Select one of the following: The entire facility was constructed more than 3 years ago and has not undergone any substantial rehabilitation in the last three years. An addition to the facility was constructed less than 3 years ago. However, the addition was not larger than the project in size (gross floor area) and number of beds. <<Provide further explanation, if necessary. If the facility does not meet either of the criteria above, the loan is not eligible under this program.>> Substantial Rehabilitation Select all applicable statements: The estimated cost of the repairs represents less than 15% of the project’s value after completion. The repairs do not include the substantial replacement of two or more major building components. <<Provide further explanation, if necessary. If the facility does not meet either of the criteria above, the loan is not eligible under this program. (Note: Concerning replacement of major building components, total replacement is not required, but the greater part (at least 50%) must be replaced.>>
should be reported by resident day, the total of which should be equal to the number of operating beds x 365 x occupancy percentage. Assisted living may be reported by occupied unit, the total of which should equal the number of operating units x 12 x occupancy percentage. Do not enter potential gross incomes here, but rather effective gross income, wherein vacancy has already been accounted for.>> <<Discuss any departures from historical reimbursements, mix, and trends here.>> <<Instructions: Each type of care should have its own subsection below discussing the Payor source identified in the rent schedule, as demonstrated below. You may delete the sections (Skilled Nursing, Assisted Living, and Independent Living) that do not apply to your subject. >> Skilled Nursing 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
<<Provide this section for each parent organization of the operator. This section is not applicable to individuals who are principals unless you are depending on the person or persons for approval of the operator (e.g., newly formed entity). In that instance (individuals), follow the principal of the borrower template and modify it appropriately for an operator. >> Name: State of organization: Date formed: Termination date: Key Questions Yes No Is the parent of the operator rated by S&P or another rating agency? . According to the application exhibits, is or has the parent of the operator been delinquent on any federal debt? According to the application exhibits, is or has the parent of the operator been a defendant in any suit or legal action? According to the application exhibits, has the parent of the operator ever filed for bankruptcy or made compromised settlements with creditors? According to the application exhibits, are there judgments recorded against the parent of the operator? According to the application exhibits, are there any unsatisfied tax liens? Does the parent of the operator have other HUD properties which are master leased separately from the subject project? <<For each “yes” answer above, provide a narrative discussion on the topic describing the risk and how it will be mitigated. Example: S&P Rating: The entity is rated X by S&P. The rating agency indicates the outlook for the company is X.>> Organization <<Provide organization chart and narrative, as applicable.>> Experience/Qualifications <<Provide narrative description of experience and qualifications. Discussion should highlight direct experience and involvement in other HUD transactions. This section should clearly demonstrate the expertise to successfully operate the facility. >>