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Workforce challenges remain one of the biggest threats to rural healthcare sustainability—and they’re not going away on their own. Staffing shortages persist, the workforce continues to age, and demand for care keeps rising. For many rural leaders, this creates a constant state of reaction: hiring under pressure, shuffling roles, and implementing short‑term fixes just to keep services running. 

The organizations making progress are doing something different. Instead of chasing talent in an increasingly competitive market, they’re taking proactive steps to stabilize today’s workforce, grow tomorrow’s pipeline, and remove unnecessary strain from already‑lean teams. That work starts with people, extends into education partnerships, and is reinforced by practical—not experimental—use of technology. 

Strengthening the pipeline through higher education partnerships 

Many rural staffing challenges begin well before recruitment. Clinicians are often trained in urban environments, with limited exposure to rural practice. When it comes time to choose a career path, rural healthcare may feel unfamiliar—or simply unavailable. 

Strategic partnerships with colleges and universities help address this challenge at its source. When rural health systems and academic institutions collaborate, they can recruit students from rural communities, provide early and meaningful rural clinical experiences, expand residency and graduate training capacity, and align education with the realities of rural care delivery. 

These efforts have been shown to improve long‑term retention, particularly for roles that are consistently hard to fill, including primary care physicians, nurses, advanced practice clinicians, behavioral and mental health providers, and key allied health positions. 

These partnerships also create value for academic institutions. Colleges and universities benefit from stronger enrollment pipelines, improved completion and job placement rates, and deeper alignment with regional workforce needs. Faculty gain applied teaching opportunities, students receive hands‑on experience, and institutions reinforce their role as anchor organizations within rural communities. 

The most successful partnerships are built for the long term. Academic partners typically lead curriculum design, accreditation, faculty support, and student recruitment. Health systems contribute paid clinical placements, preceptors, residency or practicum sites, and real‑time insight into workforce demand and care models. Shared funding—through tuition revenue, health system investment, grants, and joint philanthropic support—helps programs remain sustainable. Clear governance structures and shared data ensure these initiatives evolve alongside community needs rather than functioning as one‑time solutions. 

Workforce well-being as a core retention strategy 

Even the strongest workforce pipeline will struggle if today’s clinicians are burned out. Rural healthcare workers face distinct challenges, including chronic understaffing, professional isolation, and limited backup. Many clinicians fill multiple roles while caring for older, higher‑acuity populations. 

Outside the workplace, limited access to childcare, housing, groceries, wellness resources, and other everyday supports can further compound fatigue and burnout. 

Improving retention means addressing both professional and personal realities. Effective strategies often include stabilizing staffing through team‑based care models, optimizing scopes of practice, offering flexible scheduling and protected time off, and investing in community supports such as childcare partnerships, housing assistance, and accessible wellness resources. Equally important are visible leadership engagement, meaningful frontline input into decisions, and opportunities for peer support and professional growth that reduce isolation. 

For rural clinicians, professional success means manageable workloads, access to specialty support, and room to grow. Personal success means being able to build a fulfilling life in the community they serve. When organizations invest in both, careers last longer, retention improves, and communities benefit from greater continuity of care. 

Using AI thoughtfully to relieve—not add to—workforce strain 

As rural health systems look for ways to support overextended teams, artificial intelligence is increasingly part of the conversation. Used well, AI can help reduce workload and administrative burden. Used poorly, it can introduce cost, disruption, and risk. 

In rural settings, the most valuable AI applications tend to be practical rather than cutting‑edge. For example, AI‑enabled decision trees can support centralized scheduling and contact center operations, allowing small teams to accurately route calls and schedule appointments across multiple departments. Embedded visit criteria, provider availability, and location rules reduce training time and cognitive load—an important advantage for lean teams. 

Other proven use cases include ambient clinical documentation, prior authorization support, and selected revenue cycle functions such as coding and denials management. When paired with strong workflows and change management, these tools can meaningfully reduce manual work and after‑hours burden, directly supporting workforce well-being. 

Equally important is knowing what to avoid. Rural organizations are not always the best positioned to act as early adopters or beta testers. Leaders should prioritize vendors with proven healthcare experience, seek references from similar organizations, and favor solutions that integrate with existing systems. Technology works best when it supports optimized operations—not when it is expected to compensate for broken processes. 

