If it were a cash transaction I'd suggest joint tenants with you holding a 1st position lien for the proceeds you injected into the deal.

FYI, my fav is "failure to adhere to the rules of the lease or lied on or during the application process" and inject clauses such as "any individual over more than (x number of days) is considered a tenant, and must apply or be added as an occupant". 

So basically my live-in providers would do the cooking, cleaning, providing medications (which includes injections).Was just hoping that someone might be able to answer my question that if there were changes to Medicaid or Medicare similar to these last two healthcare bills proposed would that make starting this type of business more risky?

Could easily pay off entire loan balance or inject a large amount of equity in order to refinance and still make the deal work.- Puts material equity into the deal, in the form of cash. - 750+ credit score- Pays legal fee for seller to have representation from lawyer to walk them through the terms of the subject-to deal, including making it very clear that there are extremely real, and potentially devastating risks in the event of buyer default.Irresponsible/unethical Sub-to buyer looks like this:- Poor/no credit - Would not qualify for the mortgage they are taking over payments for, much less a new mortgage if a forced refinance event happens.- Is attempting to get 100 subject-to deals, but is not even capitalized to pay off or inject enough equity to refinance a single one of the acquired deals to have it qualify for refinance, much less a few dozen of them. 

And if something is needed or a tenant has or is an issue, do I want to inject myself into resolving it directly?

Will this capital injection reward you relative to your initial investment?  

Advice NeededTLDR - Spend an additional $30k now to upgrade the sewer system on-site while the contractor is already mobilized or go with a sewer injection pump which is likely a viable solution the will last for years with proper maintenance. 

You can use the cost of the land and the other costs you have already spent toward the down payment, so I suspect you won't have to inject anything else into the deal.

It does seem a bit overhyped but I'm also wondering if current owners of these underwater properties are looking for an injection of capital.

(Couldn't resist injecting some humor here.