IB 
Union Calendar No. 803 
118TH CONGRESS 
2D SESSION 
H. R. 8245 
[Report No. 118–954] 
To amend title XVIII of the Social Security Act to establish the Rural 
Hospital Stabilization Pilot Program to provide grants to rural hospitals 
for purposes of ensuring local access to services. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 6, 2024 
Mr. FEENSTRA introduced the following bill; which was referred to the 
Committee on Ways and Means 
DECEMBER 27, 2024 
Additional sponsor: Mr. FONG 
DECEMBER 27, 2024 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on May 6, 2024] 
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A BILL 
To amend title XVIII of the Social Security Act to establish 
the Rural Hospital Stabilization Pilot Program to provide 
grants to rural hospitals for purposes of ensuring local 
access to services. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Rural Hospital Sta-
bilization Act’’. 
SEC. 2. RURAL HOSPITAL STABILIZATION PILOT PROGRAM. 
Section 1820(g) of the Social Security Act (42 U.S.C. 
1395i–4(g)) is amended by adding at the end the following 
new paragraph: 
‘‘(8) RURAL
HOSPITAL
STABILIZATION
PILOT 
PROGRAM.— 
‘‘(A) IN GENERAL.—Beginning January 1, 
2026, the Secretary, acting through the Director 
of the Office of Rural Health Policy, shall award 
grants to— 
‘‘(i) hospitals, critical access hospitals, 
and rural emergency hospitals that are lo-
cated in a rural area, as such term is used 
for purposes of section 711 of this Act (in 
this paragraph referred to as ‘rural hos-
pitals’) that have submitted applications to 
the Secretary, for purposes of assisting such 
hospitals in ensuring local access to services; 
and 
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‘‘(ii) experienced technical assistance 
providers that have submitted applications 
to the Secretary, for purposes of assisting 
such rural hospitals in planning to apply 
for grants under this paragraph and using 
any amounts received under such a grant. 
‘‘(B) PRIORITIZATION FACTORS.—In mak-
ing grants to rural hospitals under this para-
graph for a fiscal year (and determining the 
amount of each such grant), the Secretary shall 
consider the following factors: 
‘‘(i) The average daily census of the 
hospital. 
‘‘(ii) The distance between the hospital 
and the next nearest hospital. 
‘‘(iii) The financial circumstances of 
the hospital, as determined by such hos-
pital’s most recently filed Medicare cost re-
port (or other applicable source of informa-
tion). 
‘‘(iv) The risk that the hospital will 
close. 
‘‘(v) The risk that the hospital will re-
duce or stop offering a class of services. 
‘‘(C) USE OF FUNDS.— 
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‘‘(i) HOSPITALS.—Amounts received by 
a rural hospital under a grant under this 
paragraph shall be used to sustain, enhance, 
or expand the classes of services offered by 
such hospital, or to begin offering a new 
class of service, and may be used for— 
‘‘(I) minor renovations to build-
ings; 
‘‘(II) training with respect to the 
delivery of new or existing services; 
‘‘(III) recruiting or hiring new 
staff or supplementing compensation of 
existing staff; and 
‘‘(IV) equipment acquisition or 
refurbishment. 
‘‘(ii) EXPERIENCED
TECHNICAL
AS-
SISTANCE
PROVIDERS.—Amounts received 
by an experienced technical assistance pro-
vider under a grant under this paragraph 
shall be used to assist rural hospitals— 
‘‘(I) in applying for a grant 
under this paragraph; and 
‘‘(II) with respect to a rural hos-
pital that has been awarded a grant 
under 
this 
paragraph, 
in 
using 
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amounts received under such grant in 
accordance with the requirements of 
clause (i). 
‘‘(D) REPORTS TO CONGRESS.— 
‘‘(i) INITIAL REPORT.—Not later than 
January 1, 2029, the Secretary shall submit 
to Congress a report on the grants awarded 
under this paragraph that includes the fol-
lowing information: 
‘‘(I) The names of all experienced 
technical assistance providers that re-
ceived a grant under this paragraph 
and, with respect to each such experi-
enced technical assistance provider, an 
analysis of the use of the amounts re-
ceived under such grant. 
‘‘(II) The names and locations of 
all rural hospitals that received a 
grant under this paragraph and, with 
respect to each such hospital— 
‘‘(aa) the use of the amounts 
received under such grant; 
‘‘(bb) an analysis of the fi-
nancial circumstances of such hos-
pital, as determined by such hos-
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pital’s most recently filed Medi-
care cost report (or other applica-
ble source of information)— 
‘‘(AA) at the time of the 
receipt of such grant; and 
‘‘(BB) at the time the 
report is submitted under 
this clause; 
‘‘(cc) an analysis of the class-
es of services offered by the hos-
pital— 
‘‘(AA) prior to the re-
ceipt of such grant; and 
‘‘(BB) following such re-
ceipt, as determined at the 
time the report is submitted 
under this clause; and 
‘‘(dd) an analysis of any new 
classes of services offered by the 
hospital following the receipt of 
such grant. 
‘‘(ii) SUBSEQUENT REPORT.—Not later 
than 2 years after the initial report is sub-
mitted under clause (i), the Secretary shall 
submit to Congress a subsequent report on 
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the grants awarded under this paragraph 
that includes updates to the information de-
scribed in subclauses (I) and (II) of such 
clause. 
‘‘(E) FUNDING.—There are authorized to be 
appropriated from the Federal Hospital Insur-
ance Trust Fund under section 1817 for making 
grants under this paragraph, $20,000,000 for 
each of fiscal years 2026 through 2029, to re-
main available until expended.’’. 
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