VIUM's Strategies to Successful Acquisition Financing

Acquisition financing in the senior living and healthcare space is complex, requiring a deep understanding of market conditions, regulatory environments, and financial structuring. Join Managing Director, Josh Vander Plaats, as he explores how VIUM Capital tailors its financing solutions to meet the needs of owner-operators in the seniors housing and skilled nursing sectors. 

Who Does VIUM Serve the Industry?

VIUM Capital is a lender in the seniors housing and healthcare space, specifically serving owner operators of seniors housing and skilled nursing facilities. Most of the owner-operators we work with own and operate licensed facilities such as assisted living, memory care, skilled nursing, and occasionally independent living. We provide a full-service platform for our borrowers, offering:

• Bridge financing, which includes recapitalization, restructuring, and acquisition financing. 
• Permanent financing as a licensed HUD lender and as a Fannie and Freddie correspondent lender. 

‍Learn more about VIUM solutions.

How is VIUM’s Approach to Partnerships Unique?

When it comes to local relationships, we believe it is essential for us as originators to understand the markets we serve. This business is regulated differently at the state level across the country, so it's important that if you're working in a state, you fully understand how that state operates, especially regarding Medicaid reimbursement.

If the state has a Medicaid waiver program, it’s important to understand how that program operates. This local knowledge gives VIUM a head start in underwriting and helps us better serve our clients. 

VIUM is structured so that each originator becomes a subject matter expert in their dedicated territory geographically. I serve a lot of the Plains states - Iowa, Missouri, Kansas, Nebraska - and then also out west, including California. 

What are VIUM’s Strategies for Successful Acquisitions?

When it is a third-party buyer and seller, we are most interested in transactions exhibiting historical performance. Our bank partner, Merchants Bank, is a regulated bank that must meet certain underwriting characteristics. 

We can typically lend up to 75% loan-to-cost, and sometimes 80%, if supported by the asset’s historical performance.

If there are any underwriting adjustments to historical financials, they must be well-supported either by:

• Provider quotes (eg: insurance or dietary expenses)
• Comparable projects in the sponsor’s portfolio

For unstabilized or turn-around acquisitions, financing is more difficult to obtain. In these cases, we emphasize in-place purchase options. We work with many owner-operators who start as operators with a stated purchase price in their lease. With actual historical financials from the operator in place, we can often underwrite more aggressively, potentially pushing leverage beyond 80% of the purchase price. 

I would also like to mention our debt fund option. Some groups we work with are either unwilling or unable to provide a guarantee. Our debt fund offers a non-recourse option, which, while carrying a higher cost of capital, provides greater flexibility in underwriting. This allows VIUM to be more aggressive in working with strong owner-operators, particularly those with turn-around experience. 

We pride ourselves on having solutions across the spectrum of ownership profiles. 

One last piece to mention is our ability to include earn-outs in acquisition financing. For example, maybe it’s a 70% loan-to-purchase price initially. Then we earn-outs so that, after 12-18 months, the community could return additional equity based on improved performance. This strategy also avoids resetting the seasoning clock for HUD.

We’ve successfully implemented this many times - for example, structuring a $7 million bridge loan on a $10 million acquisition, with an opportunity to earn an additional $1 million - $2 million over time based on performance. 

How Do Relationships Directly Impact Transactions?

We have very strong relationships with many brokers who market sale transactions, allowing us to gain additional background details on assets or sellers when needed. 

We also maintain strong relationships with state associations, helping us stay informed about changes to Medicaid reimbursement and other regulatory shifts. 

Since state rules and regulations constantly evolve, developing these connections is critical for informing our bank partner during underwriting.

‍Gain more insights from the VIUM resource library.

Closing Thoughts

In third-party acquisitions, it's important to understand that the as-is appraised value must closely match the purchase price. A disconnect between the as-is appraised value and the open market sale price can be challenging to justify. 

If proposed changes to operations are expected post-sale, they must be evidenced through:

• Operational success at other properties in the sponsor’s portfolio
• Signed vendor contracts 

Even when it’s a non-brokered sale or a lease-to-purchase arrangement, strong historical operations must still support the financing request. 

Successful acquisition financing in the senior living and healthcare sectors requires more than just capital—it demands deep industry expertise, strategic structuring, and strong relationships. VIUM Capital combines local regulatory expertise, flexible financial products (including bank bridge, debt fund bridge, HUD, and Fannie/Freddie), and a commitment to partnership and service. For experienced owner-operators seeking a financing partner with the expertise and adaptability to navigate complex transactions, VIUM Capital is the trusted choice. Contact us today to learn more.