Creates the Rural Hospital Sustainability and Innovation Grant Program Act and Hospital Transformation and Innovation Fund to provide grants to preserve rural hospital services

This bill creates a new grant program and fund to help rural hospitals in Alabama stay open and improve their operations. It directly affects critical access hospitals, rural acute care hospitals, and other facilities designated as rural. The program provides financial assistance for immediate needs like preventing closures or fixing financial problems, as well as funding for infrastructure upgrades, telehealth expansion, and converting to rural emergency hospital designations. Hospitals must show community support and submit detailed plans before receiving grants, which are limited to one per hospital per year and must be repaid if milestones aren't met. The bill also requires annual reporting on how funds are used and how hospital services and finances perform.