Rural Hospital Flexibility Improvement Project Grant 2021-2023

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

Date of this notice: August 4th, 2021

Working title of the funding program: Rural Hospital Flexibility Project

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 local delivery systems in CAH communities to improve Population Health

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 metrics, and management of population health according to performance measures as defined by the Federal Office of Rural Health Policy. Specifically, these funds will support a hybrid technical assistance model that includes both group and individual CAH support.

This two-year 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 on quality, financial and operational areas of interest, population health and investigate primary care capacity, innovative model ideas and workforce concerns. Project anticipates up to six statewide and/or regional meetings per year.
  • Develop individualized projects with select CAHs or groups of CAHs to identify opportunities for and initiate improvement in quality, financial and operational and population health. 
  • Conduct ongoing productivity, financial and operational benchmarking performance for review and educational opportunities for CAHs.
  • 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 aforementioned activities will be performed with intent to improve CAH performance in the following areas:

  • Key financial indicators identified by the Flex Monitoring Team (FMT)
  • Improvement of Population Health Management 
  • 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

During the grant period, the Office of Rural Health will monitor and provide technical assistance to the grantee to support the activities mentioned above.

The maximum total per grant year not to exceed $350,000. For the two-year grant programming, the maximum total grant award cannot exceed $700,000. All funding must be expended by August 31, 2023. (funding amount is dependent on federal allocation)

Eligible applicants must demonstrate the organizational capacity to manage the projects, including the ability to employ or contract with professionals credentialed in hospital financial, operational, quality and/or population health improvement, as applicable to the grant proposal scope. Applicants may focus on one area of improvement if applicable. 

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:
Request Application Here.

Deadline for Submission: Grant applications must be electronically received and submitted within the Qualtrics survey link, or by the individual listed below, by 5:00 PM August 18th, 2021. 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 August 18, 2021, will not be reviewed.

How to Obtain Further Information: Questions regarding the grant application may be directed to Nick Galvez at No phone calls will be fielded for questions, only in writing by email.