Operator: Parent of operator: Management agent: General contractor: License holder: Borrower Operator Management agent Type of facility: Skilled Nursing (SNF): beds units Assisted Living (AL): beds units Board & Care (B&C): beds units Dementia Care: beds units Independent Living (IL): beds units Total: beds units Mortgage Amount: $ Loan-to-value: % Loan to transaction cost: % Term: years Interest rate: % Principal & interest: (without MIP) $ DSCR (with MIP): % Market value per bed/unit*: $ Underwritten market value: $ Cap rate: % Mortgage amount per bed/unit*: $ *Use per bed for SNF, or facilities with multiple care types (e.g., SNF/ALF). Use per unit for ALF only. Mortgage Criteria: Sensitivity Analysis: Criterion A: Requested loan amount: $ A 1.0 debt service coverage is still realized if: Average rental drops $ per month. Occupancy rate decreases %. Operating expenses increase % per year. Annual net operating income (NOI) decreases $ or %. Criterion C: Amount based on replacement cost: $ Criterion D: Amount based on loan-to-value: $ Criterion E: Amount based on debt service coverage: $ Criterion F: Amount based on estimated cost of rehabilitation plus: $ Criterion L: Amount based on deduction of grant(s), loan(s), LIHTCs, and gift(s) for mortgageable items: $ As rehabilitated: Gross income: $ UW occupancy rate: % Effective gross income: $ Expenses & repl. res.: $ Expense ratio: % Net operating income: $ Expense per bed/unit*: $ Total project cost: $ Total project cost per bed/unit*: $
Skilled Nursing – as Is Private Pay In addition to an analysis of the subject’s rent roll, the appraiser and underwriter analyzed the private pay rates at X comparable facilities. A summary of their analysis is provided below. Private Pay Rates Comparability Analysis (Double click inside the Excel Tables to add information) <<Provide narrative discussion of private pay rate conclusion. Discuss how the rate conclusion compares to the achieved rents shown on the rent roll. Expand or shorten the table above as needed to accommodate the types of rooms or the number of comparables used. Additional analysis can be provided at the Lender’s option to support its conclusions, as appropriate. Identify any modification from the appraiser’s concluded rent and provide justification. >> Medicare Daily rate – Underwriting: $ Appraisal: $ Subject’s historical average RUG Rate: $ Time period of quoted average: <<Identify any anticipated changes to the reimbursement rate. Provide narrative discussion of conclusion. For example: “The appraiser provided a detailed Resource Utilization Group (RUG) rate analysis of the facility’s operation over the last 12-month operating period. The analysis concluded a weighted average Medicare rate of $XX PRD. The RUG Rates used to determine the average rate are based on the <<DATE>> rates. The underwriter concurs with the appraiser’s conclusion.”>> Medicaid Daily Rate – Underwriting: $ Appraisal: $ Published Rate: $ Date of Rate <<Provide narrative discussion of the state’s reimbursement system and how the subject’s or tenant’s rate is determined. If rate is facility specific, discuss evidence of current or prospective rate. If rate is based on resident care requirements, provide an analysis of the last 12-months of rates for this payor source, as appropriate. Identify and discuss any other sources or copayments that are required, e.g., Supplemental Security Income (SSI). Identify any anticipated changes to the reimbursement rate, such as when rates are tied to depreciating capital components .>> Veteran’s Administration (VA) Daily Rate – Underwriting: $ Appraisal: $ <<If applicable, provide narrative discussion of how the rate is determined. Discuss review of evidence (e.g., rate letter) or historical precedent for the underwritten rate. >>
Title Title Search Date of search: Firm: File number: Key Questions Yes No Is the title currently vested in an entity or individual other than the proposed borrower? . Does the report indicate that delinquent real estate taxes are owed? Does the report indicate any outstanding special assessments? Does the report identify any outstanding debt that is not disclosed on the borrower’s listing of outstanding obligations? Are there or will there be any Use and Maintenance Agreements associated with this facility? <<For each “yes” answer above, provide a narrative discussion on the topic describing the risk and how it will be mitigated.>> Pro-forma Policy Date/time: Firm: Policy number: Key Questions Yes No Is the title vested in an entity or individual other than the proposed borrower? . Are there any covenants, , encumbrances, liens, restrictions, or other exceptions indicated on Schedule B-1? . Are there any use or affordability restrictions remaining in effect on the property? Are there any easements or rights-of-way listed that are not indicated on the survey? Are there any endorsements included aside from the standard HUD-required endorsements? Are there any subordination agreements, encroachments or similar issues that require HUD’s approval?