SUPPLEMENTARY INFORMATION:

Background

Section 711 of the Social Security Act (42 U.S.C. 912) directs FORHP to advise the Secretary of HHS on policies affecting rural hospitals and health care and coordinating activities within HHS that relate to rural health care. Since the 1990s, FORHP has administered grants that support activities related to increasing access to health care in rural areas. The Consolidated Appropriations Act, 2026, Public Law 119-75, H.R. 7148, authorized $25,000,000 for making payments to eligible hospitals for the maintenance of health care providers. This program will be administered by FORHP. Eligible hospitals will apply directly to HRSA, and funds will be awarded directly to hospitals.

Eligibility Information

As set forth in the Consolidated Appropriations Act, 2026, eligible hospitals must meet the following criteria to receive payments: (1) have no more than 50 inpatient beds and (2) have an established wage index values of less than 0.90 as determined by the Secretary of HHS under section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(E)). The payment amounts will be determined by dividing total available funding equally among eligible hospitals. Up to 10 percent of the funds may be used by eligible hospitals for administrative expenses.

For the purposes of this grant program, HRSA will use the following methodology and best and most current data available at the time of this notice to determine eligible hospitals:

1. Inpatient Beds: the number of inpatient beds will be determined by the number of acute care inpatient beds reported in the Medicare cost report provided in the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System Quarterly Update for FY 2025 as of December 31, 2025. Acute care inpatient beds are derived from the Medicare cost report, Worksheet S-3, Part I, Line 14, column 2, which represents staffed beds and excludes beds paid under separate psychiatric or rehabilitation payment systems.

2. Hospital Wage Index: HRSA will use the wage index values published in Table 2, as finalized in the FY 2026 Hospital Inpatient Prospective Payment System final rule (or correction notice, if applicable), which reflect the full application of all relevant policies and adjustments to determine whether a hospital had an established wage index value of less than 0.90. Table 2 is available on the CMS website at https://www.cms.gov/​medicare/​payment/​prospective-payment-systems/​acute-inpatient-pps. To access it, select the link for the applicable final rule on the left-hand side of the page or navigate to “Acute Inpatient Files for Download.” With each Inpatient Prospective Payment System final rule (or correction notice, if applicable), CMS publishes Table 2: Case-Mix Index and Wage Index by CMS Certification Number. This table reflects the final wage index assigned to each hospital for the upcoming fiscal year at the time of the development of the final rule. The wage index values incorporate all applicable policies and adjustments, including reclassifications, wage index floors, caps, and other statutory or regulatory requirements.

3. Rural Status: eligible hospitals must be located in a HRSA-designated rural area ( https://www.hrsa.gov/​rural-health/​about-us/​what-is-rural). The Rural Health Grants Analyzer ( https://data.hrsa.gov/​topics/​rural-health/​rural-health-eligibility) identifies all counties and census tracts that are considered a HRSA-designated rural area.

Preliminary analysis identified 167 hospitals across 13 states that met the criteria established in the Consolidated Appropriations Act, 2026, and located in HRSA-designated rural areas. Based on this analysis, HRSA estimates awarding $24,750,000 to 167 eligible hospitals in the amount of approximately $148,000 per hospital assuming all eligible hospitals apply. All eligible hospitals must apply for grant funding in order to receive payment. The final per hospital award amount will be adjusted based on the total number of eligible hospitals that apply for funding. Further information on the identified hospitals is provided under “Preliminary List of Hospitals Meeting Eligibility Criteria” section.

Applications and Submission Information

HRSA anticipates releasing the Rural Hospital Provider Assistance Program (HRSA-26-105) Notice of Funding Opportunity in May 2026. Applicants can find more information on Grants.gov: https://www.grants.gov/​search-results-detail/​361524. Eligible hospitals are encouraged to subscribe to the funding forecast to receive updates on the application release and an upcoming informational webinar, where applicants can ask questions on the program and application process. For general information about federal grants, applicants can visit https://www.grants.gov/​learn-grants/​grants-101/​.

Applications must be submitted through Grants.gov by July 1, 2026, at 11:59 p.m. Eastern Time. Since registration can take several weeks, eligible hospitals are strongly encouraged to begin the process of registering with SAM.gov and Grants.gov as soon as possible to avoid delays and ensure timely submission. For additional guidance, applicants can refer to the Quick Start Guide for Applicants ( https://www.grants.gov/​quick-start-guide/​applicants) and How to Apply for Grants ( https://www.grants.gov/​applicants/​grant-applications/​how-to-apply-for-grants).

Preliminary List of Hospitals Meeting Eligibility Criteria

The table below is provided for informational purposes only and is ( printed page 23104) based on preliminary analysis to identify hospitals that may meet the eligibility criteria set forth in the Consolidated Appropriations Act, 2026, and are located in HRSA-designated rural areas ( https://www.hrsa.gov/​rural-health/​about-us/​what-is-rural). This includes hospitals with no more than 50 acute care inpatient beds and a FY 2026 wage index of less than 0.90, including hospitals that may have converted to a Critical Access Hospital or Rural Emergency Hospital. For questions, please contact RuralHospitals@hrsa.gov.