Acquisition and Refinance of Healthcare Properties

Our HUD FHA SECTION 232/223(F) platform offers 35-year, non-recourse loans that are designed to allow for lower equity requirements and a flexible lending program. 

Section 232 insures mortgage loans to facilitate the construction and substantial rehabilitation of nursing homes, intermediate care facilities, board and care homes, and assisted-living facilities. Section 232/223(f) allows for the purchase or refinancing with or without repairs of existing projects not requiring substantial rehabilitation.

The program allows for long-term, fixed rate financing (up to 40 years) for new and rehabilitated properties and (up to 35 years) for existing properties without rehabilitation.

Program Benefits

Long Term, Fixed-Rate & Non-Recourse
With loan terms up to 35 years, INSIGNIA offers an attractive permanent solution for your refinancing and acquisition needs on a nationwide basis. A fixed rate means you can take advantage of today’s historically low rates for years to come. Non-recourse means no personal guarantees*.

Lower Equity Requirements
Equity requirements for purchases typically start at 20% for market-rate properties and decrease to 15% for non-profits.

Assumable Loan
This is a fully assumable loan, subject to approval from HUD. Future buyers will benefit from your foresight for taking advantage of today’s interest rates.

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Healthcare Real Estate Lending

Our healthcare lending professionals have extensive experience structuring, approving, processing and closing loans, and understands the process from start to finish.

Eligible Projects

  • Maximum Loan Amount: None
  • Existing healthcare facilities at least three years old
  • Independent living units may be no greater than 25% of total
  • Need to rehab? Repairs are allowed up to 15% of the appraised value

Information Needed for Evaluation

  • Current rent roll with both In-Place Rents and Market Rents, ideally supported with rent comp data
  • Estimate of Stabilized NOI
  • Estimate of Stabilized Value, ideally with support for exit cap rate, value / unit and value / sf
  • Detailed renovation budget
  • Sponsor information, ideally PFS, SREO and bio describing re-position experience

Eligible Properties

  • Licensed Nursing Homes, Assisted Living, Intermediate Care, and Board and Care
  • Must provide continuous protective oversight
  • Must offer three meals per day
  • Facility must be licensed by state
  • Non-resident day care not to exceed 20% of gross area and 20% of gross income
  • May include up to 25% non-licensed independent living units
  • Three years must have passed since last certificate of occupancy was issued

Additional HUD FHA SECTION 232/223(F) program details

Eligible Borrowers:
Eligible mortgagors include investors, builders, developers, public entities (nursing homes) and private nonprofit corporation and associations.

For nursing homes only, applicants may be public agencies that are licensed or regulated by a State to care for convalescents and people who need nursing or intermediate care. A potential applicant must submit a Certificate of Need from the State agency designated by the Public Health Service Act. (If no State agency exists, an alternative study is required.)

No Certificate of Need is required for board and care homes or assisted living facilities; instead, the applicant needs a statement from the appropriate State agency. 

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