An integrated approach to rural healthcare workforce sustainability 

Successful rural healthcare transformation will take more than a single program or policy change. It requires deliberate, coordinated action across care delivery, workforce development, and operations. 

Health systems that invest in workforce well-being can slow burnout and retain the clinicians they already have. Those that build strong partnerships with higher education create a steady pipeline of professionals trained for rural practice. And those that adopt technology thoughtfully can reduce administrative burden and give staff back time and focus for patient care. 

The path forward is clear—but it requires moving beyond crisis management and into long‑term planning. By aligning well-being strategies, education partnerships, and practical innovation, rural health systems can strengthen their workforce today while building a more resilient future for the communities they serve. 

Key takeaways

Rural healthcare workforce sustainability takes action—not quick fixes 

Address staffing challenges at the source. 
Higher education partnerships help build a local, long‑term workforce pipeline aligned with rural realities. 

Treat well-being as a retention strategy. 
Flexible scheduling, team‑based care, leadership visibility, and community supports reduce burnout and improve retention. 

Use AI to simplify work, not complicate it. 
Focus on proven, practical tools that reduce administrative burden and integrate with existing systems. 

Avoid being an early adopter. 
Rural organizations benefit most from solutions with established healthcare track records and peer validation. 

Connect today’s needs with tomorrow’s workforce. 
Sustainable progress happens when well-being, education, and operations work together. 

Rural healthcare transformation consulting

Our experienced consultants have decades of expertise advising rural healthcare providers. We partner with clients to deliver rural healthcare transformation services that are practical, compliant, and sustainable—grounded in firsthand experience with rural delivery models, workforce constraints, and community needs, and aligned with CMS requirements. Learn more about our services and team. 

There has been a recent flurry of proposals surrounding payment stablecoin regulation. In March and April 2026, the Office of the Comptroller of the Currency (OCC) and Federal Deposit Insurance Corporation (FDIC) issued Notices of Proposed Rulemaking (NPR) to implement major provisions of the Guiding and Establishing National Innovation for US Stablecoins (GENIUS) Act. While this article focuses on the OCC and FDIC proposals, the US Department of the Treasury, the Financial Crimes Enforcement Network, and the Office of Foreign Assets Control have also issued recent proposals on implementing the GENIUS Act.  

The OCC and FDIC proposals, among other reforms, establish regulatory frameworks for the issuance of payment stablecoins. While the OCC proposal is broader and more prescriptive, reflecting its role as the primary regulator for national banks, federal savings associations, nonbank federal issuers, and foreign payment stablecoin issuers, the FDIC proposal is narrower and more bank-centric, focusing on FDIC-supervised insured depository institutions (IDI) and their payment stablecoin subsidiaries. The FDIC proposal also clarifies deposit insurance treatment for stablecoin reserve deposits and affirms how tokenized deposits are treated under existing deposit insurance rules.

While many community banks may not be planning to issue payment stablecoins in the near term, the proposed rules remain relevant because they: 

• Define the permissible role of community banks in the digital asset ecosystem 
• Signal how stablecoins and tokenized deposits may coexist with traditional banking 
• Clarify deposit insurance boundaries, reducing regulatory ambiguity

Key takeaways from the NPRs 

There are five main considerations from the NPRs. Comments on the OCC’s proposal are due by May 1, 2026, and comments on the FDIC’s proposal are due by June 9, 2026. 

1. A new federal framework for payment stablecoin issuance 

The proposed rules operationalize the GENIUS Act by creating detailed standards for Permitted Payment Stablecoin Issuers (PPSIs)—entities approved to issue payment stablecoins. For FDIC-supervised institutions, a PPSI must be a subsidiary of an IDI and is subject to full FDIC supervision. 

