The frequently asked questions below serve as a supplement to the Rural Hospital Stabilization Program (RHSP) introduction webinar and is not comprehensive. Click here for that webinar playback.
Applications are due by January 15, 2025.
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Questions and answers are grouped into the following categories:
If you have questions that have not been addressed here, please contact stabilization@ruralcenter.org.
Eligibility
Application Process
Selection Process
Community Engagement Champion
Technical Assistance
General Questions
What kind of other programs, past technical assistance (TA), or funding would disqualify us from participating in RHSP?
Currently participating in other federal or state technical assistance programs or receiving funding that offers similar services may disqualify you from RHSP. Services that tie directly to in-depth financial assessments that evaluate the hospital’s operations at a department level and directly affect the operational and financial management of the hospital. Programs that may disqualify an applicant include current involvement in the Delta Region Community Health Systems Development (DRCHSD), USDA Rural Hospital Technical Assistance program, Rural Emergency Hospital Technical Assistance Center, Targeted Technical Assistance for Rural Hospitals Program (TTAP), Appalachian Region Healthcare Support Program, or Northern Border Region Technical Assistance. Participation in Flex or SHIP does NOT disqualify a hospital. During the application process, RHSP will seek information regarding past and current TA funding received by the hospital.
Reach out to stabilization@ruralcenter.org with questions about specific programs.
Are hospitals located in U.S. territories eligible to participate?
Yes, hospitals in U.S. territories can participate if they meet the HRSA definition of rural for prospective payment system (PPS) hospitals and not enrolled in other similar programs.
Can a critical access hospital (CAH) that is not Health Resources and Services Administration (HRSA) rural designated still apply if they meet other rural definitions?
Any hospital participating in Medicare as a CAH or rural emergency hospital (REH) is eligible for RHSP.
Are county-owned and government-owned hospitals eligible for the program?
Yes, county-owned and government-owned hospitals can apply if they meet the HRSA definition of rural hospitals and other eligibility criteria or if they are designated as CAHs or rural emergency hospital (REH) facilities.
Does participation in the state Small Rural Hospital Improvement Program (SHIP) or Medicare Rural Hospital Flexibility (Flex) Program disqualify a hospital from participation?
Participation in the Medicare Rural Hospital Flexibility (Flex) Program or the Small Rural Hospital Improvement Program (SHIP) does NOT disqualify a hospital from participating in RHSP.
Are regional partnerships among rural care network hospital affiliates eligible to participate together or only individual facilities?
Only individual CAH, PPS, REH, and tribal facilities (regardless of bed size) are eligible to participate. RHSP has a focus on individual hospitals.
Who from the hospital should fill out the application?
The application should be filled out by the hospital's CEO.
What questions are asked on the application?
The application includes questions about the hospital's current financial and operational status, specific needs for technical assistance, and plans for service line development. You can click the Apply button to view questions without submitting responses.
How can state hospital associations or state offices of rural health support hospitals interested in applying? Letters of recommendation? Supporting data?
While state hospital associations and state offices of rural health can support hospitals by sharing the program website and assisting with the application process, they cannot apply on behalf of a hospital. A letter of support or recommendation is not needed.
How should a health system apply, as a single system or hospital by hospital?
All hospitals meeting eligibility criteria must apply individually. This includes hospitals that are part of a health system.
Can small rural hospitals apply collaboratively?
No. Hospitals must apply individually.
If a hospital that is a part of a system applies, does both the system president and the hospital CEO need to sign the Memorandum of Understanding (MOU)?
The hospital CEO's engagement and commitment are crucial for program participation. Therefore, the Memorandum of Understanding (MOU) must be signed by the hospital's CEO. While support from the system's leadership is valuable, there is not a separate MOU currently. This may be updated later. If selected, the hospital system leadership should support the hospital in its program participation and adoption of best practice recommendations from assessment action plans.
How many hospitals will be selected to participate in the program?
A total of 8 hospitals are selected to participate in each cohort. A new cohort starts each program year.
Is selection weighted primarily on financial need?
Financial need is a significant factor in the selection process. The program aims to support hospitals that are experiencing financial challenges and are at mid-to high financial risk, among other areas.
How are applicants selected to participate?
