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Rural Hospital Revitalization Act of 2026
Introduced May 21, 2026 · Last action May 21, 2026 — Referred to the House Committee on Agriculture.
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Summary
This legislation is called the Rural Hospital Revitalization Act of 2026. Referred to the House Committee on Agriculture.
Full bill text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9005 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 9005
To amend the Consolidated Farm and Rural Development Act to direct the
Secretary of Agriculture to make temporary zero-percent interest loans
under the community facilities direct loan program to construct or
renovate certain rural hospitals, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 21, 2026
Ms. Tokuda (for herself, Mr. Bergman, Mr. Figures, Mrs. Miller of West
Virginia, Ms. Dexter, Mr. Mann, Ms. Davids of Kansas, Mr. Hurd of
Colorado, and Ms. Boebert) introduced the following bill; which was
referred to the Committee on Agriculture
_______________________________________________________________________
A BILL
To amend the Consolidated Farm and Rural Development Act to direct the
Secretary of Agriculture to make temporary zero-percent interest loans
under the community facilities direct loan program to construct or
renovate certain rural hospitals, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rural Hospital Revitalization Act of
2026''.
SEC. 2. RURAL HOSPITAL REVITALIZATION LOANS.
Subtitle A of the Consolidated Farm and Rural Development Act is
amended by inserting after section 306A (7 U.S.C. 1926a) the following:
``SEC. 306B. RURAL HOSPITAL REVITALIZATION LOANS.
``(a) In General.--Under the community facilities direct loan
program established under section 306(a)(1) (referred to in this
section as the `community facilities direct loan program'), the
Secretary shall make temporary zero-percent interest loans to eligible
rural hospitals described in subsection (b) for the construction of
replacement hospital facilities or the improvement or renovation of
existing hospital facilities in accordance with this section.
``(b) Eligible Hospitals.--
``(1) In general.--An eligible rural hospital described in
this subsection is a rural hospital--
``(A) the campus (as defined in section
413.65(a)(2) of title 42, Code of Federal Regulations
(or successor regulations)) of which is in a county
with a population of less than 20,000 inhabitants;
``(B)(i) the campus (as so defined) of which is not
less than 35 miles from the nearest hospital;
``(ii) if the campus (as so defined) of which is in
an area with mountainous terrain or only secondary
roads, as determined by the Secretary, such campus is
not less than 15 miles from the nearest hospital;
``(iii) that is a critical access hospital (as
defined in section 1861(mm)(1) of the Social Security
Act (42 U.S.C. 1395x(mm)(1))); or
``(iv) that is a rural emergency hospital (as
defined in section 1861(kkk)(2) of that Act (42 U.S.C.
1395x(kkk)(2)));
``(C) that has been continuously licensed as a
hospital in the community in which the hospital is
located for not less than 30 years;
``(D) that submits to the Secretary an application
at such time, in such manner, and containing such
information to determine eligibility under this
paragraph and priorities under paragraph (2) and such
other information as the Secretary may require,
including--
``(i) a statement demonstrating the need
for the loan, which shall describe--
``(I) the age and condition of
existing facilities to be replaced,
improved, or renovated, including a
certification that funds from a loan
under this section will not be used for
facilities that have been significantly
improved during the 10-year period
preceding the date of the application;
and
``(II) the manner in which the use
of the loan funds will address issues
relating to the quality and viability
of the facilities to preserve access to
healthcare;
``(ii) a demonstration that the hospital
has had a positive impact in the community
served by the hospital, which shall include--
``(I) a positive impact on access
to primary healthcare, emergency
services, and services required under
conditions of participation applicable
under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.);
and
``(II) a meaningful economic
impact; and
``(iii) a statement of the anticipated
health and economic impacts of the loan,
including--
``(I) an impact on sustaining the
provision of services that the hospital
currently provides;
``(II) an impact on offering
healthcare services that the hospital
does not currently offer, as
appropriate;
``(III) an impact on the provision
of community-based services, including
such services that influence social
determinants of health;
``(IV) any other economic impacts;
and
``(V) impacts compared to the
impacts if the loan funds were not made
available; and
``(E) that, subject to paragraph (3), is
financially stable, as measured by having--
``(i) not less than 30 days cash on hand;
and
``(ii) a projected debt-service coverage
ratio of at least 1.2.
