II 

117TH CONGRESS 

1ST SESSION S. 3105 

To amend the Public Health Service Act to establish a hospital revitalization 

program to assist certain health facilities in constructing and modernizing 

their facilities and to support community development. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 28, 2021 

Mr. BENNET introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to establish a hospital revitalization program to assist certain health facilities in constructing and modernizing their facilities and 

to support community development. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Hospital Revitalization 

5 Act of 2021’’. 


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1 SEC. 2. HOSPITAL REVITALIZATION PROGRAM. 

2 Title VI of the Public Health Service Act (42 U.S.C. 

3 291 et seq.) is amended by adding at the end the fol4 lowing: 

5 ‘‘PART E—HOSPITAL REVITALIZATION PROGRAM 

6 ‘‘SEC. 651. ESTABLISHMENT OF HOSPITAL REVITALIZATION 

7 PROGRAM. 

8 ‘‘(a) IN GENERAL.—The Secretary shall award 

9 grants and loans to eligible hospitals for purposes of as10 sisting such hospitals in constructing and modernizing 

11 their facilities, including rural health clinics, off-site out12 patient departments, skilled nursing facilities, and other 

13 facilities not physically part of the eligible hospital build14 ing, to increase capacity and better serve communities in 

15 need. 

16 ‘‘(b) ELIGIBLE HOSPITALS.— 

17 ‘‘(1) IN GENERAL.—To be eligible to receive an 

18 award under this section, a hospital shall submit an 

19 application to the Secretary at such time, in such 

20 manner, and containing such information as the Sec21 retary may require, including information to dem22 onstrate that, based on available data for fiscal or 

23 calendar years 2017 through 2019, such hospital— 

24 ‘‘(A) had less than $50,000,000 in net pa25 tient revenue or fewer than 50 beds (as reVerDate Sep 11 2014 17:45 Nov 01, 2021 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3105.IS S3105

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1 ported by the Health Care Cost and Informa2 tion Reporting System); 

3 ‘‘(B) had a negative total margin for at 

4 least 2 of the 3 fiscal years prior to fiscal year 

5 2020; and 

6 ‘‘(C) had a public payer mix percentage, 

7 for each of the 3 fiscal years prior to fiscal year 

8 2020, that is at least 65 percent (at least 65 

9 percent of net patient revenue from the Medi10 care program or Medicaid program). 

11 ‘‘(2) PRIORITIZATION CRITERIA.—The Sec12 retary shall develop prioritization criteria for the 

13 grant and loans under subsection (d), including— 

14 ‘‘(A) the year in which the hospital was 

15 built; 

16 ‘‘(B) the physical state of the hospital; 

17 ‘‘(C) the average age-of-plant ratio (accu18 mulated depreciation divided by annual depre19 ciation expense); 

20 ‘‘(D) the level of the hospital’s electronic 

21 health record implementation; 

22 ‘‘(E) whether the hospital is located in a 

23 health professional shortage area (as defined in 

24 section 332(a)(1)(A) of the Public Health Serv25 ice Act); and 


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1 ‘‘(F) the level of, relative to the national or 

2 statewide average, individuals with income 

3 below 150 percent of the Federal poverty level 

4 in the area served by the hospital. 

5 ‘‘(c) APPLICATION.—Each eligible hospital desiring 

6 an award under this section shall submit to the Secretary 

7 an application, at such time, in such manner, and con8 taining such information to determine eligibility and 

9 prioritization required under subsection (b) and other in10 formation as the Secretary may require, including— 

11 ‘‘(1) a community health needs assessment, 

12 which shall be made available on the websites of the 

13 hospital and the Department of Health and Human 

14 Services, that— 

15 ‘‘(A) accounts for health equity through 

16 factors (like socioeconomic, racial, ethnic, sex17 ual preference, gender identity, health insurance 

18 coverage, education level, and geography) that 

19 have an impact on the overall health of the pop20 ulation; 

21 ‘‘(B) honors indigenous history and cur22 rent presence with a land acknowledgment 

23 statement; 


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1 ‘‘(C) outlines a projection for not less than 

2 5 years, and if possible for 10 years, with re3 spect to— 

4 ‘‘(i) population and demographic 

5 trends within the local community and re6 gion; 

7 ‘‘(ii) current availability of, and pro8 jected community need for— 

9 ‘‘(I) inpatient hospital services; 

10 outpatient and ambulatory services; 

11 ‘‘(II) diagnostic and lab services; 

12 ‘‘(III) post-acute and community 

13 services; 

14 ‘‘(IV) emergency medical serv15 ices; 

16 ‘‘(V) oral and dental care; and 

17 ‘‘(VI) preventive and population 

18 health services; 

19 ‘‘(iii) current availability and pro20 jected community need for Tribal or vet21 eran health and wellness services; and 

22 ‘‘(iv) current availability and projected 

23 community need for non-clinical services, 

24 such as food support, housing assistance, 

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1 ices that impact the health care status of 

2 the impacted population; 

