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Medical Treatment in Hill-Burton Funded Healthcare Facilities

This is a description of the services Hill-Burton funded health care facilities are required to provide. This information is for individuals and adovcates.


Issued by: Office for Civil Rights (OCR)

Issue Date: November 27, 2015

Medical Treatment in Hill-Burton Funded Healthcare Facilities

Woman standing at clinic reception desk

Public and nonprofit facilities received financial assistance under Titles VI and XVI of the Public Health Service Act, commonly known as the Hill-Burton Act. Recipient facilities include:         

  • Acute care general hospitals
  • Special hospitals
  • Nursing homes
  • Public health centers
  • Rehabilitation facilities

Every hospital or other facility that ever gave a Community Service Assurance in exchange for Hill-Burton funds under Title VI of the Public Health Service Act must:

  • Provide emergency services to any person living in its service area who cannot afford those services
  • Give each person living in its service area non-emergency medical treatment at the facility no matter their race, color, national origin, creed, or any other factor unrelated to a person’s ability to pay for a needed service and the facility’s ability to provide the needed service
  • Participate in the Medicare and Medicaid programs unless they are ineligible
  • Make arrangements for reimbursement for services with principal state and local third-party payers that provide reimbursement that is not less than the actual cost of the services
  • Post its community service obligations in English and Spanish, and any other language spoken by 10 percent or more of the households in the service area
  • The Hill-Burton Act also applies to people working in the service area of the facility if it was funded under Title XVI of the Public Health Service Act.
  • The community service obligation does not require the facility to make non-emergency services available to persons unable to pay for them

A facility’s Community Service Assurance obligations also extend  to people working in its service area if the facility received funds under Title XVI of the Public Health Service Act.

Find a Hill-Burton Facility that provides free or reduced-cost health care.


42 CFR Part 12, Subpart G (Community Service obligations of Hill-Burton facilities).

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.