This legislation amends the Public Health Service Act to establish a new grant program aimed at assisting rural hospitals. The Secretary of Health and Human Services, acting through the Director of the Office of Rural Health Policy, is authorized to award these grants. Funds can be used for two primary purposes: to acquire, repair, and upgrade hospital systems, facilities, and equipment, and to provide financial assistance for operational costs, including payroll expenses (excluding hospital leadership positions) and debt payments. The overarching goal is to bolster the financial viability of rural hospitals and ensure continued access to healthcare services for rural residents. To receive a grant, rural hospitals must submit an application detailing how the funds will address their financial needs, ensure access to services, and include a plan for sustaining projects after federal support ends. A rural hospital may receive a maximum of $5,000,000 in grant funds over any five-year period, and these funds are intended to supplement, not supplant, other available funding. The Secretary is also required to report to Congress within 18 months on the program's activities, outcomes, and impact on financial viability and service access. The bill authorizes an appropriation of $500,000,000 for fiscal years beginning after September 30, 2025, to carry out this program.