Finding Text
Identifying Number: 2023-001
Information on the Federal Program: ALN #14.129, U.S. Department of Housing and Urban Development: Mortgage Insurance – Nursing Homes, Intermediate Care Facilities, Board and Care Homes and Assisted Living Facilities.
Criteria or Specific Requirement: The regulatory agreement (form HUD 92466-E) specifies in Paragraph 4(c): “Owners shall not without the prior written approval of the Secretary [of HUD]: remodel, reconstruct, or demolish any part of the mortgaged property or subtract from any real or personal property of the project” and also specifies in section B of the Lean Rider “Certain matters requiring approval of the secretary (of HUD)” item 2(k) “Use of the mortgaged property for any purpose other than the Approved Use” in which “Approved Use” is defined per section J(i) of the Lean Rider “as a 112-bed skilled nursing and 35-bed assisted living facility.” Approved use was subsequently amended by HUD to allow an addition of 34 skilled nursing beds.
Condition: The Organization did not receive HUD approval prior to starting a construction project to add an addition completed in May 2014, which encompasses 22 additional assisted living beds. The costs of the portion of the completed project that has not been approved totaled $2,501,965, which is included as a liability in the advance from member.
Cause: Construction of the addition was started and the number of licensed beds was increased before HUD approval was received.
Effect: Noncompliance with the HUD compliance requirements per the regulatory agreement.
Questioned Costs: Not Applicable.
Context: The construction project and bed change population was tested 100%, therefore was statistically valid. This instance is isolated to this one construction and bed change project.
Repeat finding: This finding is a repeat finding (2022-001, 2021-001, 2020-001, 2019-001, 2018-001, 2017-002, 2016-001, 2015-001, 2014-001 and 2013-1).
Recommendation: Procedures should be implemented and placed in service to ensure HUD approval, for which all conditions can be met, is obtained before any construction is started on the mortgaged property as well as any bed addition. The Organization should also obtain approval after-the-fact for the specific construction project and bed addition noted above.
Views of Responsible Officials: Management disagrees with finding 2023-001.