The Rural Hospital Revitalization Act of 2026 establishes a program for temporary zero-percent interest loans to eligible rural hospitals, administered by the Secretary of Agriculture. These loans, provided under the community facilities direct loan program, are intended for the construction of replacement hospital facilities or the improvement and renovation of existing ones. To qualify, a rural hospital must meet specific criteria, such as being located in a county with a population under 20,000, serving a remote area, or being a critical access or rural emergency hospital. Hospitals must also have been continuously licensed for at least 30 years, demonstrate financial stability, and show a positive impact on community healthcare access and the local economy. Priority is given to hospitals in very sparsely populated areas, those facing financial feasibility challenges, or those serving a high proportion of Medicare, Medicaid, or self-pay patients. Loans feature an initial five-year period at zero percent interest , with principal repayment amortized over the facility's expected life, up to 40 years. After this period, the Secretary assesses the hospital's financial stability; if stable, the loan is refinanced into a standard community facilities direct loan at prevailing rates, without charging interest on the initial zero-percent period. The bill allows for a one-time renewal of the zero-percent interest period for an additional five years if a hospital is not yet financially stable (provided it seeks federal technical assistance) or if prevailing interest rates for standard loans exceed 2.5% (contingent on continued positive community impact). Hospitals receiving these loans are also eligible for technical assistance grants to support operational improvements and enhance financial stability.