Health Care Facilities
New Construction / Substantial Rehabilitation
FHA Section 232

Purpose:

New Construction / Substantial Rehabilitation financing for:

Assisted Living / Board & Care Homes

Skilled Nursing / Intermediate Care Facilities

Eligible Borrowers:

Single asset borrower may be comprised of:

For-Profit Sponsor

Nonprofit Sponsor

Public Entity Sponsor (Nursing homes only)

Qualifications:

New Construction of:

Proposed nursing home or intermediate care facility, which consists of at least 20 beds, and:

- Is licensed or regulated by the State, municipality or other political subdivision in which the facility is located,

- Corresponds to the Department of Health and Human Services “Skilled Nursing Facility” (SNF) or ”Intermediate Care Facility (ICF), and

- Has obtained a Certificate of Need from the State agency with jurisdiction, or is supported by a State commissioned independent study of market need and feasibility.

Proposed board and care home or assisted living facility, which consists of at least 5 beds, and:

- Is licensed or regulated by the State, municipality or other political subdivision in which the facility is located,

- Which offers three meals per day to each resident, and

- Provides room, board, and continuous protective oversight.

Substantial Rehabilitation - must meet one of the following criteria:

Cost of repairs, replacements, improvements (including major movable equipment) and additions exceeds 15% of the project’s value after completion of all repairs, replacements, improvements and additions, or

Two or more major building components are being substantially replaced.

Commercial Space:

Commercial space is permitted, limited to:

10% of gross floor area of the project (commercial space that exclusively serves the residents of the facility is not counted), and

15% of gross income of the project.

Maximum Loan:

New Construction – the lesser of:

90% (95% for nonprofits) of value including major movable equipment, and

Loan supportable by 90% (95% for nonprofits) of net earnings attributable to realty and equipment (excluding proprietary earnings).

Substantial Rehabilitation – the lesser of:

Loan amount determined by above criteria for new construction, and

If property is owned:

- 100% of cost of rehabilitation, plus

- the lesser of existing secured indebtedness or 90% (95% for nonprofits) of existing value before rehabilitation, or

If property is to be acquired:

- 90% (95% for nonprofits) of cost of rehabilitation, plus

- 90% (95% for nonprofits) of the lesser of purchase price or existing value before rehabilitation.

Loan Features:

Loan Term – construction period plus up to 40 years.

Fully amortizing loan, no balloon payment.

Non-recourse during both construction and permanent loan phases.

Loan is fully assumable by new owner.

Rate is fixed for entire loan term prior to initial loan closing.

No lease-up hurdle is required for conversion to permanent loan.

Program may be used to credit enhance tax exempt bonds.

Secondary financing, including grants and tax credits, is permitted in conjunction with the FHA-insured loan to cover certified project costs in excess of 100% of value or replacement cost if provided by a Federal, State or local governmental authority or instrumentality.

Davis-Bacon prevailing wage requirements apply to costs of new construction or rehabilitation.

Leased facilities (operating lease) to qualified operators are permitted.

Medicaid rates will be used in underwriting the income estimate for 67% of the nursing home/intermediate care beds and Medicare rates will be used for 3% of the beds (not applicable to board and care or assisted living).

In underwriting net earnings, management fees are excluded from expenses; however, a proprietary income amount (varying by level of care) is deducted.

Information Request:

Please provide the following information for a preliminary loan quote:

Brief description of proposed improvements including number of units/beds with breakdown of rents by unit/bed type.

Development or rehabilitation budget, including equipment to be financed.

Pro forma income and expenses for completed project, including identification of payor sources and their corresponding reimbursement rates.

Copy of most recent mortgage statement, with escrow balances, for property owned, or copy of purchase contract for property to be acquired.

Any available market studies, appraisals or environmental reports.

Names of sponsor, developer, management agent, operator, general contractor, architect, etc.; resumes if available.

Site plan, unit floor plans, elevations, survey, architectural drawings, etc. to the extent available.