Financial Services

FHA/HUD Healthcare Facilities (LEAN)

CSG can finance the purchase, refinance, new construction, or substantial rehabilitation of a healthcare project (or some combination thereof) through HUD’s LEAN healthcare program.  HUD developed its LEAN process in 2008 for Section 232 applications.  LEAN represents a methodology based on the Toyota model to increase efficiency by reducing waste.  Underwriting, processing, and closing methods are continuously studied so that ongoing revisions are made to the process for efficiency and effectiveness.

All of CSG’s underwriters are fully approved to process LEAN loans.  Their combined experience has led to closing over 43 healthcare loans, providing over $320 million in financing to healthcare projects.  Of the healthcare loans closed, 12 loans totaling over $115 million, were under the FHA/HUD LEAN program.  Please contact one of our Production Officers to learn more about the LEAN program.

FHA/HUD Section 232 Program – Section 232 is an FHA loan product that provide mortgage insurance for eligible health care properties including.  Nursing Homes, Assisted Living Facilities, Skilled Nursing Homes, Intermediate Care, and Board and Care. Up to 25% of the beds/units can be unlicensed Independent Living.

FHA/HUD Section 232 Program Highlights

  • Construction Advance Financing: A 232 closes and interest rate locks at construction closing, requiring interest only payments until the project stabilizes, and then converts to standard principal and interest amortization.
  • Non-Recourse Financing: The 232 program is non-recourse to the borrower from construction through operations, except for standard bad-boy carve-outs.  For more information on FHA’s non-recourse program please click here.
  • Low Interest Rates: Because an FHA232 loan is insured by the government and securitized through Ginnie Mae, we are able to offer some of the best rates in the business.  For a rate quote please contact one of our Production Officers.
  • Fully Amortizing 40-Year Term: The 232 program offers 40-year term / 40-year amortization, starting at permission to occupy.  Act now to take advantage of historically low interest rates to lock in a 40-year term and never worry about refinance risk.

For additional information on any of the FHA/HUD programs please contact one of our Production Officers or click on one of the links below for detailed product information.


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