Rural Hospital Revitalization Act of 2026

Key Points

• The bill creates a new loan program through the USDA to help rural hospitals build new facilities or renovate old ones. These loans start with a 0% interest rate for the first five years, making large construction projects much more affordable for small hospitals.
• To qualify, a hospital must be in a county with fewer than 20,000 people and meet distance requirements from the nearest hospital (at least 35 miles, or 15 miles in mountainous areas). It must also have been licensed in its community for at least 30 years and be financially stable.
• After five years, the USDA checks the hospital's finances. If the hospital is strong enough, the loan converts to a standard community facilities interest rate. If the hospital is still struggling, it can apply for a one-time renewal of the 0% rate for up to five more years.
• Even financially healthy hospitals get protection from high interest rates. If the standard rate is above 2.5% when the initial period ends, they can apply to keep the 0% rate for another five years, shielding them from borrowing costs that could threaten their survival.
• The bill prioritizes hospitals in the most remote areas (fewer than 6 people per square mile) and those where most patients rely on Medicare, Medicaid, or are self-pay. This targets the hospitals most at risk of closing.
• Hospitals receiving these loans also become eligible for technical assistance grants to improve their operations and financial stability, available through programs at HRSA and the USDA rural development mission area.