``(2) Priorities.--In making loans under this section, the
Secretary shall give priority to an eligible rural hospital--
``(A) that serves an area in which there are fewer
than 6 inhabitants per square mile, taking into
consideration--
``(i) the distance from the hospital to a
population center;
``(ii) the travel time from the hospital to
reach a population center or specific health
service; and
``(iii) seasonal variations in the need for
access to healthcare services;
``(B) that requires replacement, improvement, or
renovation that is not financially feasible at the
rates and terms offered under the community facilities
direct loan program;
``(C) for which not less than 50 percent of its
inpatient days or discharges and outpatient visits
during the most recent cost reporting period for which
data are available were attributable to--
``(i) individuals entitled to, or enrolled
for, benefits under part A or enrolled for
benefits under part B of title XVIII of the
Social Security Act, including individuals
enrolled in a Medicare Advantage plan under
part C of such title;
``(ii) individuals eligible for medical
assistance under a State plan under title XIX
of the Social Security Act (or a waiver of such
a plan); or
``(iii) self-pay individuals; or
``(D) that meets 2 or more of the criteria
described in subparagraphs (A) through (C).
``(3) Waiver.--The Secretary may waive the requirements
described in paragraph (1)(D) in the case of a hospital that
demonstrates sufficient community impacts described in
paragraph (1)(C)(ii).
``(4) Eligibility.--For purposes of making loans under this
section, the Secretary shall consider an eligible rural
hospital described in paragraph (1) to be eligible for the
community facilities direct loan program.
``(c) Loan Interest and Terms.--
``(1) Initial interest-free loan.--Except as otherwise
provided in this subsection, a loan made under this section
shall, for the first 5 years of the loan--
``(A) have a zero percent interest rate; and
``(B) require repayment of principal for a period
of 5 years, amortized--
``(i) in accordance with the expected
amortization schedule of a loan under the
community facilities direct loan program; and
``(ii) over a period that is equal to the
lesser of--
``(I) the expected life of the
facility being constructed or
renovated; and
``(II) a maximum term of 40 years.
``(2) Assessment.--At the end of the 5-year period of a
loan described in paragraph (1), the Secretary shall conduct an
assessment of the financial stability of the eligible rural
hospital to determine whether the hospital has the financial
strength for the loan to be refinanced at the prevailing rates
offered under the community facilities direct loan program.
``(3) Refinancing.--If the Secretary determines through an
assessment under paragraph (2) that an eligible rural hospital
has sufficient financial strength to repay a loan under the
community facilities direct loan program, subject to subsection
(d)(2), the Secretary shall refinance the loan under this
section into a loan under the community facilities direct loan
program--
``(A) at the prevailing interest rate applicable to
a loan under the community facilities direct loan
program;
``(B) without a requirement of the payment of any
interest on the amount of principal repaid during the
period in which the interest rate of the loan was zero
percent;
``(C) based on the unpaid principal balance; and
``(D) amortized in accordance with the community
facilities direct loan program for the remaining term
of the loan.
``(d) Renewals.--
``(1) Failure under assessment.--
``(A) In general.--If the Secretary determines
through an assessment under subsection (c)(2) that an
eligible rural hospital does not have sufficient
financial strength to repay a loan under the community
facilities direct loan program, the hospital may submit
to the Secretary an application for a 1-time renewal of
the zero-percent interest loan in accordance with the
terms described in subsection (c)(1) for 1 additional
term of not more than 5 years.
