Hospital Revitalization Act of 2021
Bill: S.3105 | Sponsor: Sen. Bennet, Michael F. (D-CO)
Policy area: Health

Summary:
Hospital Revitalization Act of 2021
This bill establishes a program within the Department of Health and Human Services (HHS) to provide grants and low-interest loans to hospitals that, prior to 2020, were small, had poor financial indicators, and served a high number of patients with public insurance. Hospitals may use grants to construct and modernize their facilities, including rural health clinics, off-site outpatient departments, and other facilities that are not physically part of the hospital building.
HHS must develop criteria to prioritize grant recipients based on, for example, the age and physical state of the hospital and whether the hospital is located in an area with a shortage of health care providers.

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.

    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 ``Hospital Revitalization Act of 
2021''.

SEC. 2. HOSPITAL REVITALIZATION PROGRAM.

    Title VI of the Public Health Service Act (42 U.S.C. 291 et seq.) 
is amended by adding at the end the following:

               ``PART E--HOSPITAL REVITALIZATION PROGRAM

``SEC. 651. ESTABLISHMENT OF HOSPITAL REVITALIZATION PROGRAM.

    ``(a) In General.--The Secretary shall award grants and loans to 
eligible hospitals for purposes of assisting such hospitals in 
constructing and modernizing their facilities, including rural health 
clinics, off-site outpatient departments, skilled nursing facilities, 
and other facilities not physically part of the eligible hospital 
building, to increase capacity and better serve communities in need.
    ``(b) Eligible Hospitals.--
            ``(1) In general.--To be eligible to receive an award under 
        this section, a hospital shall submit an application to the 
        Secretary at such time, in such manner, and containing such 
        information as the Secretary may require, including information 
        to demonstrate that, based on available data for fiscal or 
        calendar years 2017 through 2019, such hospital--
                    ``(A) had less than $50,000,000 in net patient 
                revenue or fewer than 50 beds (as reported by the 
                Health Care Cost and Information Reporting System);
                    ``(B) had a negative total margin for at least 2 of 
                the 3 fiscal years prior to fiscal year 2020; and
                    ``(C) had a public payer mix percentage, for each 
                of the 3 fiscal years prior to fiscal year 2020, that 
                is at least 65 percent (at least 65 percent of net 
                patient revenue from the Medicare program or Medicaid 
                program).
            ``(2) Prioritization criteria.--The Secretary shall develop 
        prioritization criteria for the grant and loans under 
        subsection (d), including--
                    ``(A) the year in which the hospital was built;
                    ``(B) the physical state of the hospital;
                    ``(C) the average age-of-plant ratio (accumulated 
                depreciation divided by annual depreciation expense);
                    ``(D) the level of the hospital's electronic health 
                record implementation;
                    ``(E) whether the hospital is located in a health 
                professional shortage area (as defined in section 
                332(a)(1)(A) of the Public Health Service Act); and
                    ``(F) the level of, relative to the national or 
                statewide average, individuals with income below 150 
                percent of the Federal poverty level in the area served 
                by the hospital.
    ``(c) Application.--Each eligible hospital desiring an award under 
this section shall submit to the Secretary an application, at such 
time, in such manner, and containing such information to determine 
eligibility and prioritization required under subsection (b) and other 
information as the Secretary may require, including--
            ``(1) a community health needs assessment, which shall be 
        made available on the websites of the hospital and the 
        Department of Health and Human Services, that--
                    ``(A) accounts for health equity through factors 
                (like socioeconomic, racial, ethnic, sexual preference, 
                gender identity, health insurance coverage, education 
                level, and geography) that have an impact on the 
                overall health of the population;
                    ``(B) honors indigenous history and current 
                presence with a land acknowledgment statement;
                    ``(C) outlines a projection for not less than 5 
                years, and if possible for 10 years, with respect to--
                            ``(i) population and demographic trends 
                        within the local community and region;
                            ``(ii) current availability of, and 
                        projected community need for--
                                    ``(I) inpatient hospital services; 
                                outpatient and ambulatory services;
                                    ``(II) diagnostic and lab services;
                                    ``(III) post-acute and community 
                                services;
                                    ``(IV) emergency medical services;
                                    ``(V) oral and dental care; and
                                    ``(VI) preventive and population 
                                health services;
                            ``(iii) current availability and projected 
                        community need for Tribal or veteran health and 
                        wellness services; and
                            ``(iv) current availability and projected 
                        community need for non-clinical services, such 
                        as food support, housing assistance, 
                        transportation, linguistic, and other services 
                        that impact the health care status of the 
                        impacted population;
                    ``(D) provides a statement outlining the 
