to lay the foundation for a national community healthcare worker (chw) training network in 2011. Nrha has successfully implemented more than 30 trainings in the past sixteen years and has trained more than 2,200 rural chws in the us. The journal of rural health (jrh), which has been published by nrha for the past 45 years, serves to advance professional practice, research, theory development, and public policy. It is a peer-reviewed quarterly journal used to disseminate evidence-based best practices to the membership working in rural communities. It's reach has increased to include more than 7,000 institutions in developing countries at low or no cost due to philanthropic initiatives. Nrha also publishes a quarterly magazine, rural horizons, featuring articles to engage and inform all those working to improve health care in rural america. The weekly electronic newsletter nrha today is delivered every thursday morning to all active members with valid email addresses and provides updates on activities and opportunities within nrha's programming, government affairs, funding and educational efforts, as well as national news that impacts rural health.

Financial Efficiency

• Mission deployment rate: 88%; rating input score 88
• Program expense ratio: 89.6%; rating input score 90
• Fundraising efficiency: $12.84 raised per $1 spent on fundraising; rating input score 41; 41st percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 64th percentile among comparable filings
• Pay-setting controls: 1 of 6 controls in place; rating input score 17
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: 100%; rating input score 100; 76th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 100%; rating input score 100; 64th percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Fail
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 2%; rating input score 33; 33rd percentile among comparable filings
• Total-asset coverage ratio: 1.55; rating input score 43; 43rd percentile among comparable filings
• Liabilities to assets ratio: 0.1; rating input score 66; 66th percentile among comparable filings
• Officer compensation ratio: 18%; rating input score 8; 8th percentile among comparable filings

Growth

• Program expense growth: 7% per year; rating input score 100; 52nd percentile among comparable filings
• Revenue growth: 8.5% per year; rating input score 100; 66th percentile among comparable filings
• Asset growth: 24.2% per year; rating input score 100; 94th percentile among comparable filings