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HR 9005

Rural Hospital Revitalization Act of 2026

119th Congress Introduced by Jack Bergman and 12 co-sponsors

The bill creates zero‑interest loans to replace/renovate rural hospitals and improve access, with eligibility, prioritization, and technical aid.

Introduced in House
0
WeVote Research Nonpartisan
Bill Summary · HR 9005

Purpose and intent

  • HR 9005, the Rural Hospital Revitalization Act of 2026, would amend the Consolidated Farm and Rural Development Act to expand and streamline zero-interest loan opportunities for rural hospitals.
  • The core aim is to support construction of replacement facilities or modernization/renovation of existing facilities in rural areas, with a focus on sustaining or improving access to healthcare in underserved communities.

Key provisions and changes

  • Creation of Rural Hospital Revitalization Loans (Section 306B):
    • Establishes a new subprogram within the Existing Community Facilities Direct Loan Program.
    • Eligible borrowers: Rural hospitals meeting specific location, service, and licensure criteria (see below).
    • Loan purpose: Construction of replacement hospital facilities or improvement/renovation of existing facilities.
  • Eligible hospitals (paragraph (b)):
    • Location criteria: Hospital campus must be in a county with population under 20,000.
    • Distance/access criteria: Campus must be at least:
    • 35 miles from the nearest hospital, or
    • 15 miles if mountainous terrain/limited secondary roads, or if designated as a rural emergency hospital or a critical access hospital.
    • Licensing: Hospital must have been continuously licensed for at least 30 years.
    • Application requirements: Must submit an eligibility package detailing need, facility condition, anticipated health and economic impacts, and other information requested by the Secretary.
    • Demonstrated community impact: Must show positive impact on access to primary and emergency services, Medicare/Medicaid beneficiaries served, and a positive economic impact.
    • Financial stability criteria: Must show at least 30 days cash on hand and a projected debt-service coverage ratio of at least 1.2.
  • Priorities in loan selection (paragraph (2)):
    • Favor hospitals in sparsely populated areas (fewer than 6 inhabitants per square mile) considering distance to population centers, travel times, and seasonal accessibility.
    • Prioritize hospitals needing financial feasibility improvements not possible under standard terms.
    • Consider hospitals with at least 50% of inpatient days or outpatient visits tied to Medicare/Medicaid beneficiaries or self-pay.
    • Hospitals that meet two or more of the above criteria may receive priority.
  • Eligibility requirements and flexibility (paragraph (4)):
    • Secretary may waive certain eligibility requirements if the hospital demonstrates substantial community impact.
  • Interest rates and terms (paragraph (1)):
    • Initial loan terms: Zero percent interest for the first 5 years.
    • Repayment: Principal amortized over 5 years, with term length capped at the lesser of the facility’s expected life or 40 years.
  • Refinancing and renewal (paragraphs (3) and (4)):
    • End of 5-year initial period: The Secretary assesses financial strength; if viable, the loan can be refinanced under the standard Community Facilities Direct Loan Program at prevailing rates, with no interest charged on principal repaid during the zero-rate period.
    • Renewal options:
    • If the hospital cannot repay, one-time renewal of the zero-interest loan for up to 5 more years is allowed, subject to conditions (e.g., pursuing federal technical assistance and meeting all program criteria).
    • If the hospital’s financial strength improves and interest rates fall to 2.5% or less, a one-time renewal of the zero-interest loan for 5 years is permitted.
    • After renewal, refinancing into the standard program is possible.
    • Disapproval or withdrawal processes follow existing Community Facilities Direct Loan Program procedures.
  • Technical assistance (Section on TA grants, subsection (e)):
    • Hospitals receiving the zero-interest loan would be eligible for targeted technical assistance to support operational improvements and financial stability during the initial loan term and any renewal period.
    • Covered programs include:
    • HHS Health Resources and Services Administration’s Targeted Technical Assistance for Rural Hospitals.
    • Rural Development’s Rural Hospital Technical Assistance Program, in collaboration with the National Rural Health Association.

Who would be affected

  • Eligible rural hospitals meeting the statutory criteria (location, connectivity, licensure, and financial thresholds) could receive zero-interest loans for facility construction, replacement, or renovation.
  • Rural communities served by these hospitals may experience improved access to primary care, emergency services, and Medicare/Medicaid-covered care.
  • Eligible hospitals could access technical assistance funding to support operational improvements and financial stability.

Procedural and timeline aspects

  • Legislative action: The bill was introduced in the 119th Congress on May 21, 2026, and referred to the House Committee on Agriculture.
  • Funding mechanics: The zero-interest period lasts 5 years, with potential renewal and eventual refinancing into the standard Community Facilities Direct Loan Program.
  • Administrative process: Hospitals must submit eligibility applications with evidence of need, impact, and financial viability; the Secretary has discretion to waive certain requirements under specified circumstances.
  • Oversight: Renewal and refinancing are conducted under the ongoing framework of the Community Facilities Direct Loan Program, with assessments of financial strength and adherence to program criteria.

Notable details

  • Zero-interest period for initial loans: 5 years.
  • Maximum loan term: 40 years, or the facility’s expected life, whichever is shorter.
  • Financial thresholds: Minimum 30 days cash on hand and debt-service coverage ratio of at least 1.2 at the time of initial eligibility.
  • Distance/terrain considerations: Special proximity rules to accommodate mountainous terrain and remote rural settings.

This summary captures the bill’s core objective to revitalize rural hospitals through favorable loan terms, targeted eligibility and prioritization criteria, and accompanying technical assistance.

Compiled from official sources — confirm details with the bill’s official record.

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