When an existing HUD 232 loan is worth a 223(a)(7) refinance
How the 223(a)(7) streamlined refinance works for nursing homes, what it can and cannot do, and how many active HUD 232 loans carry rates of 5% or more.
CMS and HUD data in one record
Every nursing home, who owns it, and its HUD loan
One record per Medicare and Medicaid certified facility, joining CMS ratings, staffing and ownership filings to HUD's FHA-insured loan files.
Or browse all 14,690 by state.
- Certified nursing homes
- 14,690
- Certified beds
- 1,567,452
- With an active FHA loan matched
- 2,060
- Balance on those loans
- $25.2 billion
- Median note rate
- 3.72%
CMS data as of September 2026; HUD active loans as of September 30, 2026. 741 of the matched active loans carry a note rate of 5% or more.
What a facility record holds
Care Compare is built for families choosing a nursing home. Who sits behind the license, when the building last changed hands and what HUD debt is on it are public too, spread across five CMS files and three HUD files that use different names for the same building.
SNF Register puts them on one page per facility: beds and occupancy, the four CMS star ratings, staffing against the state median, every owner and operator CMS lists, private equity and REIT flags from Medicare enrollment, changes of ownership since 2016, and each FHA-insured Section 232 loan with rate, balance and maturity for loans still active.
Forest Manor Health and Rehab
Northport, AL. 182 beds, 3 stars. Active FHA loan.
Sierra View Care Center
Baldwin Park, CA. 98 beds, 4 stars. Past FHA loans. REIT owner reported.
Mission Carmichael Healthcare Center
Carmichael, CA. 135 beds, 3 stars. Past FHA loans. Private equity owner reported.
HUD 232 nursing home endorsements by fiscal year
Initial endorsements of FHA-insured loans on nursing homes and intermediate care facilities, from HUD's healthcare database (data run July 8, 2026). Fiscal 2026 runs through June.
For owners and operators
Run a 223(f) or 223(a)(7) refinance through HUD's loan tests with your own NOI, value and rate, and see which test sets the loan.
Open the 232 sizerGuides
HUD 223(f) Express Lane criteria for nursing homes, 2026
The criteria HUD set on March 31, 2026 for 223(f) Express Lane priority, and how many of the 14,690 certified nursing homes clear the CMS star-rating part.
HUD 232/223(f) refinance sizing, worked through
How HUD sizes a 223(f) nursing home refinance, test by test, with the arithmetic shown for a 120-bed facility and the reasons each test binds.
Who owns a nursing home? Reading CMS ownership data
How to find a nursing home's owners, operator, chain, private equity and REIT ties in CMS data, what each file shows, and where the public record runs out.
Questions people ask
Where does the data come from?
CMS publishes the facility, rating, staffing and ownership files every month on data.cms.gov. HUD publishes its active and terminated FHA-insured mortgages monthly and its healthcare endorsement database quarterly. SNF Register downloads all of them, joins them by facility and shows the date of each file on every page.
How do you know which HUD loan belongs to which facility?
HUD's files do not carry the CMS certification number, so loans are matched by name, city, state and bed count, and each match shows the HUD project name next to the CMS name so you can judge it. The methodology page explains the rules and what they miss.
Is SNF Register part of CMS or HUD?
No. It is an independent site operated by Janover Capital LLC, a commercial mortgage firm, and is not affiliated with or endorsed by CMS, HUD or FHA.
Can I see what my facility could borrow?
Yes. The 232 refinance sizer runs the loan tests in HUD Handbook 4232.1 on your own NOI, value, rate and payoff. Open it from any facility page and it fills in the beds and, where there is one, the existing FHA loan.