Our highly experienced team delivers creative capital solutions across the full continuum of seniors housing and care— navigating every facet of the sector—from premier skilled nursing and Class A full-continuum seniors housing communities to Class B Medicaid waiver seniors housing, skilled and seniors campus models, standalone independent living, vibrant active adult properties, and specialized freestanding memory care.
With over $5 billion* in combined closed transactions, our team specializes in HUD, Fannie Mae, Freddie Mac, bank and credit union loans, debt funds, SBA debt, USDA debt, mezzanine financing, preferred equity**, RIDEA structures, and joint venture equity.
Our teams experience, deep industry knowledge, and strategic capital relationships make us a trusted advisor for developers, operators, and investors navigating the seniors housing and skilled nursing market.
*Represents transactions completed by Team Clare since 2013, at Greystone and other lenders.
How Greystone Increased HUD Loan Proceeds by 20% for a Texas Skilled Nursing Facility
17M
Total Closed
104
Beds
THE SITUATION
A modern Texas SNF had strong operations but was leaving significant HUD loan proceeds on the table until Greystone stepped in with both a financing solution and active policy advocacy.
This 104-bed skilled nursing facility in Texas built in 2019 and operated by Creative Solutions in Healthcare needed acquisition financing. The asset was modern, purpose-built, and performing well: occupancy was improving, expenses were stable, and revenue was supported in part by Texas' Quality Incentive Payment Program (QIPP).
The challenge: traditional HUD underwriting wasn't fully capturing the facility's QIPP income, which compressed proceeds and limited what the acquisition financing could achieve. The sponsor needed a lender who could deliver near-term execution certainty while positioning the asset for optimal long-term financing.
THE SOLUTION
Greystone originated a $17,000,000 bridge loan to finance the acquisition, structured specifically to facilitate a seamless transition to HUD-insured permanent financing under HUD 232.
Beyond the capital, Greystone engaged directly with HUD to advocate for updated QIPP underwriting treatment pushing for a methodology that more accurately reflects the revenue's consistency and quality-driven nature.
This bridge-to-HUD approach is central to Greystone's integrated lending platform: borrowers get near-term execution certainty and a clear, coordinated path to permanent financing without switching lenders mid-process.
THE RESULTS
OUTCOME
DETAILS
Acquisition Financing Closed
$17.0M bridge loan
HUD Proceeds Increase
20% higher than prior underwriting
Driver
Updated QIPP income recognition
The updated QIPP underwriting is expected to increase HUD loan proceeds by approximately 20% unlocking meaningful additional capital for reinvestment in staff, operations, and continued quality of care.
For the operator, the outcome is a stronger capital stack, improved long-term financing terms, and a clear path to maximize the asset's value in a growing Texas market.
We saw a disconnect between how these assets were being underwritten and the real performance driven by QIPP. Our role was to advocate for a more accurate approach, one that reflects the stability and impact of these programs today. By working collaboratively with operators and HUD, we were able to help drive changes that increase proceeds and better align financing with the realities of the market. This is exactly the kind of strategic partnership we aim to bring to every client relationship.”