``(B) Requirements.--To be eligible for the renewal
of a zero-percent interest loan under subparagraph (A),
an eligible rural hospital shall demonstrate in the
application submitted under that subparagraph that the
hospital--
``(i) has first applied for and accepted
any available Federal technical assistance for
rural hospitals to support operational
improvements and improve financial stability;
and
``(ii) continues to meet all applicable
community facilities direct loan program
eligibility criteria.
``(C) Refinancing.--At the end of the period for
which a zero-percent interest loan is renewed under
subparagraph (A), the Secretary shall refinance the
loan into a loan under the community facilities direct
loan program in accordance with subsection (c)(3).
``(2) Interest rate protection.--
``(A) In general.--If the Secretary determines
through an assessment under subsection (c)(2) that an
eligible rural hospital has sufficient financial
strength to repay a loan under the community facilities
direct loan program, and the interest rate applicable
to a loan under the community facilities direct loan
program is more than 2.5 percent, the hospital may
submit to the Secretary an application for a 1-time
renewal of the zero-percent interest loan in accordance
with the terms described in subsection (c)(1) for 1
additional term of 5 years.
``(B) Requirements.--To be eligible for the renewal
of a zero-percent interest loan under subparagraph (A),
an eligible rural hospital shall demonstrate in the
application submitted under that subparagraph that the
hospital--
``(i) has had a positive impact on access
to primary healthcare, emergency services, and
services required under conditions of
participation applicable under title XVIII of
the Social Security Act (42 U.S.C. 1395 et
seq.) in the community served by the hospital;
and
``(ii) has had positive impacts in the
community described in subsection
(b)(1)(C)(ii).
``(C) Refinancing.--During the period of a zero-
percent interest loan that has been renewed under
subparagraph (A), at any time that the interest rate
applicable to a loan under the community facilities
direct loan program is 2.5 percent or less, the
eligible rural hospital may elect to refinance the loan
into a loan under the community facilities direct loan
program in accordance with subsection (c)(3).
``(3) Disapproval.--If the Secretary disapproves an
application to renew a zero-percent interest loan under
paragraph (1)(A) or (2)(A), the Secretary shall resolve the
applicable issues in accordance with the procedures that apply
to the community facilities direct loan program.
``(e) Technical Assistance Grants.--
``(1) In general.--A hospital that receives a loan under
this section shall be eligible for assistance through an award
under a covered program to support operational improvements and
improve financial stability during--
``(A) the 5-year period of a zero-percent interest
loan described in subsection (c)(1); and
``(B) any renewal of a zero-percent interest loan
for a lack of sufficient financial strength under
subsection (d)(1).
``(2) Covered program defined.--In this subsection, the
term `covered program' means--
``(A) the Targeted Technical Assistance for Rural
Hospitals Program of the Health Resources and Services
Administration; and
``(B) the Rural Hospital Technical Assistance
Program carried out by the rural development mission
area, in cooperation with the National Rural Health
Association.''.
<all>Official legislative text sourced from the public record (cached on CivicsHQ).
Official source
View the original bill, actions, and full legislative record on Congress.gov.
Status
In Committee
- 1Introduced
- 2Committee
- 3Floor
- 4Passed
- 5Signed
Timeline reflects current normalized status only. Full action history is not yet stored in the API.
Sponsors
- Rep. Tokuda, Jill N. [D-HI-2]DHouseHI
Cosponsors
- Rep. Bergman, Jack [R-MI-1]
- Rep. Boebert, Lauren [R-CO-4]
- Rep. Budzinski, Nikki [D-IL-13]
- Rep. Davids, Sharice [D-KS-3]
- Rep. Dexter, Maxine [D-OR-3]
- Rep. Figures, Shomari [D-AL-2]
- Rep. Fulcher, Russ [R-ID-1]
- Rep. Hurd, Jeff [R-CO-3]
- Rep. Kelly, Mike [R-PA-16]
- Rep. Mann, Tracey [R-KS-1]
- Rep. Miller, Carol D. [R-WV-1]
- Rep. Thompson, Glenn [R-PA-15]
Votes
Voting records are not yet available for this bill.