Small Rural Hospital Improvement Program 2025 (United States)

The purpose of this program is to help small rural hospitals with 49 beds or less with their quality improvement (QI) efforts and with their adaptation to changing payment systems through investments in hardware, software, and related trainings. SHIP funded investments include:

• activities that support improved data collection to facilitate quality reporting and improvement;
• activities that support the development or basic tenets of Accountable Care
• Organizations (ACOs) or Shared Savings (SS) programs; and/or activities that improve hospital financial processes.

Funding Information

• The estimated maximum budget of $13,832.00 should be used to support and implement eligible activities.
• Selected grant projects, if any, under this RFGA will receive funding on a cost reimbursement basis. Funds will not be given in advance to Grant Recipients. Grant Recipients must have the financial capacity to pay for all project costs up front.

Eligible Expenses

• Generally, expenses that are necessary and reasonable for proper and efficient performance and administration directly related to the project are eligible. Grant funds may not be used to supplant normal business costs, but instead must be used to cover the costs incurred for the approved proposed activities. The following are the only allowable expenses under this program:
  • Value-Based Purchasing (VBP) Activities
  • Accountable Care Organization (ACO) or Shared Savings (SS) Activities
  • Payment Bundling (PB) or Prospective Payment System

Eligibility Criteria

• Eligible applicants are small hospitals located in a rural area. For the purpose of this program:
  • “small hospitals” is defined as a non-Federal, short-term general acute care hospital that: (i) is located in a rural area, as defined in 42 U.S.C. 1395ww(d) and (ii) has 49 beds or less, as reported on the hospital’s most recently filed Medicare Cost Report;
  • “located in a rural area” is defined as either:
    • located outside of a Metropolitan Statistical Area (MSA);
    • located within a rural census tract of a MSA, as determined under the Goldsmith Modification or the Rural Urban Commuting Areas (RUCAs); or
    • is being treated as if being located in a rural area pursuant to 42 U.S.C. 1395(d)(8)(E); and
  • Eligible hospitals may be for-profit or not-for-profit, including faith-based. Hospitals in U.S. territories as well as tribally operated hospitals under Titles I and V of P.L. 93- 638 are eligible to the extent that such hospitals meet the above criteria.

For more information, visit TDA.