Applicants are selected based on a combination of factors including financial need, geographic location, population served, and the hospital's overall risk status. The program considers hospitals that are mid-to-high financial risk, with declining or low patient volumes, and low access to resources.
Are applications weighted more heavily if they are submitted earlier?
No, applications are not weighted more heavily based on submission date.
How long will the RHSP program last? Is this the first cohort?
This year is the first cohort. The program plans to add a new cohort of hospitals each program for three years. The addition of a new cohort in future years is contingent on congressional funding each year.
What options are there for non-selected hospitals?
Up to fifteen non-selected hospitals are eligible to participate in a separate learning collaborative. Non-selected hospitals are encouraged to apply for future cohorts.
What funding is available to support the Community Engagement Champion?
The program supports hospitals with approximately 0.5 full time equivalent (FTE) to fund a Community Engagement Champion, with reimbursement up to $4,000 per quarter for up to four quarters. This position and funding help market hospital services to the local community.
Can the Community Engagement Champion FTE be applied to an existing marketing department?
Yes, the Community Engagement Champion may be integrated into an existing marketing department. The marketing department should have an employee whose job functions currently align with the intent of the Community Engagement Champion and who can ensure the RHSP responsibilities and training criteria are met.
How long will Community Engagement Champion funding last?
The funding for the Community Engagement Champion is provided for up to four quarters, which is the estimated duration of RHSP participation after the financial and service line work concludes.
What is the time commitment anticipated for selected hospitals?
The program participation cycle for selected hospitals ranges from 15 to 24 months, depending on hospital capacity, needs, and motivation.
Which services will hospitals receive as part of this program?
Selected hospitals receive a comprehensive range of services, including financial and operational assessments, education, one-on-one coaching, peer-to-peer sharing, Community Engagement Champion support, and other forms of customized assistance. Feasibility and needs assessments for new service lines will be utilized on a hospital-by-hospital basis to provide tailored technical assistance to each hospital.
What kind of coaching/training (TA) can be expected for participating hospitals?
After a needs assessment action plan is developed, regularly scheduled implementation coaching will occur. Implementation coaching calls assist leaders with operationalizing new services, developing policies and procedures, and addressing staffing and clinical workflows. Additional training is provided to Community Engagement Champions to build foundational knowledge at the start of the program and grow their skill set.
In addition to the included TA, what else can RHSP fund?
The program supports a Community Engagement Champion and funds for developing or expanding services lines as determined by the hospital's assessments. This may include such things as obstetrics or other specific service lines, equipment, supplies, and internal training.
What is the total amount of funding a hospital could receive? How long does the funding last?
The total amount of funding varies based on the hospital's needs and the scope of the service line development.
Is there a limit on cost for the service line expansion or creation?
After completing the Financial and Operational Assessment (FOA) and Feasibility and Needs Assessment, and beginning service implementation, RHSP assists hospitals in evaluating equipment, supplies, software, etc. needs based on evidence-based care. Support may include vendor demonstrations, purchasing guidance, and other resources to ensure alignment with service line goals. The program provides funding for initial operations and equipment costs for service line development.
Do you perform a Community Health Needs Assessment (CHNA) as part of the program?
No, a CHNA as stipulated by the IRS is not a part of program services. A modified community health status report will be provided to learn more about local health outcomes and inform service line development.
Could this program be expanded in the future to ensure at least one hospital is selected from each state?
While program expansion is a possibility, there is no current plan for per-state selection or participation. Any future changes to the program are dependent on congressional appropriations and federal policy decisions.
How could others help advocate for program expansion?
To support program expansion, consider reaching out to local and state representatives, participating in public comment periods, and partnering with hospital associations and state offices of rural health to emphasize the program's benefits.
Is Fiscal Year (FY) 2025 funding secured, or could it change?
Funding for the first cohort, for which we are currently accepting applications, was in the FY2024 budget and has already been released. FY2025 funding, which will be used for the second cohort of hospitals, is not confirmed as the budget for FY2025 has not yet been passed as of Dec 18, 2024, and as with any federal program, future funding is subject to congressional appropriations.
How or when might future congressional appropriations affect this funding?
Future congressional appropriations could impact the availability and amount of funding for the program at any time. Advocacy and support from stakeholders can influence these decisions.
Who should I direct additional questions to?
Additional questions can be directed to stabilization@ruralcenter.org at the National Rural Health Resource Center.