State leaders who scrambled to win and begin spending their first-year shares of Republicans’ five-year, $50 billion fund are in the dark about how much they’ll receive in the Rural Health Transformat...

Stay up to date on the latest across Washington, D.C. with this weekly brief. Read below for news from Oct. 26 to Oct. | The latest news from CMS and HHS this week: White House aims to improve breast ...

NRHA produces several digital and print publications to engage NRHA members and inform rural health professionals. These include our Rural Health Voices Blog, weekly newsletter NRHA Today, our quarter...

Kichx̱áan (Ketchikan), Alaska — Ketchikan Indian Community (KIC) has been awarded its full $5 million funding request through the Rural Health Transformation Program (RHTP) to further the development ...

Ovation Healthcare's new playbook outlines five essential strategies for rural hospitals to effectively utilize RHTP funding, transforming healthcare access and sustainability.

Logan County staff asked the county board to approve a one-year, $2,105,514 grant agreement with the Colorado Department of Health Care Policy and Financing to fund Rural Health Transformation Program activities led by Sterling Fire Department/Logan County Ambulance Service through Sept. 30, 2027.

Logan County staff asked the county board to approve a one-year, $2,105,514 grant agreement with the Colorado Department of Health Care Policy and Financing to fund Rural Health Transformation Program activities led by Sterling Fire Department/Logan County Ambulance Service through Sept. 30, 2027.

Part of the “One Big Beautiful Bill” passed by Congress in 2025, the RHTP was promoted as a way to stabilize the rural healthcare crisis. As part of the

Part of the “One Big Beautiful Bill” passed by Congress in 2025, the RHTP was promoted as a way to stabilize the rural healthcare crisis. As part of the

Part of the “One Big Beautiful Bill” passed by Congress in 2025, the RHTP was promoted as a way to stabilize the rural healthcare crisis. As part of the legislation, federal health care funding faces a cut of between $1.4 trillion and $1.5 trillion over the next decade. To offset the cuts, Congress inserted into the legislation the RHTP initiative that would inject $50 billion back into rural American communities over the next five years to address rural healthcare needs, according to…

Trump Administration Announces Nearly $249 Million to Bring Healthcare Closer to Home for Rural Alaskans This federal investment will connect Alaska's remote clinics through telehealth, equip communit...

The Trump administration has tied billions in rural health funding for states partly to the policy commitments they make, including ending their certificate of need, or CON, laws governing the construction of new hospitals.

Part of the “One Big Beautiful Bill” passed by Congress in 2025, the RHTP was promoted as a way to stabilize the rural healthcare crisis. As part of the

