HUD programs

HUD 232/223(a)(7) Healthcare streamlined refinance

Refinance an existing HUD-insured healthcare loan to improve its long-term financing structure.

Program at a glance

Term
At least 10 years; potential extension of up to 12 years, subject to original-loan limits.
Interest
Fixed for the loan term.
Loan limits
Original mortgage amount, eligible refinance costs and debt-service limits each apply.
Debt coverage (DSCR)
At least 1.11×, including mortgage insurance.
Cash-out
Not available.
Recourse
Nonrecourse, with standard carve-outs.

The lowest applicable sizing result sets the loan amount. Debt coverage compares underwritten income with loan payments, including mortgage insurance.

Documents & videos

Program details & considerations

HUD 232/223(a)(7) offers a streamlined refinance for eligible healthcare properties with an existing HUD-insured mortgage. We'll review the current loan and proposed terms to see whether the savings justify the transaction costs.

Send us the mortgage balance, note rate, remaining amortization, prepayment schedule and original HUD loan documents. Recent operating statements and reserve balances help us evaluate eligible costs and any proposed term extension. An extension remains subject to HUD approval and the original loan's applicable limits.

Cash-out is not available. An acquisition, conventional-loan refinance or major construction project needs to be reviewed under a different program.

HUD may approve a term up to the remaining term plus 12 years, but no longer than either the original ORCF program’s statutory maximum or the term when the original loan was first insured. The minimum term is 10 years. A term extension requires a capital needs assessment and review of reserves, remaining life and operating performance. Healthcare extension rules are separate from the multifamily cumulative-extension rule.

Eligible uses & property features

  • Existing HUD-insured healthcare loans
  • Streamlined refinance evaluation
  • Eligible transaction costs
  • Healthcare lending experience

What to consider

Cash-out is not available through the streamlined program. A lower rate alone does not establish a benefit; transaction costs and prepayment provisions also matter.

Eligibility, proceeds, terms and timing depend on the property, underwriting and current HUD requirements. This overview is not a loan commitment.

Loan processing timeline

  1. Pre-qualification & engagement

    Review the existing FHA-insured healthcare loan, payoff terms and expected refinance benefit.

  2. Refinance application preparation

    Gather loan, facility and operator information for the streamlined refinance review.

  3. Application submission & HUD review

    Submit the refinance application and respond to HUD’s questions.

  4. Firm commitment

    If approved, review the new loan terms and conditions to satisfy before closing.

  5. Rate lock & closing preparation

    Coordinate the rate lock, payoff, legal documents and remaining closing requirements.

  6. Close the refinance

    Replace the existing FHA-insured healthcare mortgage with the new loan.

The schedule depends on the project and required reviews.

Have a project in mind?

Contact us