Rural Hospital Revitalization Act of 2026

Zero‑interest loans for rural hospitals

This bill would create a USDA Community Facilities loan option that gives eligible very rural hospitals 0% interest for the first five years. Hospitals would still have to repay principal during those five years, and no interest would be charged on amounts repaid in that period. Loans would be amortized for no more than the facility's expected life or 40 years. To qualify, a hospital campus would be in a county under 20,000 people and at least 35 miles from the nearest hospital (15 miles in mountainous or secondary-road areas). Hospitals would need at least 30 days cash on hand and a projected debt-service coverage ratio of 1.2 and must show need and positive community impact. After five years the Secretary of Agriculture would assess finances and, if the hospital is judged strong, would refinance the unpaid balance into a standard loan at prevailing interest rates; limited one-time renewals of the zero-percent period are allowed in specified situations. The program would prioritize the most remote hospitals, hospitals serving many Medicare/Medicaid/self-pay patients, and hospitals that cannot afford standard program terms. Technical assistance would be available and required for some renewals.