LOCATION
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CURRENT TEXT
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REVISED TEXT
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p. 1
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Public reporting burden for
this collection of information is estimated to average 73 hours
per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of
information. The agency may not conduct or sponsor, and a person
is not required to respond to a collection of information unless
that collection displays a valid OMB control number.
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Public reporting burden for this collection of information
is estimated to average 73 hours per response, including the time
for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and
reviewing the collection of information. The information is being
collected to obtain the supportive documentation that must be
submitted to HUD for approval, and is necessary to ensure that
viable projects are developed and maintained. The Department will
use this information to determine if properties meet HUD
requirements with respect to development, operation and/or asset
management, as well as ensuring the continued marketability of the
properties. Response to this request for information is required
in order to receive the benefits to be derived from the National
Housing Act Section 232 Healthcare Facility Insurance Program.
This agency may not collect this information, and you are not
required to complete this form unless it displays a currently
valid OMB control number. While no assurance of confidentiality
is pledged to respondents, HUD generally discloses this data only
in response to a Freedom of Information Act request.
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p.1
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Warning: Any person who knowingly presents a false,
fictitious, or fraudulent statement or claim in a matter within
the jurisdiction of the U.S. Department of Housing and Urban
Development is subject to criminal penalties, civil liability, and
administrative sanctions.
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Warning: Anyone who knowingly
submits a false claim or makes a false statement is subject to
criminal and/or civil penalties, including confinement for up to 5
years, fines, and civil and administrative penalties. (18 U.S.C.
§§ 287, 1001, 1010, 1012; 31 U.S.C. §3729, 3802).
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p. 1
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New paragraph
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Privacy Act Statement: The Department of Housing and Urban
Development, Federal Housing Administration, is authorized to
collect the information requested in this form by virtue of: The
National Housing Act, 12 USC 1701 et seq. and the regulations at
24 CFR 5.212 and 24 CFR 200.6; and the Housing and Community
Development Act of 1987, 42 USC 3543(a). The information requested
is used to review applications within HUD. No information will be
disclosed outside of HUD. The information requested is mandatory
to receive the mortgage insurance benefits to be derived from the
National Housing Act Section 232 Healthcare Facility Insurance
Program. No applications will be reviewed or approved without the
necessary information requested. No confidentiality is assured.
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p. 11
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New line
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Green MIP:
(If yes, provide details.)
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p. 11
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New line
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Green MIP Reports Conclusion is:
Accepted as is. Cannot be modified.
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p. 13
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New lines
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14. For Green MIP projects, did the project Architect or the
energy design professional determine that the project will not
achieve the selected green building certification, energy and
water reductions, and Energy Star Score required for the reduction
of the Green MIP rate? N/A
15. For Green MIP project, are the
energy conservation measures limited to the area of repairs,
alterations, addition and/or new construction rather than covering
the entire project?
N/A
16. For Green MIP projects, does the
energy design professional lack the relevant experience and
qualifications as provided in ORCFs Green MIP Program Guidance?
N/A
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p. 13
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<<If you answered “yes” to any of the questions
above, this facility is not eligible under this program. >>
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<<If you answered “yes” to any of the questions
above, this facility is not eligible under this program. Note: HUD
will not consider changes to participate in the Green MIP program
after the issuance of a Firm Commitment. >>
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p. 16
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5. Is the project in a state with an Olmstead Plan, pending
Olmstead cases, Olmstead settlement agreements, or is the
project’s state active in initiatives to “right-size”
nursing facilities or otherwise working to “rebalance”
long-term supports and services toward home and community-based
settings?
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5. Is the project in a state with an Olmstead Plan, pending
Olmstead-related cases, an Olmstead-related settlement agreement
or orders, or is the project’s state active in initiatives
to “right-size” nursing facilities or otherwise
working to “rebalance” long-term supports and services
toward home and community-based settings?
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p. 18
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Is the architectural reviewer knowledgeable and experienced with
local building standards and construction methods for the type of
project proposed, including the Federal Fair Housing Accessibility
Guidelines and the Uniform Federal Accessibility Standards?
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Is the architectural reviewer knowledgeable and experienced with
local building standards and construction methods for the type of
project proposed, including but not limited to the Federal Fair
Housing Accessibility Guidelines (FHAG) and the Uniform Federal
Accessibility Standards (UFAS)?
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p. 20
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New Section
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Key Questions – Green MIP Energy Professional
Yes No
1. Does the energy professional’s
qualification comply with ORCFs Green MIP Program Guidance?
N/A
2. Does the energy professional have
experience with energy modeling for the type of healthcare project
proposed ? N/A
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p. 20-21
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Lender verification of an appraiser’s
current standing can be done at http://www.asc.gov.
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Lender verification of an appraiser’s current standing can
be done at http://www.asc.gov. The Energy Professional must have
the requisite qualifications as outlined in the Green MIP Program
Guidance.
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p. 21
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<<Narrative description about the
parking including the number of spaces, compliance with
accessibility, adequacy of the parking, and any parking easements.
Also, discuss any zoning or marketability issues. >>
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<<Narrative description about
the parking including the number of spaces, compliance with
accessibility requirements, adequacy of the parking, and any
parking easements. Also, discuss any zoning or marketability
issues. >>
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p. 22
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New paragraph
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For Green MIP projects, describe the scope of work relied upon in
selecting the green building standard (e.g., gut rehab, minor
renovations, adding an addition or new construction outside the
footprint of the existing building; etc.) >>
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p. 22
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After reviewing the plans, did the architectural reviewer confirm
that the plans are not in conformance with FHAG and UFAS
requirements?
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After reviewing the plans, did the architectural reviewer confirm
that the plans are not in conformance with accessibility
standards such as FHAG and UFAS requirements?
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p. 25
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New paragraph
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Green MIP Summary – If applicable
<<Provide narrative discussion. Include the name of the
Standard Keeper and also the name of the green building
certification and level that will be provided (e.g., LEED, Silver,
Gold, etc.). Include the current Energy Star Score and provide
the current baseline Energy Use Intensity (kBtu/ft2) as analyzed
in the Statement of Energy Performance (SEP), and/or, if new
construction or an addition is contemplated, provide the design
(proposed) Energy Use Intensity (kBtu/ft2) results and prospective
Energy Score Rating as analyzed in the Statement of Energy Design
Intent (SEDI) Report. Confirm that the proposed energy and water
reductions, the green building certification and the required
Energy Star Score will be achieved per ORCFs Green MIP Program
Guidance. Energy Conservation measures must be designed for the
entire project>>
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p. 25
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Typically, an updated Construction Progress Schedule that
accurately reflects the month and date of construction start and
completion will be needed prior to closing. >>
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Typically, an updated Construction Progress Schedule that
accurately reflects the month and date of construction start and
completion will be needed prior to closing. For Green MIP
projects, the project Architect, energy design professional and
Green Building Standard Keeper/rater must coordinate with the
general contractor to include milestones for the green building
inspections. >>
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p. 24, 25, 41, 53, 59, 65, 82
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form
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Form
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