Part of the “One Big Beautiful Bill” passed by Congress in 2025, the RHTP was promoted as a way to stabilize the rural healthcare crisis. As part of the legislation, federal health care funding faces a cut of between $1.4 trillion and $1.5 trillion over the next decade. To offset the cuts, Congress inserted into the legislation the RHTP initiative that would inject $50 billion back into rural American communities over the next five years to address rural healthcare needs, according to the Centers for Medicare and Medicaid Services. However, instead of giving funding directly to individual hospitals or clinics, the funding gives money to each state, which in turn provide grants to institutions with ideas for addressing health challenges specific to their areas. Rural hospitals can apply for those grants through their states, but the states determine the qualifications for the grants themselves — and many small hospitals, particularly in rural areas, are hesitant to sign up. Alan Morgan, CEO of the National Rural Health Association, said he’s hearing concerns from rural hospitals across the country about the costs and risks of even applying for an RHTP grant. ### Fuel the future of independent rural reporting. We're dedicated to keeping our reporting and newsletters free. **But we need your help.** Please consider getting involved and making a tax-deductible donation today. Thank you! One-time Monthly Annually One-time Donation amount $ Monthly Donation amount per month $ Annually Donation amount per year $ You can make a tax-deductible donation to our 501(c)(3) nonprofit newsroom using this form. Your contribution is appreciated. Donate Now “We have heard loud and clear from some hospitals in a certain number of states that the application process is too onerous to manage with their limited staff, and that the potential for claw backs in funding has scared some hospitals off from applying for the grants,” Morgan said in an interview with the Daily Yonder. “I get a sense that after this cycle that we will get a better idea of how things are managed and what those claw backs will look like.” Effie Carlson, CEO of Watershed Health, a company that helps rural hospitals manage technology and resources, said some of the rural hospitals the company works with have decided not to apply for RHTP grants for those reasons. “If you’re a large academic medical center, you’ve got a whole group of people that do (grant applications) all day long,” Carlson said in an interview with the Daily Yonder. “If you’re a smaller organization or an organization that maybe doesn’t participate in that process as frequently, or[…]ever, it’s a scary and overwhelming process. It’s not as simple as you submit a piece of paper, and they hand you a check, and you’re off to the races. You have to have financial infrastructure, and reporting policy processes and policies in place.” ###### **Stay informed. Get the latest from the Daily Yonder directly in your inbox, twice each week.** Sign up for our newsletter Some hospitals are also putting off applying for the grants because of concerns about what happens at the end of the grant period. Hospitals are wondering, she said, if they will have the money to pay for those programs after the grant period is over, as well as the lingering questions of whether the money will be clawed back if the hospital can’t meet the performance requirements set by federal and state agencies. That is causing some hospitals and clinics to wait until the next round to apply. “A lot of hospitals we know are waiting to see what kind of programs and projects people are putting out there, and see how it goes, and then to see what will inevitably change in the next iterations of the grants as they move forward,” Carlson said. One of the things that makes the program difficult to talk about in generalities is that it’s different in every state. Kevin Stansbury, CEO of Lincoln Community Health’s Hugo Hospital in Hugo, Colorado, said many hospitals in his state aren’t as hesitant because of how the program is being handled. Colorado will disburse the money as reimbursements, he said, so there isn’t as much concern about the money being clawed back. However, there are concerns about the program’s flexibility, he said. “One of the biggest concerns I have is the lack of flexibility,” Stansbury said. “The program requirements had us submit applications covering five years. But now, even three months later, a lot has changed. In a few months, Colorado will have a new governor. And that governor will have a different set of priorities. We have to have the flexibility to reset the priorities based on the priorities of the new administration. It would be helpful to have that kind of flexibility on a national level.” Morgan said the nature of the program — the speed in which it has been implemented, the narrow window for applications, and the short term of the grants themselves — presents its own set of challenges. “I think one can argue something like this has never happened before,” Morgan said “Some people point to Covid as an example of when something of this nature was provided, but those payments went directly to hospitals. The nature of this particular grant program is problematic. There are federal regulations, and then there are state procurement regulations on top of that making this really difficult. With this rapidly stood up grant program, learning is happening in real-time.” * * * ### _Related_ Republish This Story Republish our articles for free, online or in print, under a Creative Commons license. Close window ## Republish this article This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License. You may republish our stories for free, online or in print. Simply copy and paste the article contents from the box below. Note, some images and interactive features may not be included here. Read our Republishing Guidelines for more information. # Some Rural Hospitals Are Turning Away from the RHTP Grants by Liz Carey, The Daily Yonder October 21, 2026 <h1>Some Rural Hospitals Are Turning Away from the RHTP Grants</h1> <p class="byline">by Liz Carey, The Daily Yonder <br />October 21, 2026</p> <p>Part of the “One Big Beautiful Bill” passed by Congress in 2025, the RHTP was promoted as a way to stabilize the rural healthcare crisis. As part of the legislation, federal health care funding faces a cut of between $1.4 trillion and $1.5 trillion over the next decade. </p> <p>To offset the cuts, Congress inserted into the legislation the RHTP initiative that would inject $50 billion back into rural American communities over the next five years to address rural healthcare needs, according to <a href="https://www.medicaid.gov/resources-for-states/rural-health">the Centers for Medicare and Medicaid Services</a>. </p> <p>However, instead of giving funding directly to individual hospitals or clinics, the funding gives money to each state, which in turn provide grants to institutions with ideas for addressing health challenges specific to their areas. Rural hospitals can apply for those grants through their states, but the states determine the qualifications for the grants themselves — and many small hospitals, particularly in rural areas, are hesitant to sign up.