Healdsburg District Hospital's incoming CEO Nancy Schmid says she's a "country girl" at heart, committed to the survival of rural hospitals in the face of growing competition from health care giants like Sutter Health and Kaiser Permanente.

If rural and small regional hospitals are to thrive, local communities, independent doctors and lawmakers will have to advocate for them, she said.

"I honestly believe that America has to get involved in the rural hospitals because they're being gobbled up by big hospital systems," Schmid said.

Schmid, who is currently the CEO of Kingfisher Regional Hospital in Oklahoma, will take over operations at Healdsburg District Hospital beginning in May. Schmid has been at the 25-bed hospital in Kingfisher, Okla., for three years. Prior to that, Schmid was CEO of East Morgan County Hospital in Colorado.

Schmid said the 43-bed Healdsburg hospital faces "some challenges" as the health care industry transitions into full implementation of President Obama's Affordable Care Act. But, she said, it's not new ground.

"The Affordable Care Act is really new terminology for managed care," she said. "The reality is we have to start dealing with how we spend our health care dollars. Rural hospitals have to learn to be efficient and effective."

E.J. Neil, chairman of North Sonoma County Health Care District, which owns and operates the hospital, said in a statement that Schmid would play a crucial role in implementing changes brought on by the Affordable Care Act and the introduction of electronic health records.

Schmid received her bachelor of science degree and master of arts degree in health administration from Brigham Young University. She also holds a master's degree in public administration from the University of Utah.

She replaces George Protos, who has been interim CEO at the hospital since the departure of Evan Rayner in December. Rayner was CEO for six years.

Schmid said she hopes to rally support for the hospital, both locally and in Sacramento.

"We have to advocate at a legislative level," she said. "We've got to unify and have a louder voice. ... We have to actively legislate to make sure that people can use their doctor in the community where they live."

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com.