FHA® 232/223(a)(7) Refinance Loans

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At Capital Investors Direct, we understand the unique financial challenges faced by healthcare providers. The refinancing solutions are crafted to empower healthcare facilities, supporting their commitment to excellence in patient care and financial stability.
Competitive Rates

FHA 232/223(a)(7) Loan Terms and Requirements

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Loan Term & Amortization

Extend the remaining term of the current loan by up to 12 years (subject to HUD approval), with the condition that it does not surpass the original term of the existing loan. The loan is fully amortizing throughout the entire term.

Loan amount

No Cash-Out Provision:
The FHA® 232/223(a)(7) refinancing option does not include a cash-out provision.

Determining New Loan Amount:
The new loan amount is established based on the lowest of the following:

1. Original principal balance of the existing loan.
2. 100% of the costs associated with refinancing, including the current principal balance, transaction costs, repairs, and deposits to replacement reserves.
3. Ensuring a minimum debt service coverage of 1.11.

Rate Structure

Fixed interest rate

Eligible Properties

The loan is typically applicable to various types of healthcare properties, including:

1. Skilled Nursing Facilities
2. Long-Term Acute Care (LTAC) Facilities
3. Intermediate Care Facilities (ICFs)

Eligible Borrower

A singular asset entity, whether for-profit, nonprofit or public borrowers.

Cash Out

Cash-out in not allowed

Tax & Insurance Escrows

Mandatory escrows cover taxes, mortgage insurance premiums, property insurance, and reserves for depreciable item replacements.


Nonrecourse financing as per HUD Regulatory Agreement.

Required Reports

Under specific circumstances, Project Capital Needs Assessment (PCNA), Phase I Environmental Site Assessment (Phase I ESA), and radon testing might be necessary.


A frequently used prepayment penalty format is the "10-9-8-7-6-5-4-3-2-1-0" structure. This entails a 10% prepayment penalty in the first year, with a subsequent 1% reduction on each 1-year anniversary, ultimately reaching a 0% prepayment penalty by the 10-year anniversary.


The loan is fully assumable upon approval from both HUD & CID, along with the payment of an assumption fee.

Good Faith Deposit

It is based on type of property and loan size

Expense Escrow

Yes. Enough to encompass CID's costs and expenses, as well as third-party report expenditures.

Origination Fee

It is negotiable

HUD Application Fee

HUD requires an application fee of 0.15% of the loan amount for reviewing the application to assess the eligibility of the proposed loan for HUD mortgage insurance.

HUD Inspection Fee

HUD doesn't impose inspection fee under this loan program.

Davis–Bacon Act

Not Applicable to this loan program

HUD mortgage insurance premium (MIP)

In the initial year, an upfront fee of 0.50% is due at closing. Subsequently, healthcare facilities with LIHTC incur an annual fee of 0.45%, while those without LIHTC face an annual fee of 0.55%.

FHA 232/223(a)(7) Loans & Its Benefits

What is FHA 232/223(a)(7) Loan?

The FHA 232/223(a)(7) loan program is a financing option offered by the Federal Housing Administration (FHA) specifically designed for the healthcare industry.

Unlocking Opportunities with FHA® 232/223(a)(7) Financing

Commitment to Healthcare Excellence

Capital Investors Direct understands the critical role healthcare facilities play in our communities. Our refinancing solutions are designed to support your commitment to delivering exceptional patient care and maintaining high operational standards.

Debt Restructuring & Lower Interest Rates

This refinancing enables you to restructure existing healthcare loans, potentially securing lower interest rates and reducing overall debt burden.

Compliance with HUD Guidelines

The refinancing solutions adhere to HUD guidelines, ensuring that your healthcare facility remains in compliance with regulatory requirements.

Key Feature of FHA 232/223(a)(7) Loans

When these two sections are combined in the 232/223(a)(7) program, it enables healthcare facility owners to refinance their existing FHA-insured loans, promoting financial flexibility, and potentially improving the terms of their financing.

Refinancing Existing Loans

Allows healthcare facility owners to refinance their existing FHA-insured loans, providing an opportunity to improve loan terms and potentially reduce interest rates.

HUD Mortgage Insurance

Benefits from FHA mortgage insurance, providing lenders with added security and borrowers with favorable loan terms.

HUD Approval

Requires approval from the U.S. Department of Housing and Urban Development (HUD), ensuring compliance with program guidelines.

Flexible Loan Terms

Offers flexibility in loan terms, providing borrowers with options that align with their financial goals and operational needs.

Financial Flexibility

Enhances financial flexibility for healthcare providers by optimizing existing debt structures, potentially leading to increased cash flow and improved financial stability.

Lower Interest Rates

Offers the potential for lower interest rates compared to existing loans, contributing to reduced debt service and overall cost savings.

We Cover


States & US Territories

Capital Investors Direct provides commercial hard money loan financing options in the following geographic locations of the United States:


200 MSA Tier I & Tier II Cities

Maryland, Texas, Florida, Utah, Colorado etc. We offer CRE Bridge Loan in top cities like Denver, Chicago, Colorado, San Diego etc.

How it Works?

Capital Investors Direct funds different commercial properties across the country. Below are few commercial properties we lend hard money for –
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Fill Out the Form

Apply for a commercial property loan in
5 minutes by filling out the form


Get Approval

We will get back to you within 24 hours
with a written disclosure of all loan terms


Loan Funded

Within days, the money will be credited
to your account.

Why Choose Us?

We go above and beyond to add to our list of satisfied customers and ongoing clientele We go above and beyond to add to our list of satisfied customers and
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Efficient Refinancing Process

Our experience with FHA loans allows for an efficient refinancing process, minimizing disruptions for healthcare providers and ensuring a smooth transition.


Tailored Financial Solutions

We understands the unique financial needs of healthcare facilities. They can provide tailored solutions that align with the specific requirements and goals of the healthcare industry.


Streamlined Application Process

With experience in FHA loan programs, we facilitate a streamlined application and approval process for FHA loans, making it more accessible for healthcare facility owners.


Transparent Communication

Transparent and open communication is a hallmark of Capital Investors Direct. Borrowers can expect clear and comprehensive information about loan terms, conditions, and the refinancing process.

Blogs & 

Capital Investors Direct funds different commercial properties across the country. Below are few commercial properties we lend hard money for –

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