Key policy guardrails include: 

• Narrowly defined activities limited largely to issuing and redeeming payment stablecoins, managing required reserves, and providing related custody services 
• Strict one-to-one reserve backing, requiring each outstanding stablecoin to be fully supported by highly liquid assets
• Explicit prohibitions against paying interest or yield to stablecoin holders, preventing payment stablecoins from functioning as deposit substitutes
• Under the FDIC’s NPR, PPSIs are prohibited from providing credit to their customers to purchase payment stablecoins. The OCC’s NPR does not explicitly prohibit this activity. 
• PPSIs are generally required to redeem a payment stablecoin within two business days. 

For community banks, the structure reinforces that stablecoin issuance is not a casual extension of deposit-taking, but rather a regulated, capital-sensitive activity requiring governance, systems, and risk management comparable to other significant lines of business. 

2. Reserve assets: Conservative by design 

One of the most consequential aspects of the proposals is their treatment of reserve assets backing payment stablecoins. The OCC and FDIC propose a conservative list of eligible reserve assets, including: 

• Cash and balances at Federal Reserve Banks 
• Demand deposits at insured institutions 
• Short-term US Treasury securities (93 days or less) 
• Certain Treasury-backed repurchase and reverse repurchase agreements 
• Certain securities issued by registered investment companies invested solely in otherwise permitted reserve assets 

Reserve assets must be: 

• Valued at fair value (with cash at par)
• Identifiable and segregated, particularly if multiple stablecoin “brands” are issued
• Continuously monitored to ensure reserves never fall below outstanding issuance
• Published on the PPSI’s website monthly, with the report examined by a registered public accounting firm. Under the FDIC’s NPR, the registered public accounting firm will issue a written report of findings to the PPSI’s audit committee, or board of directors, if there is no audit committee. Both proposals also require confidential reporting on reserve assets, among other information, weekly, as well as quarterly reports of financial condition.

For community banks, this matters even if the bank does not issue stablecoins. Banks may be asked to hold reserves on behalf of PPSIs, creating potentially large, volatile deposit balances with specific operational and liquidity considerations. Both proposals explicitly seek comment on whether various limits should apply to stablecoin reserve deposits to mitigate safety and soundness risks.

3. Deposit insurance clarified: No pass-through coverage 

The FDIC’s NPR squarely addresses an area of confusion by proposing amendments to the FDIC’s deposit insurance rules. Under the proposal: 

• Deposits held as reserve assets for payment stablecoins are insured only to the PPSI, as corporate deposits 
• Payment stablecoin holders do not receive pass-through FDIC insurance 
• Reserve deposits are aggregated with other deposits of the PPSI at the same bank and insured up to the standard $250,000 limit 

This clarification reinforces an important principle for banks: payment stablecoins are not insured deposits, and banks must avoid marketing or structuring arrangements that imply otherwise. The proposal aligns deposit insurance treatment with the GENIUS Act’s prohibition against representing stablecoins as FDIC-insured.

4. Tokenized deposits remain deposits 

Separately, the FDIC uses this rulemaking to confirm that tokenized deposits are still deposits for purposes of the Federal Deposit Insurance Act. The form of recordkeeping—whether traditional or distributed ledger-based—does not change the legal status of a deposit. 

This is a significant assurance for community banks exploring: 

• Distributed ledger technology for internal settlement 
• Tokenized representations of deposit balances 
• Real-time or programmable payment innovations 

As long as the product meets the statutory definition of a “deposit,” it remains eligible for FDIC insurance and depositor preference, regardless of the technology used. 

5. Capital, governance, and operational expectations 

The proposals set meaningful expectations around: 

• Capital planning, including a $5 million minimum for de novo PPSIs and ongoing capital commensurate with risk 
• An operational backstop equal to 12 months of expenses, separate from reserve assets 
• Robust risk management, IT security, AML, and audit requirements, many modeled on existing banking standards 

Importantly, the OCC and FDIC also propose to deconsolidate PPSI subsidiaries for regulatory capital purposes, ensuring that parent banks are not required to hold capital in excess of what the PPSI itself must maintain—while reserving supervisory authority to prevent “capital arbitrage.” 

