Assisted Living Loan Checklist

1. Entity & legal documents

If real estate and operations are split, include the PropCo/OpCo master lease and rent coverage.

• Formation documents for the borrowing/operating entity (Articles of Organization/Incorporation, Operating Agreement or Bylaws)
• If real estate and operations are held in separate entities (PropCo/OpCo), the master lease or operating agreement between them
• Certificate of Good Standing for each entity involved
• EIN confirmation letter(s)
• Organizational chart / ownership breakdown showing all members with 20%+ ownership
• Resolution authorizing the loan and identifying the signer(s)

2. Licensing & regulatory status

• Current state assisted living / residential care license
• Certificate of Need (CON), if required by the state
• Medicaid and/or Medicare certification status and provider agreement, if applicable
• Copies of the last 2–3 state licensing survey/inspection reports, including any deficiencies and plans of correction
• Any pending or historical complaints, sanctions, or litigation with the licensing authority
• Administrator’s license/certification and staff credentialing summary

3. Property & physical plant

• Total unit/bed count by care level (independent living, assisted living, memory care)
• Floor plans and unit mix
• Fire/life safety compliance — sprinkler system status, fire marshal inspection history, and any citations
• Elevator inspection certificates, if applicable
• Commercial kitchen/dietary licensing and health department inspection history
• ADA compliance status and any identified deficiencies
• Recent property condition assessment (PCA) or capital needs assessment

4. Financial performance

• Trailing 3 years of financial statements (P&L / income statement) plus current year-to-date
• Tax returns for the operating entity, last 3 years
• Monthly census/occupancy history for the trailing 2–3 years, by care level
• Payor mix breakdown — private pay vs. Medicaid, Medicare, or insurance
• Average daily/monthly rate by care level and any recent or planned rate increases
• Accounts receivable aging, particularly for Medicaid/Medicare reimbursement
• Bank statements, most recent 3–6 months, for the operating account

5. Staffing & operations

• Current staffing schedule and staff-to-resident ratios by shift
• Employee background check / screening compliance documentation
• Resident agreement / admission contract template
• Current resident roster with level of care and length of stay
• Summary of any incident reports, elopements, or reportable events in the last 2–3 years

6. Environmental & flood

• Phase I Environmental Site Assessment (if one exists, or note if one will need to be ordered)
• FEMA flood zone determination for the property
• Flood insurance policy, if the property is in a flood zone

7. Sponsor / guarantor & operator financials

Operator experience is one of the most heavily weighted factors in ALF underwriting.

• Personal Financial Statement (PFS) for each guarantor (20%+ owners)
• Schedule of Real Estate Owned (SREO) for each guarantor
• Personal tax returns, last 2–3 years, for each guarantor
• Credit authorization / consent to pull credit for each guarantor
• Detailed healthcare/senior living operating experience for the sponsor or third-party management company
• Management company agreement and management company’s own financial statements, if third-party operated
• Verification of post-closing liquidity (bank/brokerage statements)

8. Insurance & risk

• Current general liability and professional/malpractice liability insurance declarations
• Insurance loss run history (prior 3–5 years)
• Summary of any current or historical litigation involving the facility

9. Purchase & appraisal-related (acquisitions only)

• Fully executed purchase and sale agreement
• Earnest money deposit confirmation
• Seller’s/current operator’s trailing financials (if different from borrower-prepared financials above)
• Access authorization for lender’s appraiser and property condition inspector

10. Additional items commonly requested

• Existing debt schedule and payoff statements for current loans on the property
• Any transition/management plan if there will be a change of operator at closing
• State change-of-ownership (CHOW) licensing application status, if applicable