HUD 232 Healthcare construction & substantial rehab

HUD 232 finances eligible healthcare new construction and substantial rehabilitation, including assisted living, skilled nursing, memory care and board-and-care facilities. We review the real estate, facility operations, licensing and development plan together.

For an initial review, send us the proposed beds or units, care types, licensing information, construction scope and operating budget. The operator's experience and the local market are key parts of the review.

We'll also need the development team's relevant facility experience, including locations, care types, beds or units, dates and each principal's role. Include the borrower, operator and management agent so we can review the full team.

In addition to equity, the budget needs to account for working capital, lease-up support, completion assurance and reserves. During construction, the process includes inspections and draw administration, followed by cost certification and final endorsement.

Eligible uses & property features

• Eligible licensed healthcare facilities
• New construction and substantial rehabilitation
• Construction-to-permanent execution
• Healthcare-focused underwriting

What to consider

Facility type, licensing, operator experience and resident services are central to eligibility. Independent living components and ancillary uses require specific review; standalone medical offices are not the focus of this program.