What community banks should do now 

Even if stablecoin issuance is not imminent, community banks should: 

• Assess potential exposure to stablecoin reserve deposits and custodial activities 
• Monitor how peers and core providers are engaging with tokenization and stablecoin infrastructure 
• Ensure marketing and disclosures clearly distinguish deposits from non-deposit digital assets 

The proposals make clear that stablecoins will coexist with the banking system—but firmly within traditional prudential boundaries. For community banks, the rule offers clarity, guardrails, and opportunity, while underscoring that innovation must be anchored in safety, soundness, and transparency. As always, please don’t hesitate to reach out to your BerryDunn team if you have any questions.

Maine’s recent housing legislation, including LD 1829, changes how municipalities regulate housing and where growth can occur. This article explains how the law affects comprehensive plans and zoning, why alignment between planning documents and ordinances now matters more than ever, and what Maine communities can do to stay compliant while still shaping development outcomes locally. 

What is LD 1829 and how does it change housing regulation? 

LD 1829 is a Maine housing reform law, which aims to increase housing supply by reducing local regulatory barriers. It establishes statewide minimum housing allowances, reduces barriers to developing ADUs, and raises the threshold for Planning Board and subdivision review while preserving local authority through planning and zoning decisions. 

Under the law, municipalities must allow at least three dwelling units on any residential lot statewide, and up to four units in designated growth areas or areas served by public water and sewer. 

Why this matters now for Maine communities 

Across the country, states are taking action to address housing shortages by easing zoning restrictions and streamlining development rules. Maine is no exception. 

LD 1829 directly affects local zoning ordinances, development review processes, and dimensional standards. Municipalities that rely on outdated comprehensive plans may find their policies in conflict with state law—creating confusion, delays, and missed opportunities to guide housing and growth to appropriate locations. 

Considerations for municipalities

• Does your community have a current comprehensive plan and defined growth area?
• Do growth areas reflect current community goals and values?
• Does your community have public water and sewer service areas and do service areas align with growth areas?
• Does your community have concerns about future public water and sewer infrastructure capacity?
• How does your community regulate residential density?
• What are your community’s housing goals?

How comprehensive plans shape outcomes under LD 1829 

Comprehensive plans—especially future land use plans and growth area designations—now carry direct regulatory consequences. Future land use plans and growth areas defined in comprehensive plans will now carry more weight in determining growth potential in a community.

Communities with clear, current plans are better positioned to: 

• Direct housing to locations with existing or planned infrastructure 
• Coordinate zoning updates with water, sewer, and transportation capacity 
• Invest strategically in growth rather than enabling sprawl 

Plans adopted before recent housing reforms may lack clear growth area definitions or include policies that no longer align with state requirements. 

Aligning zoning with comprehensive plans 

LD 1829 does not eliminate local zoning authority, but it changes how municipalities can regulate housing. 

Effective zoning updates should: 

• Reflect adopted comprehensive plan policies 
• Address dimensional standards, definitions, and review thresholds affected by state law 
• Clearly define residential density allowances
• Balance neighborhood context with compliance requirements 

When planning and zoning are aligned, communities reduce friction during project review and implementation. 

What municipalities should do next 

Municipalities can take practical steps now to respond proactively: 

• Review comprehensive plans for alignment with current housing laws 
• Clarify growth areas and future land use priorities 
• Evaluate infrastructure capacity to support growth
• Identify zoning provisions affected by LD 1829 
• Engage boards, officials, and residents on what the law does—and does not—require 
• Coordinate planning, zoning, and infrastructure decisions together 

Key takeaways 

• Understand how LD 1829 changes housing regulation statewide. 
• Recognize that comprehensive plans now play a direct regulatory role. 
• Align zoning ordinances with updated planning policies and planned infrastructure investments. 
• Use planning tools to guide growth—not just respond to it. 
• Act proactively to reduce confusion and implementation challenges. 

How BerryDunn helps Maine communities navigate change 

BerryDunn works with municipalities across Maine to align community vision with evolving state requirements. Our planning and advisory services support communities through: 

• Comprehensive plan updates that integrate housing, infrastructure, and economic goals 
• Housing plans that provide clear strategies for addressing community housing needs
• Land use and zoning analysis, including legislative compliance and best‑practice benchmarking 
• Community and board engagement to build understanding and transparency 
• Development process improvement and system modernization 

With a national perspective in all aspects of operating, growing, and maintaining community development organizations, we work collaboratively with clients to establish a clear vision, develop actionable strategies, and manage plan implementation. From comprehensive planning to digital transformation to fee studies, we can help you improve your operations to better serve your community. Learn more about our services and team.