</p> <p>Alan Morgan, CEO of the <a href="https://www.ruralhealth.us/">National Rural Health Association</a>, said he’s hearing concerns from rural hospitals across the country about the costs and risks of even applying for an RHTP grant.</p> <p>“We have heard loud and clear from some hospitals in a certain number of states that the application process is too onerous to manage with their limited staff, and that the potential for claw backs in funding has scared some hospitals off from applying for the grants,” Morgan said in an interview with the Daily Yonder. “I get a sense that after this cycle that we will get a better idea of how things are managed and what those claw backs will look like."</p> <p>Effie Carlson, CEO of <a href="https://watershedhealth.com/">Watershed Health</a>, a company that helps rural hospitals manage technology and resources, said some of the rural hospitals the company works with have decided not to apply for RHTP grants for those reasons.</p> <p>“If you're a large academic medical center, you've got a whole group of people that do (grant applications) all day long,” Carlson said in an interview with the Daily Yonder. “If you're a smaller organization or an organization that maybe doesn't participate in that process as frequently, or[...]ever, it's a scary and overwhelming process. It's not as simple as you submit a piece of paper, and they hand you a check, and you're off to the races. You have to have financial infrastructure, and reporting policy processes and policies in place.”</p> <p>Some hospitals are also putting off applying for the grants because of concerns about what happens at the end of the grant period. Hospitals are wondering, she said, if they will have the money to pay for those programs after the grant period is over, as well as the lingering questions of whether the money will be clawed back if the hospital can’t meet the performance requirements set by federal and state agencies. That is causing some hospitals and clinics to wait until the next round to apply.</p> <p>“A lot of hospitals we know are waiting to see what kind of programs and projects people are putting out there, and see how it goes, and then to see what will inevitably change in the next iterations of the grants as they move forward,” Carlson said.</p> <p>One of the things that makes the program difficult to talk about in generalities is that it’s different in every state. Kevin Stansbury, CEO of <a href="https://hugohospital.com/">Lincoln Community Health’s</a> Hugo Hospital in Hugo, Colorado, said many hospitals in his state aren’t as hesitant because of how the program is being handled. Colorado will disburse the money as reimbursements, he said, so there isn’t as much concern about the money being clawed back.</p> <p>However, there are concerns about the program’s flexibility, he said.</p> <p>"One of the biggest concerns I have is the lack of flexibility,” Stansbury said. “The program requirements had us submit applications covering five years. But now, even three months later, a lot has changed. In a few months, Colorado will have a new governor. And that governor will have a different set of priorities. We have to have the flexibility to reset the priorities based on the priorities of the new administration. It would be helpful to have that kind of flexibility on a national level.”</p> <p>Morgan said the nature of the program — the speed in which it has been implemented, the narrow window for applications, and the short term of the grants themselves — presents its own set of challenges.</p> <p>"I think one can argue something like this has never happened before,” Morgan said “Some people point to Covid as an example of when something of this nature was provided, but those payments went directly to hospitals. The nature of this particular grant program is problematic. There are federal regulations, and then there are state procurement regulations on top of that making this really difficult. With this rapidly stood up grant program, learning is happening in real-time."</p> <hr class="wp-block-separator has-alpha-channel-opacity" /> <p>This <a target="_blank" href="https://dailyyonder.com/some-rural-hospitals-are-turning-away-from-the-rhtp-grants/2026/10/21/">article</a> first appeared on <a target="_blank" href="https://dailyyonder.com">The Daily Yonder</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nd/4.0/">Creative Commons Attribution-NoDerivatives 4.0 International License</a>.<img src="https://i0.wp.com/dailyyonder.com/wp-content/uploads/2021/03/cropped-dy-wordmark-favicon.png?resize=150%2C150&amp;ssl=1" style="width:1em;height:1em;margin-left:10px;"></p> <img id="republication-tracker-tool-source" src="https://dailyyonder.com/?republication-pixel=true&post=243438&amp;ga4=G-QXTK9L73TZ" style="width:1px;height:1px;"><script> PARSELY = { autotrack: false, onload: function() { PARSELY.beacon.trackPageView({ url: "https://dailyyonder.com/some-rural-hospitals-are-turning-away-from-the-rhtp-grants/2026/10/21/", urlref: window.location.href }); } } </script> <script id="parsely-cfg" src="//cdn.parsely.com/keys/dailyyonder.com/p.js"></script> Copy to Clipboard

La inversión federal permitirá ampliar la telemedicina, los servicios médicos móviles y la atención paramédica comunitaria para acercar la prevención, las especialidades médicas y la atención de urgencias a las zonas rurales de Florida. El presidente Donald Trump - Foto: The White House La administración de Donald Trump anunció una financiación de 193,7 millones de dólares para 45 organizaciones de Florida, en el marco del Programa de Transformación de la Salud Rural (RHTP, por sus siglas en inglés).

Star Valley Health applied for Rural Health Transformation Program funds to recoup about $2.2 million; funding requires regionalized EMS and includes categories for system acquisition, ambulance purchases and operating support. The town's EMS contract expires Nov. 21, and the hospital said it plans to continue operating three stations.

Across South Dakota, many communities and residents rely on one of the state’s 40 federally designated Critical Access Hospitals (CAH).

Council was briefed on a Rural Health Transformation Program preapproval of about $2.2 million to support EMS regionalization; members questioned whether current staffing and certification models are sustainable and pressed for clearer metrics tying staffing models to service levels and funding eligibility.