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Closed Date:
October 15, 2019

Develop and implement metrics to evaluate each nursing home’s financial data for changes in utilization, payments, profitability, and solvency (debt service credit ratios).

Publication Report

2018-BO-0001 | September 17, 2018

HUD’s Office of Residential Care Facilities Did Not Always Have and Use Financial Information to Adequately Assess and Monitor Nursing Homes

We audited the U.S. Department of Housing and Urban Development’s (HUD) monitoring of the financial performance of Section 232 nursing homes based on the size of their program, the inherent risks in the program, the length of time since our last audit,… more

Related Recommendations

Housing

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-A
    Closed on December 10, 2019

    Work with the owners, lenders, operators, and management agents (as applicable) to develop and implement an action plan for potentially troubled and troubled nursing homes. Each plan should include an analysis of the root causes of that nursing home’s challenges and define specific and measureable steps that address the root causes. Each step should have a defined completion date.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-B
    Closed on March 04, 2021
    $41,435,357.00
    Funds Put to Better Use

    Recommendations that funds be put to better use estimate funds that could be used more efficiently. For example, recommendations that funds be put to better use could result in reductions in spending, deobligation of funds, or avoidance of unnecessary spending.

    Implement the action plan for the four defaulted nursing homes to protect HUD’s investment of $41,435,357. This amount represents the collective funds put to better use for these nursing homes. Appendix E lists the funds to be put to better use by nursing home

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-C
    Closed on December 10, 2019

    Develop and implement policies and procedures to address delinquent or defaulted mortgages that would not benefit from refinancing.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-D
    Closed on November 19, 2019

    Refer regulatory agreement violations to the Departmental Enforcement Center within 30 days of HUD having identified it and work with the Departmental Enforcement Center to develop a plan for resolving the violation. Any revisions to the plan must be accepted by the Departmental Enforcement Center.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-E
    Closed on August 19, 2019

    Review and revise the policies and procedures for making partial payments of claims to check that each decision to make a partial payment of claim ensures that the payment restores the subject nursing home to financial viability to avoid a repeat of the situation that led to the loss on Hebrew Home.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-F
    Closed on January 05, 2024
    $8,974,000.00
    Questioned Costs

    Recommendations with questioned costs identify costs: (A] resulting from an alleged violation of a law, regulation, contract, grant, or other document or agreement governing the use of Federal funds; (B] that are not supported by adequate documentation (also known as an unsupported cost]; or (C] that appear unnecessary or unreasonable.

    Require Jamaica Hospital Nursing Home to provide support for $8,974,000 paid to its related company. Any amount that the owner cannot support as reasonable in price and necessary to the nursing home should be repaid to the nursing home.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-G
    Closed on January 05, 2024
    $44,483,000.00
    Funds Put to Better Use

    Recommendations that funds be put to better use estimate funds that could be used more efficiently. For example, recommendations that funds be put to better use could result in reductions in spending, deobligation of funds, or avoidance of unnecessary spending.

    Require Jamaica Hospital Nursing Home to provide support for $44,483,000 in accounts payable. Any amount that the owner cannot support as reasonable in price and necessary to the nursing home should be removed from the accounts payable

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-H
    Closed on July 13, 2022
    $7,027,289.00
    Questioned Costs

    Recommendations with questioned costs identify costs: (A] resulting from an alleged violation of a law, regulation, contract, grant, or other document or agreement governing the use of Federal funds; (B] that are not supported by adequate documentation (also known as an unsupported cost]; or (C] that appear unnecessary or unreasonable.

    Require the owners of Bishop Wicke Health and Rehabilitation Center, Plaza Village Senior Living, Golden Hill Health Care Center, Immanuel Campus of Care, and their related companies to reimburse the nursing homes for the ineligible expenses of $7,027,289.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-I
    Closed on November 19, 2019
    $815,973.00
    Questioned Costs

    Recommendations with questioned costs identify costs: (A] resulting from an alleged violation of a law, regulation, contract, grant, or other document or agreement governing the use of Federal funds; (B] that are not supported by adequate documentation (also known as an unsupported cost]; or (C] that appear unnecessary or unreasonable.

    Require Shawnee Christian Nursing Center to return 27 beds to operation or pay down the mortgage by $815,973

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-J
    Closed on October 15, 2019

    Define the troubled and potentially troubled classifications for nursing homes and develop specific measures to identify when and how nursing homes are classified.

  •  
    Status
      Open
      Closed
    2018-BO-0001-001-K
    Closed on October 15, 2019

    Develop and implement policies and procedures to revisit the classifications at least annually.

  •  
    Status
      Open
      Closed
    2018-BO-0001-002-A
    Closed on September 05, 2023

    Develop and implement computerized controls to flag blank data fields and illogical financial data.

  •  
    Status
      Open
      Closed
    2018-BO-0001-002-B
    Closed on September 05, 2023

    Develop and implement procedures to require owners, operators, and lenders to submit accurate and complete financial data.

  •  
    Status
      Open
      Closed
    2018-BO-0001-002-C
    Closed on August 13, 2019

    Develop and implement internal controls to routinely compare financial data on mortgage payments to Multifamily Delinquency and Default Reporting System data on mortgage payments and follow up on any conflicting data.

  •  
    Status
      Open
      Closed
    2018-BO-0001-002-D
    Closed on October 15, 2019

    Develop and implement procedures for referring operators who fail to provide required financial statements to the Departmental Enforcement Center.