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The Middlesex Health Care Center, Middletown, CT, Was Not Always Operated According to Its Regulatory Agreement and HUD Requirements

Submitted by system on
We audited the Federal Housing Administration-insured nursing home, Middlesex Health Care Center in Middletown, CT, because we identified profitability and solvency issues during ongoing work with the Section 232 program.  Additionally, the U.S.

The Office of Residential Care Facilities’ Use of Real Estate Assessment Center Scores

Submitted by system on
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 property types across HUD, including multifamily buildings, public housing buildings, and RCFs.  This approach presents challenges when applied to cer

Sons of Divine Providence Did Not Ensure That the Don Orione Home, East Boston, MA, Operated in Accordance With Its Regulatory Agreement

Sons of Divine Providence did not properly oversee the HUD-insured nursing home to ensure that it operated in accordance with its regulatory agreement.  By not informing HUD of the lawsuits, the changes in management agents, and the loans, Sons of Divine Providence did not provide HUD the necessary data to understand the risk to the HUD insurance fund.  However, when Sons of Divine Providence sold the nursing home and paid off the HUD-insured mortgage, it also terminated this regulatory agreement.

HUD Did Not Always Address Risks Reported in Borrowers’ Audited Financial Statements for Section 232 Residential Care Facility Portfolios

Submitted by bnettles2023 on

We audited the U.S. Department of Housing and Urban Development (HUD), Office of Residential Care Facilities’ (ORCF), oversight of Section 232 residential care facilities’ mortgage insurance program.  We performed this audit because HUD-insured residential care facility loan defaults were rising.  As of June 2024, 167 of the 3,670 HUD-insured Section 232 borrowers, or nearly 5 percent, defaulted on their mortgages.  These 167 loans had an unpaid principal balance of more than $1.1 billion.

HUD's Oversight of Section 232 Nursing Home Portfolios

HUD OIG is auditing HUD's oversight of Section 232 nursing home portfolios. HUD's Office of Residential Care Facilities is responsible for administering the Section 232 mortgage insurance program which insures more than 3,600 loans, with an unpaid principal balance of more than $32 billion. Our audit objective is to assess the extent to which HUD's Office of Residential Care Facilities identifies and mitigates risks in Section 232 nursing home portfolios. 

Challenges Faced by Section 232 Nursing Homes During the Pandemic

We conducted a limited review of nursing home owners to identify their operational challenges and needs of nursing homes in responding to the Coronavirus Disease 2019 (COVID-19) pandemic.  Our objective was to determine the biggest challenges operators of Section 232 nursing home facilities face related to the COVID-19 pandemic and whether nursing homes are prepared to meet their future financial obligations.  Most of the owners who responded to our survey indicated that nursing homes experienced financial and operational challenges during the pandemic.  These challenges include
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