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, and the inclusion of this review in the annual audit plan.  Our audit objective was to determine whether HUD had sufficient financial information and used this information to adequately…

The U.S. Department of Housing and Urban Development (HUD) Office of Inspector General (OIG) reviewed concerns from a complaint within HUD regarding the physical condition of HUD-insured residential care facilities (RCF).  This review is part of an ongoing effort of the Office of Inspector General (OIG).  At least 10 RCFs had received a score below 31 out of a possible 100 on their most recent Real Estate Assessment Center (…

Very low REAC scores are not prevalent across ORCF’s portfolio.  The majority of RCFs that received a REAC score scored at least 80 on their last inspection, and more than three quarters scored at least 60.  Despite the small percentage of RCFs that scored below 31, we noticed an overall decline in REAC inspection scores across ORCF’s portfolio from 2000 to 2016. REAC has adopted an inspection process that applies uniformly to all…

We audited Folts, Inc.’s management of the Folts Adult Home and Folts Home projects to address our concern with U.S. Department of Housing and Urban Development (HUD)-assisted health care facilities.  We selected this auditee as the result of a risk assessment of nursing homes located in New York State, which considered HUD’s risk indicators and factors such as loan default; internal control issues; and financial statements not being filed…

The Office of Hospital Facilities (OHF) provides mortgage insurance for acute care hospitals.  The insurance it provides reduces risk to lenders and lowers borrowing costs for hospitals.  As of May 2016, the unpaid principal balance for its 105 insured mortgages was approximately $7 billion. OHF collects and generates many records to support its mission.  These records include application materials, internal reports, and…

We audited Morris Park Nursing and Rehabilitation Center based on a risk assessment we performed on nursing homes located in New York and New Jersey.  Morris Park has a Section 232 HUD-insured loan in the amount of $7.4 million.  The objective of the audit was to determine whether Morris Park officials managed funds in compliance with the regulatory agreement and applicable HUD requirements. Morris Park officials generally managed…

The U.S. Department of Housing and Urban Development (HUD), Office of Inspector General reviewed HUD’s Section 242 Mortgage Insurance for Hospitals program to determine whether HUD established controls to approve and administer projects under the Section 242 program and whether HUD used an updated handbook to administer its Section 242 program and used and provided to program participants written guidance that had been approved through HUD’s…

We audited the U. S. Department of Housing and Urban Development’s (HUD) Section 232 program as part of the Office of Inspector General’s (OIG) goal of contributing to the improvement of HUD’s execution and accountability of fiscal responsibilities. Our objective was to determine whether HUD had implemented adequate controls to properly monitor Section 232-insured mortgages. We found that HUD’s Office of Healthcare Programs had taken steps to…