HUD 24 CFR PART 242-2011 MORTGAGE INSURANCE FOR HOSPITALS《医院按揭保险》.pdf

1、406 24 CFR Ch. II (4111 Edition) 241.1220 207.259(c) of this chapter shall also in-clude an amount bid by the lender to satisfy the senior insured mortgage at the foreclosure sale. 241.1220 Termination of insurance benefits. All of the provisions of 207.253a of this chapter apply to subpart F of thi

2、s part, except that the following shall also constitute grounds for termi-nating the contract of insurance: (a) The failure of the lender to notify the Commissioner in a timely manner of a foreclosure action initiated by the holder of the senior insured mortgage; and (b) The failure of the lender wh

3、en di-rected by the Commissioner to assign the equity or acquisition loan or bid an amount necessary to acquire title to the project and convey the project to the Commissioner, in accordance with 241.1210. 241.1230 No vested right in fund. Neither the lender nor the borrower shall have any vested or

4、 other right in the insurance fund under which the loan is insured. 241.1235 Cross default. In the event the borrower commits a default under a prior recorded insured mortgage and the holder thereof initi-ates a foreclosure proceeding, said de-fault under the prior recorded insured mortgage shall co

5、nstitute a default under the equity or acquisition loan. 241.1245 Insurance endorsement. (a) Endorsement. The Commissioner shall indicate his insurance of the eq-uity loan or acquisition loan by endors-ing the original credit instrument and identifying the section of the Act and the regulations unde

6、r which the loan is insured and the date of insurance. (b) Endorsement of phased loan. In the event the loan is phased, the Commis-sioner shall indicate his insurance of each amount by endorsing the original credit instrument and identifying the section of the Act and the regulations under which suc

7、h amount is insured and the date of the insurance. (c) Final advance of phased loan. When all advances of a phased loan have been made and the terms and conditions of the commitment have been complied with to the satisfaction of the Commis-sioner, the Commissioner shall indi-cate on the original cre

8、dit instrument the total of all advances the Commis-sioner has approved for insurance and again endorse such instrument. 241.1250 Effect of endorsement. From the date that the equity or ac-quisition loan is endorsed, the Commis-sioner and the lender shall be bound by the provisions of subpart F of t

9、his part to the same extent as if they had exe-cuted a contract including the provi-sions of subpart F of this part and the applicable sections of the Act. PART 242MORTGAGE INSURANCE FOR HOSPITALS Subpart AGeneral Eligibility Requirements Sec. 242.1 Definitions. 242.2 Program financial self-sufficie

10、ncy. 242.3 Encouragement of certain programs. 242.4 Eligibility for insurance and transi-tion provision. 242.5 Eligible mortgagees/lenders. 242.6 Property requirements. 242.7 Maximum mortgage amounts. 242.8 Standards for licensure and methods of operation. 242.9 Physician ownership. 242.10 Eligible

11、mortgagors. 242.11 Regulatory compliance required. 242.13 Parents and affiliates. 242.14 Mortgage reserve fund. 242.15 Limitation on refinancing existing indebtedness. Subpart BApplication Procedures and Commitments 242.16 Applications. 242.17 Commitments. 242.18 Inspection fee. 242.19 Fees on incre

12、ases. 242.20 Reopening of expired commitments. 242.21 Refund of fees. 242.22 Maximum fees and charges by mort-gagee. 242.23 Maximum mortgage amounts and cash equity requirements. 242.24 Initial operating costs. Subpart CMortgage Requirements 242.25 Mortgage form and disbursement of mortgage proceeds

13、. 242.26 Agreed interest rate. 242.27 Maturity. VerDate Mar2010 10:21 May 10, 2011 Jkt 223078 PO 00000 Frm 00416 Fmt 8010 Sfmt 8010 Y:SGML223078.XXX 223078WReier-Aviles on DSKGBLS3C1PROD with CFRProvided by IHSNot for ResaleNo reproduction or networking permitted without license from IHS-,-,-407 Off

14、ice of Assistant Secretary for Housing, HUD 242.1 242.28 Allowable costs for consultants. 242.29 Payment requirements. 242.30 Application of payments. 242.31 Accumulation of accruals. 242.32 Covenant against liens. 242.33 Covenant for malpractice, fire, and other hazard insurance. 242.35 Mortgage li

15、en certifications. 242.37 Mortgage prepayment. 242.38 Late charge. Subpart DEndorsement for Insurance 242.39 Insurance endorsement. 242.40 Mortgagee certificate. 242.41 Certification of cost requirements. 242.42 Certificates of actual cost. 242.43 Application of cost savings. Subpart EConstruction 2

