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Small Rural Hospital Improvement Program Grant Program


The purpose of the Small Rural Hospital Improvement Grant Program (SHIP) is to help small rural hospitals of less than 50 beds implement quality and operational improvement efforts.

  1. Enable the purchase of equipment and/or training to help hospitals attain value-based purchasing provision in the Patient Protection and Affordable Care Act (ACA);
    • Activities that support improved data collection to facilitate quality reporting and improvement.
  2. Aid small rural hospitals in joining or becoming accountable care organizations (ACOs), or create shared savings programs per the ACA;
    • Activities that support the development or the basic tenets of ACOs or shared savings programs.
  3. Enable small rural hospitals to purchase health information technology, equipment, and/or training to comply with meaningful use, ICD-10 standards, and payment bundling.
    • Activities that improve hospital financial processes.


Eligible hospitals are notified each year by their State Office of Rural Health (SORH) when applications are available. SORH collects the individual hospital applications and completes an application for the state. The Federal Office of Rural Health Policy reviews the state applications and notifies each SORH of their award prior to the grant cycle beginning. SORH then notifies individual hospitals of their award (calculated by dividing the total award by the number of applicants, less 5% which contributes to the costs associated with administering the grant).

The regular FY23 SHIP funding year runs 6/1/2023 – 5/31/2024.

SHIP funding priority areas returned this year are:

  • Consistently reporting MBQIP measures
  • Implementing ICD-11 coding readiness or implementation activities

The priority areas must be addressed before working on additional SHIP eligible activities. This information is reflected in each Critical Access Hospital's (CAH) subaward paperwork in the Scope of Work section. Continue working on your selected activities. A December mid-year check-in will occur to see how CAH-selected activities are progressing. The new SHIP FY24 (6/1/2024 – 5/31/2025) hospital application form will be sent out to each CAH once released from our Federal funder.


To be eligible for these grants, a hospital must:

  • have 49 or fewer staffed beds
  • be located in a non-metropolitan area

All North Dakota rural CAHs are eligible.


Nicole Threadgold, MBA
Senior Project Coordinator