Rural Hospital Flexibility Grant Program 2023-2024

DHHS Division/Office issuing this notice: NC Office of Rural Health

Date of this notice: April 5, 2023

Working title of the funding program: Rural Hospital Flexibility Grant Program 2023-2024

The Rural Hospital Flexibility Program (Flex Program) is a federal grant program directed to State Offices of Rural Health to support:

  • Improving the quality of health care provided in communities served by Critical Access Hospitals (CAHs)
  • Improving the financial and operational performance of CAHs
  • Developing collaborative regional and systems in CAH communities to improve Population Health management.

The purpose of these Flex Program funds is to improve the quality of care provided by CAHs by focusing on improvement of financial and operational implementation, quality measures, and management of population health according to the measures from the Federal Office of Rural Health Policy. These funds will support a technical assistance model that includes group and individual CAH projects. 

This grant will be awarded to an organization or organizations that create a plan to perform the following activities:

  • Conduct, manage, and facilitate meetings of CAH executives to share best practices, receive technical assistance for quality, financial and operational areas of interest, population health; investigate primary care capacity, develop innovative model ideas and assist with workforce recruitment and retention. 
  • The statewide and/or regional meetings that will require contractor attendance and participation.
  • Individual projects with CAHs or a network of CAHs to identify opportunities for and initiate improvement in quality, financial and operational measures.
  • Engage CAHs in submitting quality performance data as required by the Medicare Beneficiary Quality Improvement Program (MBQIP).
  • Organize collaborative networks for CAHs to share best practices and work together on various quality initiatives.
  • Support ongoing network needs and activities by providing technical assistance when necessary.

The activities will be performed with intent to improve CAH performance in the following areas:

  • Key financial indicators identified by the Flex Monitoring Team (FMT)
  • Inpatient core measures as defined by MBQIP
  • Outpatient core measures as defined by MBQIP
  • Patient satisfaction / Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores

The maximum total per grant year not to exceed $395,000. All funding must be expended by August 31, 2024. (Funding is dependent on federal allocation).

How to Apply: Using the link provided below, you will enter your contact information and a personalized link to the application will be sent to the e-mail address you provide:

Deadline for Submission: Grant applications must be electronically received and submitted within the survey link, or by the individual listed below, by 5:00 PM May 26, 2023. Only electronic copies will be accepted. Incomplete applications and applications not completed in accordance with the following instructions will not be reviewed. Applications received after the 5:00 PM deadline on May 26, 2023 will not be reviewed.

How to Obtain Further Information: Questions regarding the grant application may be directed to Nick Galvez at