16、42.44 Construction standards. 242.45 Early commencement of work. 242.46 Insured advancesbuilding loan agreement. 242.47 Insured advances for building compo-nents stored off-site. 242.48 Insured advances for certain equip-ment and long lead items. 242.49 Funds and finances: deposits and let-ters of c

17、redit. 242.50 Funds and finances: off-site utilities and streets. 242.51 Funds and finances: insured advances and assurance of completion. 242.52 Construction contracts. 242.53 Excluded contractors. Subpart FNondiscrimination and Wage Rates 242.54 Nondiscrimination. 242.55 Labor standards. Subpart G

18、Regulatory Agreement, Ac-counting and Reporting, and Financial Requirements 242.56 Form of regulation. 242.57 Maintenance of hospital facility. 242.58 Books, accounts, and financial state-ments. 242.59 Inspection of facilities by Commis-sioner. 242.61 Management. 242.62 Releases of lien. 242.63 Addi

19、tional indebtedness and leasing. 242.64 Current and future property. 242.65 Distribution of assets. 242.66 Affiliate transactions. 242.67 New corporations, subsidiaries, affili-ations, and mergers. Subpart HMiscellaneous Requirements 242.68 Disclosure and verification of Social Security and Employer

20、 Identification Numbers. 242.69 Transfer fee. 242.70 Fees not required. 242.72 Leasing of hospital. 242.73 Waiver of eligibility requirements for mortgage insurance. 242.74 Smoke detectors. 242.75 Title requirements. 242.76 Title evidence. 242.77 Liens. 242.78 Zoning, deed, and building restric-tion

21、s. 242.79 Environmental quality determina-tions and standards. 242.81 Lead-based paint poisoning preven-tion. 242.82 Energy conservation. 242.83 Debarment and suspension. 242.84 Previous participation and compli-ance requirements. 242.86 Property and mortgage assessment. 242.87 Certifications. 242.8

22、9 Supplemental loans. 242.90 Eligibility of mortgages covering hos-pitals in certain neighborhoods. 242.91 Eligibility of refinancing trans-actions. 242.92 Minimum principal loan amount. 242.93 Amendment of regulations. AUTHORITY: 12 U.S.C. 1709, 1710, 1715b, 1715u, and 1715z7; 42 U.S.C. 3535d. SOUR

23、CE: 72 FR 67546, Nov. 28, 2007, unless otherwise noted. Subpart AGeneral Eligibility Requirements 242.1 Definitions. As used in this subpart, the following terms shall have the meaning indi-cated: Act means the National Housing Act (12 U.S.C. 1701 et seq.). Affiliate means a person or entity which,

24、directly orindirectly, either controls or has the power to control or exert significant influence on the other, or a person and entity both con-trolled by a third person or entity, which may be a parent entity. Indicia of control include, but are not limited to: Interlocking management or owner-ship

25、, identity of interests among fam-ily members, shared facilities and equipment, common use of employees, or a business entity organized fol-lowing the suspension or debarment of a person or entity that has the same or similar management, ownership, or principal employees as the suspended, debarred,

26、ineligible, or voluntarily ex-cluded person or entity or as defined in VerDate Mar2010 10:21 May 10, 2011 Jkt 223078 PO 00000 Frm 00417 Fmt 8010 Sfmt 8010 Y:SGML223078.XXX 223078WReier-Aviles on DSKGBLS3C1PROD with CFRProvided by IHSNot for ResaleNo reproduction or networking permitted without licen

27、se from IHS-,-,-408 24 CFR Ch. II (4111 Edition) 242.1 the Medicare reimbursement regula-tions. AMPO (Allowance for Making Project Operational) relates to non-profit projects and means a fund that is primarily for accruals during the course of construction for mortgage in-surance premiums (MIPs), ta

28、xes, ground rents, property insurance pre-miums, and assessments, when funds available for these purposes under the Building Loan Agreement have been exhausted; and also for allocation to such accruals after completion of con-struction, if the income from the hos-pital at that time is insufficient t

29、o meet such accruals. AMPO may also be used for such other purposes as ap-proved by HUD. Any balance remaining unused in the fund at final endorse-ment will be treated in accordance with 242.43. Applicant means a HUD multifamily- approved lender that would be the mortgagee of record. Chronic convale

30、scent and rest means skilled nursing services, intermediate care services, respite care services, hospice services, and other services of a similar nature. Construction means the creation of a new or replacement hospital facility, or the substantial rehabilitation of an existing facility. The cost o

31、f acquiring new or replacement equipment may be included in the cost of construction. Days of cash on hand means the num-ber of days of operating cash available to the hospital, calculated pursuant to standards determined by HUD. Debt service coverage ratio is a meas-ure of a hospitals ability to pa

