USDA Rural Development currently lists Rural Energy for America Program (REAP) guaranteed loans as open. The Agency states that REAP grant applications are not being accepted at this time, but guaranteed loan applications may be submitted. Applications for guaranteed loans are accepted year-round through participating lenders and USDA Rural Development.
Rural healthcare relevance
REAP guaranteed loans can support qualifying rural small businesses with renewable energy systems and energy efficiency improvements. A for-profit rural clinic, dental practice, pharmacy, therapy practice, healthcare service company, or other healthcare business may potentially qualify when it meets SBA small-business size standards, is located in an eligible rural area, and the proposed project independently satisfies REAP requirements. Public agencies and ordinary nonprofit healthcare organizations are not automatically eligible merely because they provide healthcare.
Eligible project uses
Eligible uses include renewable energy systems and energy efficiency improvements such as high-efficiency HVAC, insulation, lighting, cooling or refrigeration, doors and windows, and replacement of energy-inefficient equipment. Energy efficiency projects require a compliant energy audit or energy assessment. All projects must have technical merit, use commercially available technology, and complete environmental review before award or construction.
FY2026 financing structure
USDA’s current OneRD FY2026 dashboard shows $119,189,272 in Rural Energy for America Guaranteed Loan Program authority, with $11,500,000 obligated, $107,689,272 remaining, and $21,000,000 pending at the latest posted update. USDA’s FY2026 OneRD terms provide an 80 percent loan guarantee, a 1 percent guarantee fee, a 0.25 percent periodic retention fee, and a 0.50 percent fee when a loan note guarantee is issued before construction completion. REAP guaranteed loan financing may cover up to 75 percent of total eligible project costs, so at least 25 percent of project cost must come from other funds. Loan terms may not exceed 40 years, and interest rates are negotiated between lender and borrower.
Eligibility and application controls
Eligible borrowers are agricultural producers and rural small businesses. Rural small-business projects generally must be located in rural areas with populations of 50,000 or fewer. The lender submits the guaranteed-loan application through the OneRD Guarantee process. Before advancing any healthcare project, verify rural eligibility, SBA size status, borrower legal eligibility, lender eligibility, energy-audit or assessment requirements, environmental review, technical merit, financing sources, and current USDA restrictions affecting the proposed technology.
Atlas assessment
Atlas Opportunity Score: 78/100. REAP is a useful capital pathway for qualifying for-profit rural healthcare businesses that need building-energy improvements or renewable energy systems and can support debt financing. It is not a general healthcare equipment program and should not be represented as one.
N9+ Fit Score: 0/100. The program is limited to qualifying renewable-energy and energy-efficiency purposes. No basis was identified to treat the N9+ remote examination platform itself as an eligible REAP project cost.
Dr. Miltie direct-applicant/vendor fit: 0/100 pending independently verified borrower eligibility. A direct Dr. Miltie application would require verified rural small-business eligibility and a qualifying energy project. No such facts have been established. No direct vendor path is established because REAP finances energy projects rather than medical-device procurement.
Assistance Listing: 10.868, Rural Energy for America Program.
Official sources: USDA Rural Development — REAP Renewable Energy Systems & Energy Efficiency Improvement Guaranteed Loans; USDA Rural Development — OneRD Guarantee FY2026 funding availability and fee terms; Grants.gov / Simpler Grants — REAP opportunity record.