3 ‘‘(D) provides a statement outlining the 

4 overarching gap in local community or regional 

5 services; 

6 ‘‘(E) provides a statement that identifies 

7 the highest priority services that have the po8 tential to improve overall health and wellness of 

9 the local region; and 

10 ‘‘(F) establishes a hospital transformation 

11 plan that contains— 

12 ‘‘(i) a process for consulting with rep13 resentatives of the community’s interests 

14 and input; 

15 ‘‘(ii) a list of community input sources 

16 representing the broad interests of the 

17 community, that is representative of indi18 viduals who are medically underserved, 

19 low-income, or from minority populations 

20 and that may include representatives of 

21 local hospitals, physicians, allied health 

22 professionals, private and public payers, 

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1 cluding local or regional social service or2 ganizations; and 

3 ‘‘(iii) an outline of goals and action 

4 steps for improving or maintaining access 

5 to care, strengthening quality of care, bet6 ter coordinating care across the local or re7 gional health care delivery system, and ad8 dressing other community needs or gaps 

9 identified in the needs assessment; 

10 ‘‘(2) a preliminary construction project plan 

11 that— 

12 ‘‘(A) outlines a project budget with costs 

13 of— 

14 ‘‘(i) administrative and legal expenses; 

15 ‘‘(ii) land, structure, rights-of-way ap16 praisals; 

17 ‘‘(iii) relocation expenses; 

18 ‘‘(iv) architectural and engineering 

19 fees; 

20 ‘‘(v) inspection fees; 

21 ‘‘(vi) site work (such as helipad equip22 ment and telecommunication and data net23 work upgrades); 

24 ‘‘(vii) demolition and removal; 


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1 ‘‘(viii) equipment (such as medical 

2 equipment and technology systems, fur3 niture, kitchen and bathroom appliances, 

4 and signage); and 

5 ‘‘(ix) any other costs the Secretary de6 termines appropriate; and 

7 ‘‘(B) outlines the planned spaces with de8 scriptions (including square footage and pur9 pose), as the Secretary determines appropriate, 

10 which shall include— 

11 ‘‘(i) care units or wards and the num12 ber of expected beds in such areas; 

13 ‘‘(ii) diagnostic and treatment areas, 

14 including imaging areas, emergency de15 partments, laboratories, and pharmacies; 

16 ‘‘(iii) administrative areas, including 

17 lobbies, office space, education areas; and 

18 ‘‘(iv) other types of spaces the Sec19 retary determines appropriate; 

20 ‘‘(3) an energy plan for how the project ac21 counts for energy resilience and efficiency; and 

22 ‘‘(4) a report on the economic impact of the 

23 award on the area or region served, including an 

24 analysis of local labor market effects such as how 

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1 comes, employment and unemployment rates, and 

2 meet labor demands and how the hospital may help 

3 improve wages in the area. 

4 ‘‘(d) SAFE STRUCTURE WAIVER.—The Secretary 

5 may grant a waiver to eligible hospitals with respect to 

6 the timing of submissions of information required under 

7 paragraph (1), (3), or (4) of subsection (c), if the Sec8 retary determines that the project to be carried out by 

9 the eligible hospital receiving such waiver should be expe10 dited to ensure the safety of patients or workers. 

11 ‘‘(e) GRANT AND LOAN AMOUNTS.— 

12 ‘‘(1) IN GENERAL.—An award to an eligible 

13 hospital under this section shall be in an amount de14 termined by the Secretary, based on the information 

15 submitted by the eligible hospital under subsection 

16 (c)(2). The total amount of such an award shall not 

17 exceed $40,000,000, of which not more than 30 per18 cent may be awarded as a grant, and any remaining 

19 amount may be awarded as a low interest loan. 

20 ‘‘(2) NO EFFECT ON ELIGIBILITY FOR OTHER

21 FUNDING.—Amounts received by an eligible hospital 

22 under this section shall have no effect on the hos23 pital’s eligibility for funding made available through 

24 other Federal programs, including any such funding 


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1 available with respect to the project supported by 

2 the award under this section. 

3 ‘‘(f) REPORTING.—Each recipient of an award under 

4 this section shall submit an annual report to the Secretary 

5 on the use of such award funds in the previous fiscal year, 

6 including the use of such funds to address issues raised 

7 in the community health needs assessment, the energy 

8 plan, and economic impact report submitted with the re9 cipient’s application under subsection (c). Such recipient 

10 shall post each such report on the website of the recipient. 

11 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

12 ‘‘(1) IN GENERAL.—There are authorized to be 

13 appropriated $17,000,000,000 for fiscal year 2022 

14 to carry out this section. Amounts appropriated 

15 under this subsection shall remain available through 

16 fiscal year 2025. 

17 ‘‘(2) MANAGEMENT AND OVERSIGHT.—The Sec18 retary may allocate up to 0.1 percent of the funds 

19 appropriated under this subsection for the manage20 ment and oversight of programs under this section.’’. 

Æ 


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