Rural Hospital Revitalization Act of 2026

Summary

Creates a temporary federal loan program that gives eligible rural hospitals a five-year, zero-percent interest loan to build, replace, renovate, or improve facilities. After the five-year zero-interest period the hospital will either be refinanced into the standard community facilities loan program at prevailing rates (if financially stable) or may apply for a one-time five-year zero-percent renewal if it still lacks financial strength, with technical assistance available during zero-interest periods.

• Creates a temporary zero-percent interest loan program for eligible rural hospitals to build, replace, or renovate facilities.
• Initial loan term is five years interest-free, with principal amortization per existing community facilities rules and up to 40 years or facility life.
• After five years the loan is either refinanced into the standard program at prevailing rates if the hospital is financially stable, or the hospital may apply for a one-time five-year zero-percent renewal if not financially strong.
• Eligibility is limited to rural hospitals in counties under 20,000 (or meeting distance/designation tests) with at least 30 years of continuous licensure and minimum financial metrics (≥30 days cash on hand and projected DSCR ≥1.2).
• Priority is given to very low density areas, projects not feasible under existing terms, hospitals with ≥50% Medicare/Medicaid/self-pay, and projects meeting multiple priorities.
• The Secretary may waive some application requirements to expedite projects with clear community impact.
• Recipients are eligible for targeted federal technical assistance during zero-interest periods and renewals granted for lack of financial strength.
• The program is implemented through the existing community facilities direct loan authority within the Consolidated Farm and Rural Development Act.