The FDIC's Quarterly Banking Profile for quarter four 2025 reports the performance for the 3,909 community banks evaluated. Here are the key highlights: 

Note: Graphs are for all FDIC-insured institutions unless the graph indicates it is only for FDIC-insured community banks. 

Financial Performance 

• Quarterly net income decreased $307.6 million (3.8%) from the previous quarter to $7.9 billion, with 53.4% of community banks reporting a decrease. 

• Pretax return on assets decreased to 1.35%, down 11 basis points quarter over quarter; however, overall increased by 28 basis points year over year. 

• Net interest margin rose to 3.77%, up 4 basis points from the prior quarter and 33 basis points year over year.

Costs and Efficiency 

• Noninterest expense increased by $841 million (4.8%) from the previous quarter and has increased 7.7% year over year. 

• Provision expenses decreased by 0.1% quarter over quarter and have increased 8.1% year over year, signaling consistent concern over potential credit losses. 

• Efficiency ratio increased to 62.46%, up 1.87% from the prior quarter, indicating declining cost control relative to revenue. 

Loan and Deposit Trends  

• Loan and lease balances increased by $26.8 billion (1.4%) quarter over quarter and 5.4% year over year, led by nonfarm nonresidential CRE, 1–4 family residential loans, and commercial and industrial loans. 

• Domestic deposits rose 1.5% quarter over quarter and 5.0% year over year, with stronger growth in interest-bearing vs. noninterest-bearing accounts. 

• Nearly 70% of community banks reported loan growth, and about 65% reported deposit growth during the quarter. 

Asset Quality 

• Past-due and nonaccrual loans (PDNA) increased 10 basis points to 1.36% from the previous quarter. 

• Net charge-off ratio increased six basis points from the prior quarter to 0.29%, continuing to be above the pre-pandemic average of 0.15%. 

• Reserve coverage ratio continued to decline to 154.3%, indicating that allowance growth lagged increases in noncurrent.

Capital and Structural Stability 

• Capital ratios remained stable across the board: CBLR rose to 14.30%, and the leverage capital ratio remained at 11%. 

• Unrealized losses on securities fell by $3.2 billion (9.8%) from the prior quarter to $30.0 billion in total. 

• Community bank count declined by 44 during the quarter due to transitions, sales, and mergers and acquisitions. 

Conclusion and Outlook 

The fourth quarter of 2025 presented a more mixed performance for community banks, as earnings softened modestly while core balance sheet growth remained steady. Quarterly net income declined $307.6 million (3.8%) from the prior quarter to $7.9 billion, with slightly more than half of institutions reporting lower earnings. Pretax return on assets decreased 11 basis points quarter over quarter to 1.35%, though it remained 28 basis points higher than the same period a year earlier. Net interest margin continued to improve, rising to 3.77%, up 4 basis points from the previous quarter and 33 basis points year over year, reflecting the ongoing benefits of repricing assets in a higher-rate environment. 

Cost pressures, however, weighed on operating efficiency. Noninterest expenses increased by $841 million (4.8%) during the quarter and are now 7.7% higher than a year ago. This contributed to a higher efficiency ratio, which rose to 62.46%, up 1.87 percentage points from the prior quarter, indicating weaker cost control relative to revenue generation. Provision expenses remained relatively stable quarter over quarter but increased 8.1% year over year, signaling that institutions continue to prepare for potential credit deterioration. 

From a capital and structural standpoint, the community banking sector remained stable. Regulatory capital ratios held steady, with the community bank leverage ratio rising slightly to 14.30% and the leverage capital ratio remaining at 11%. Unrealized losses on securities declined by $3.2 billion (9.8%) during the quarter to $30.0 billion, reflecting modest improvements in securities valuations. Meanwhile, consolidation within the sector continued, as the number of community banks declined by 44 during the quarter due to mergers, acquisitions, and other structural transitions. 