32、y inter-est and principal with cash generated from current operations. Debt service ratio is calculated as follows: Debt Service Coverage Ratio (total debt service coverage on all long-term cap-ital debt) equals the excess of revenues over expenses (not-for-profit) or net in-come (for-profit) plus i

33、nterest expense plus depreciation expense plus amorti-zation expense, all divided by current portion of long-term debt (including capital leases) from the previous years audited financial statement plus inter-est expense. The calculation can be ex-pressed as: (Excess of revenues over expenses OR net

34、 income) + interest eexpense + depreciation expense + amortization expenseCurrent pportion of long-term debt prior year, including capital leases + interest expenseHospital means a facility that has been proposed for approval or has been approved by HUD under the provisions of this subpart, and: (1)

35、 That provides community services for inpatient medical care of the sick or injured (including obstetrical care); (2) Where not more than 50 percent of the total patient days during any year are customarily assignable to the cat-egories of chronic convalescent and rest, drug and alcoholic, epileptic

36、, mentally deficient, mental, nervous and mental, and tuberculosis, except that the 50 percent patient day restric-tion does not apply to Critical Access Hospitals (hospitals designated as such under the Medicare Rural Hospital Flexibility Program) between January 28, 2008 and July 31, 2011. (3) Tha

37、t is a facility licensed or regu-lated by the state (or, if there is no such state law providing for such li-censing or regulation by the state, by the municipality or other political sub-division in which the facility is lo-cated) and is: (i) A public facility owned by a state or unit of local gove

38、rnment or by an instrumentality thereof, or owned by a public benefit corporation established by a state or unit of local government or by an instrumentality thereof; (ii) A proprietary facility; or (iii) A facility of a private nonprofit corporation or association. Identity of interest means a rela

39、tion-ship that must be disclosed and may be prohibited pursuant to the require-ments of the Regulatory Agreement. Examples of a prohibited Identity of Interest relationship are, but are not limited to, a financial or family rela-tionship between the mortgagor (which VerDate Mar2010 10:21 May 10, 201

40、1 Jkt 223078 PO 00000 Frm 00418 Fmt 8010 Sfmt 8010 Y:SGML223078.XXX 223078ER28NO07.052WReier-Aviles on DSKGBLS3C1PROD with CFRProvided by IHSNot for ResaleNo reproduction or networking permitted without license from IHS-,-,-409 Office of Assistant Secretary for Housing, HUD 242.1 includes but is not

41、 limited to an offi-cer, director, or partner of the mort-gagor) and general contractor, subcon-tractor, seller of the land or property, any consultants, or other parties to the transaction. Mortgage means such classes of first liens as are commonly given to secure advances on, or the unpaid purchas

42、e price of, real estate under the laws of the state in which the real estate is lo-cated, together with any mortgage note secured thereby. The mortgage may be in the form of one or more trust mortgages or mortgage inden-tures or deeds of trust securing notes, bonds, or other mortgage notes; and, by

43、the same instrument or by a sepa-rate instrument, it may create a secu-rity interest in the personalty, includ-ing, but not limited to, the equipment, whether or not the equipment is at-tached to the realty, and in the reve-nues and receivables of the hospital. Mortgagee or lender means the appli-ca

44、nt for insurance or the original lend-er under a mortgage. Mortgagor means the original bor-rower under a mortgage and its succes-sors and assigns. Mortgage Reserve Fund means a trust account, or an account held by the mortgagee, for and on behalf of the mortgagor, to which the mortgagor contributes

45、 and from which with-drawals must be approved by HUD. The purpose of the fund is to provide HUD a means to assist the hospital to avoid mortgage defaults and to preserve the value of the mortgaged property and the hospitals business. Most recent audited financial statement means the audited financia

46、l statement required under the regulatory agree-ment for the prior fiscal year. Net income means the net income of a for-profit entity, or, in the case of a nonprofit entity, the excess of revenues less expenses. Non-operating revenues and expenses are those revenues and expenses not di-rectly relat

47、ed to patient care, hospital- related patient services, or the sale of hospital-related goods. Examples of items classified as non-operating are state and federal income tax, general contributions, gains and losses from in-vestments, unrestricted income from endowment funds, and income from re-lated

48、 entities. Classification of items as operating or non-operating shall follow written guidance by HUD. Operating margin is operating income divided by operating revenue, where: (1) Operating revenue is the revenue from the core patient care operations of the hospital. It includes revenues from the p

49、rovision of such items as pa-tient care (including, but not limited to, hospital-based nursing home and physicians clinics); transfers from temporarily restricted accounts that are used for current operating ex-penses; and patient-related activities such as the operation of the cafeteria, parking facilities, television services to patients, sale of medical scrap or waste, etc. (Additional sources of rev-enue, which are classified as non-oper-ating, are excl