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H H S Department of Health and Human Services
Health Resources and Services Administration
Rural Health

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Access to Capital

A critical access hospital image.Finding funding for capital projects is a major concern for many rural healthcare facilities, especially Critical Access Hospitals (CAHs). Capital funding is defined as funding used to expand or renovate a building, purchase major equipment or construct a new facility for a rural health provider. In searching for funding for capital projects, facilities should consider and use a variety of potential sources, including public grants and loan programs, as well as private sources, such as foundations and donations from local residents.

Public Sector Funding Sources

USDA Community Facilities Direct and Guaranteed Loan Program

HUD 242 - FHA Hospital Mortgage Insurance Program

Business and Industry Guaranteed Loans

Distance Learning and Telemedicine Grant and Loan Program

SBA Certified Development Company (504) Loan Program

National Association of Health and Educational Facilities Finance Authorities (NAHEFFA) Go to exit disclaimer.

CAH Replacement Information

Critical Access Hospital (CAH) Architectural Prototype (PDF 23.85 MB), funded by ORHP .

Critical Access Hospital Replacement Process Roadmap (Word - 554 KB)

Critical Access Hospital Replacement Process Manual (PDF - 956 KB)

2008 Rural Hospital Replacement Facility Study (PDF 2.04 MB), analyzes both quantitative data and qualitative input of 45 CAHs that replaced clinical areas between January 1, 1998 and January 1, 2008.

Video of a small community that replaced their CAH Go to exit disclaimer. with a new facility, the Rooks County Health Center in Plainville, KS.

Transforming Hospitals: "Designing for Safety and Quality," a DVD from the Agency for Healthcare Research and Quality (AHRQ), reviews the case for evidence-based hospital design and how it increases patient and staff satisfaction and safety, quality of care, and employee retention, and results in a positive return on investment. Order DVD Go to exit disclaimer. or Download print version (PDF 419 KB) Go to exit disclaimer.

Rural Assistance Center Go to exit disclaimer. provides information on CAHs.

Rural Health Research Gateway Go to exit disclaimer. provides research on access to capital funding.

National Organizations

National Organization of State Office of Rural Health Go exit disclaimer.

Rural Assistance Center exit disclaimer

National Rural Health Association exit disclaimer

National Rural Health Association Government Affairs Office exit disclaimer

National Rural Health Resource Center exit disclaimer

National Rural Recruitment and Retention Network exit disclaimer

Rural Health Research Gateway

Rural Health Research Gateway logo.

The Rural Health Research Gateway Go to exit disclaimer. is a “one stop shop” for research findings from all the Rural Health Research Centers.

Subscribe to Research Gateway email updates Go to exit disclaimer. to receive periodic notices of new publications.