This notice announces the opportunity to apply for funding under the Rural Hospital Stabilization Pilot Program. The purpose of this program is to improve health care in rural areas by providing in-depth technical assistance (TA) to rural hospitals to enhance and/or expand service lines to meet local need and keep health care services available locally. Service lines may include, but are not limited to pulmonary rehabilitation, infusion/chemotherapy, inpatient psychiatric services, outpatient behavioral health services, obstetric services, cardiac rehabilitation, and expanded primary care. The Rural Hospital Stabilization Pilot Program aims to increase service volume and revenue to improve hospital financial sustainability in rural hospitals that have limited access to resources needed to expand their services. The TA provider(s) funded under this cooperative agreement will work with individual hospitals to meet the following program objectives: • Identify clinical areas where expansion would meet local medical need, help keep health care services available locally and improve hospital finances and operations; • Implement new service lines by providing support for initial operating and equipment costs that provides the participating hospital the ability to build up patient volume for the new service line to eventually become self-sustaining. For the purposes of this notice of funding opportunity (NOFO), “rural hospitals” are defined as short-term, non-federal general facilities located outside Metropolitan Core-Based Statistical Areas (CBSAs) or located within Metropolitan areas in locations with Rural-Urban Commuting Area (RUCA) codes of four (4) or greater, facilities in any location participating in Medicare as Critical Access Hospitals (CAHs), or facilities in any location participating in Medicare as Rural Emergency Hospitals (REHs). Hospitals operated by tribes and tribal organizations under the Indian Self-Determination and Education Assistance Act (Public Law 93-638, as amended) may also receive technical assistance if they meet this definition of “rural hospitals.” For more details, see Program Requirements and Expectations.