Rural Hospital Revitalization Act of 2026

Zero-interest loans for rural hospitals

If enacted, eligible rural hospitals would be able to get zero-percent loans for the first 5 years to build replacement hospitals or to improve or renovate existing facilities. Loans would require principal repayment during that zero-percent period, be amortized like community facilities loans, and run for up to the lesser of the facility's expected life or 40 years. After 5 years the Secretary would assess financial strength and could refinance the unpaid balance at prevailing rates; hospitals found not sufficiently stable could apply for a one-time 5-year renewal only after receiving available Federal technical assistance. To apply, hospitals would need to meet location and program tests (county population under 20,000; at least 35 miles from another hospital or 15 miles in mountainous/secondary-road areas; be a critical access or rural emergency hospital; licensed continuously for 30 years) and file a detailed need statement, a certification that funds won't pay for facilities substantially improved in the prior 10 years, and statements about anticipated health and economic impacts; the Secretary could waive some application rules for hospitals showing strong community impact. Hospitals that get loans would also be eligible for technical assistance from HRSA's targeted program and a rural development technical assistance program with the National Rural Health Association during the zero-percent period and any approved renewal.