With just 19 beds, Grace Cottage is the smallest hospital in Vermont and one of the smallest in the country. Its primary care facilities are comprised of two houses that were gifted to the hospital and date back to the 1840s.

Despite its ultra-modest size, the 76-year-old hospital and its staff are a bright light in the country's troubled rural healthcare system . Grace Cottage will finish fiscal year 2025 in the red, as it did last year, but its CEO Olivia Sweetnam says its financial standing has significantly improved over the past year.

The Green Mountain Care Board approved Grace Cottage's budget for the coming fiscal year and waived the need for a budget hearing. The hospital's administrators saw this as a significant stamp of approval in a year in which regulators cut nearly $

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