1. Short title This Act may be cited as the Rural Hospital Sustainability Act . 2. Findings Congress makes the following findings: (1) Approximately 10,000,000 individuals age 65 and older live in rural America today. In fact, 1 out of every 4 older adults lives in a small town or other rural area. (2) Residents of rural areas are more likely to be poorer, sicker, and have lower incomes compared to their urban counterparts. (3) According to the Office of Rural Health Policy, from 2005 to 2009, people living in rural areas had an average life expectancy of 76.8 years, a full two years less than their urban counterparts who had an average life expectancy of 78.8 years. (4) Many rural hospitals are located in areas where a majority of the population is age 65 and older and has Medicare coverage. (5) Certain State-based demonstrations to improve payment models for rural hospitals show promise in improving healthcare, reducing costs, and integrating services for patients. (6) Experts and organizations suggest that transitioning rural hospitals to global payment systems would benefit patients, providers, and rural communities. 3. Expanding the use of global payments to hospitals in rural areas Section 1115A(b)(2) of the Social Security Act ( 42 U.S.C. 1315a(b)(2) ) is amended— (1) in subparagraph (B), by adding at the end the following new clause: (xxviii) National testing of a model for global payments to hospitals in rural areas as described in subparagraph (D).