Looking ahead, community banks enter 2026 with solid capital positions and continued loan and deposit growth, but with growing attention on operating costs and credit quality trends. As economic conditions evolve and consolidation persists, institutions will need to balance growth opportunities with disciplined risk management and operational efficiency. As the regulatory environment is ever-evolving, BerryDunn has a Federal Impacts page, where we are frequently posting updates on the federal landscape. Check out this page for timely information that may impact your institution or your institution’s borrowers. We wish you all the best in 2026 and, as always, your BerryDunn team is here to help! 

Read this if you are a business owner or individual taxpayer in Maine. 

On April 10, 2026, Maine’s governor signed into law the supplemental budget for the fiscal year. The supplemental budget includes several significant changes to the state’s income tax regime. The law updates Maine’s conformity to the Internal Revenue Code and outlines key provisions from which Maine tax law will decouple from federal treatment. The supplemental budget also introduces a 2% high-income tax surcharge and creates a Pass-Through Entity Tax (PTET) whereby electing flow-through businesses can pay income tax on behalf of their owners. 

High-income surcharge 

Effective date: Tax years beginning on or after January 1, 2026 

A new 2% income tax surcharge will apply to Maine taxable income exceeding the following thresholds: 

• $1,000,000 for single filers 
• $1,500,000 for joint filers and heads of household 
• $750,000 for married individuals filing separately 

These thresholds will be indexed for inflation for tax years after 2026. The surcharge also applies to the taxable income of estates and trusts. High-net-worth individuals and fiduciaries should review projected income and consider timing strategies for large transactions to manage the impact of this new surcharge.

Federal conformity and decoupling 

IRC update: Maine will conform to the Internal Revenue Code as of December 31, 2025, with targeted exceptions and phased implementation.

Key provisions: 

• Standard deduction: Maine’s standard deduction will increase in phases, matching the federal standard deduction by 2027. 
• R&D expensing: Maine will phase in conformity to federal immediate expensing for domestic R&D expenditures, with a delayed full deduction for large businesses through 2030. Small businesses (gross receipts ≤ $31 million) will receive immediate conformity. 
• Bonus depreciation: Maine continues to decouple from federal 100% bonus depreciation and the new 100% expensing for certain real property used in production. 
• Opportunity zones: Maine decouples from the federal gain exclusion for investments in Qualified Opportunity Funds made after December 31, 2026. 
• Dependent exemption tax credit: For tax years beginning in 2026, eligibility for the $300 dependent exemption tax credit will be based on the federal personal exemption, not the child tax credit. 
• Employer credit for family and medical leave: This credit is repealed for tax years beginning after January 1, 2026. 

Businesses and individuals should carefully review these conformity and decoupling provisions to avoid surprises on Maine returns and to optimize tax planning strategies. 

New Pass-Through Entity Tax 

Effective date: Tax years beginning on or after January 1, 2026 

Maine has established an elective PTET for partnerships and S corporations, designed as a workaround to the federal state and local tax (SALT) deduction limitation.  

Key features: 

• Electing PTEs pay tax at Maine’s highest individual marginal income tax rate on their taxable income. 
• Qualified members of the electing PTE receive a refundable income tax credit equal to 90% of their share of the tax paid by the entity. 
• Maine resident individuals may also claim a credit for their share of substantially similar PTET paid to other states. 
• The election is made annually. 

This “SALT cap workaround” can provide significant federal tax benefits for owners of Maine-based PTEs. Entities should evaluate the benefits of making the PTET election for 2026 and beyond.

Next steps for taxpayers and advisors
 

• Review entity structures: PTEs should assess the potential benefits of the new PTET election. 
• Monitor federal conformity: Stay alert to Maine’s ongoing conformity and decoupling from federal tax law, especially for depreciation, R&D, and capital gains. 
• Plan for surcharge: High-income individuals and trusts should consider the impact of the new surcharge on future transactions and income recognition. 

BerryDunn’s tax consultants offer expertise for large corporations and small businesses alike. We keep abreast of the latest updates, laws, and regulations to make sure our clients are in compliance with all reporting obligations, while executing planning opportunities to minimize adverse tax consequences. Learn more about our team and services.