                overarching gap in local community or regional 
                services;
                    ``(E) provides a statement that identifies the 
                highest priority services that have the potential to 
                improve overall health and wellness of the local 
                region; and
                    ``(F) establishes a hospital transformation plan 
                that contains--
                            ``(i) a process for consulting with 
                        representatives of the community's interests 
                        and input;
                            ``(ii) a list of community input sources 
                        representing the broad interests of the 
                        community, that is representative of 
                        individuals who are medically underserved, low-
                        income, or from minority populations and that 
                        may include representatives of local hospitals, 
                        physicians, allied health professionals, 
                        private and public payers, patients and 
                        consumers, Tribal representatives, and other 
                        relevant stakeholders, including local or 
                        regional social service organizations; and
                            ``(iii) an outline of goals and action 
                        steps for improving or maintaining access to 
                        care, strengthening quality of care, better 
                        coordinating care across the local or regional 
                        health care delivery system, and addressing 
                        other community needs or gaps identified in the 
                        needs assessment;
            ``(2) a preliminary construction project plan that--
                    ``(A) outlines a project budget with costs of--
                            ``(i) administrative and legal expenses;
                            ``(ii) land, structure, rights-of-way 
                        appraisals;
                            ``(iii) relocation expenses;
                            ``(iv) architectural and engineering fees;
                            ``(v) inspection fees;
                            ``(vi) site work (such as helipad equipment 
                        and telecommunication and data network 
                        upgrades);
                            ``(vii) demolition and removal;
                            ``(viii) equipment (such as medical 
                        equipment and technology systems, furniture, 
                        kitchen and bathroom appliances, and signage); 
                        and
                            ``(ix) any other costs the Secretary 
                        determines appropriate; and
                    ``(B) outlines the planned spaces with descriptions 
                (including square footage and purpose), as the 
                Secretary determines appropriate, which shall include--
                            ``(i) care units or wards and the number of 
                        expected beds in such areas;
                            ``(ii) diagnostic and treatment areas, 
                        including imaging areas, emergency departments, 
                        laboratories, and pharmacies;
                            ``(iii) administrative areas, including 
                        lobbies, office space, education areas; and
                            ``(iv) other types of spaces the Secretary 
                        determines appropriate;
            ``(3) an energy plan for how the project accounts for 
        energy resilience and efficiency; and
            ``(4) a report on the economic impact of the award on the 
        area or region served, including an analysis of local labor 
        market effects such as how the hospital may help improve wages, 
        household incomes, employment and unemployment rates, and meet 
        labor demands and how the hospital may help improve wages in 
        the area.
    ``(d) Safe Structure Waiver.--The Secretary may grant a waiver to 
eligible hospitals with respect to the timing of submissions of 
information required under paragraph (1), (3), or (4) of subsection 
(c), if the Secretary determines that the project to be carried out by 
the eligible hospital receiving such waiver should be expedited to 
ensure the safety of patients or workers.
    ``(e) Grant and Loan Amounts.--
            ``(1) In general.--An award to an eligible hospital under 
        this section shall be in an amount determined by the Secretary, 
        based on the information submitted by the eligible hospital 
        under subsection (c)(2). The total amount of such an award 
        shall not exceed $40,000,000, of which not more than 30 percent 
        may be awarded as a grant, and any remaining amount may be 
        awarded as a low interest loan.
            ``(2) No effect on eligibility for other funding.--Amounts 
        received by an eligible hospital under this section shall have 
        no effect on the hospital's eligibility for funding made 
        available through other Federal programs, including any such 
        funding available with respect to the project supported by the 
        award under this section.
    ``(f) Reporting.--Each recipient of an award under this section 
shall submit an annual report to the Secretary on the use of such award 
funds in the previous fiscal year, including the use of such funds to 
address issues raised in the community health needs assessment, the 
energy plan, and economic impact report submitted with the recipient's 
application under subsection (c). Such recipient shall post each such 
report on the website of the recipient.
    ``(g) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        $17,000,000,000 for fiscal year 2022 to carry out this section. 
        Amounts appropriated under this subsection shall remain 
        available through fiscal year 2025.
            ``(2) Management and oversight.--The Secretary may allocate 
        up to 0.1 percent of the funds appropriated under this 
        subsection for the management and oversight of programs under 
        this section.''.
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