Open Recommendations

Implement procedures for monitoring property owners' reserve for replacement accounts for compliance with HUD's requirements, using reserve for replacement account data collected on projects from PHAs.

Provide inspection reports for the units identified in this report that failed to meet HQS showing that the units and associated buildings meet HUD's current physical condition standards.

Implement a policy to ensure that monitoring of RAD PBV projects includes, at a minimum, a review of the accuracy of the reserve for replacement account balances and compliance with HUD's physical condition and inspection requirements.

Review the reserve for replacement accounts for the 12 underfunded projects to ensure that the account balances are maintained in accordance with the applicable HUD requirements and executed HUD business documents and require owners to fully fund any underfunded reserves, as applicable.

Review the reserve for replacement accounts for the 14 project owners that did not make annual adjustments for inflation, as identified in the capital needs assessment, to determine whether the account balances are sufficient to meet anticipated capital needs. If the account balances are not sufficient, HUD should require the owners to appropriately fund the accounts.

Implement a plan to review the reserve for replacement accounts for all RAD PBV projects to ensure that reserve for replacement accounts are appropriately funded.

Obtain documentation from the PHAs to support that more than $1 million in withdrawals from the eight reserve accounts complied with HUD's requirements or require the project owners to reimburse the reserve accounts for the unsupported withdrawals.

Implement a process, in conjunction with the Office of Recapitalization, to ensure that the reserve for replacement requirements in HUD's business documents, such as the RAD conversion commitment, HAP contract, and operating agreement, are consistent for converted projects.

Collect data on projects' reserve for replacement accounts to support the Office of Field Operations' monitoring activities.

The Facility Director ensures the mental health executive council operates in accordance with VHA requirements.

The Chief of Mental Health identifies barriers and implements processes to provide a minimum of four hours of recovery-oriented, interdisciplinary programming on weekends on the inpatient mental health unit and monitors for compliance.

The Facility Director develops and implements processes to monitor and track compliance with involuntary commitment requirements.

The Chief of Staff ensures timely documentation of informed consent discussions between the prescriber and veteran on the risks and benefits of newly prescribed medications and monitors for compliance.

The Chief of Staff ensures discharge instructions for veterans are written in easy-to-understand language and include the purpose for each medication.

The Chief of Staff directs staff to complete or review safety plans with veterans prior to discharge and monitors for compliance.

The Chief of Staff directs staff to complete the Columbia-Suicide Severity Rating Scale within 24 hours before discharge and monitors for compliance.

The Chief of Staff directs staff to address ways to make the veterans environment safer from potentially lethal means in safety plans and monitors for compliance.

The Facility Director directs staff to comply with Lethal Means Safety training and monitors for compliance.

The Facility Director directs staff to comply with Skills Training for Evaluation and Management of Suicide training and monitors for compliance.

The Facility Director directs staff to comply with VA S.A.V.E. training and monitors for compliance.

The Facility Director ensures Interdisciplinary Safety Inspection Team requirements are met and monitors for compliance.

The Facility Director implements processes to ensure the Interdisciplinary Safety Inspection Team applies Mental Health Environment of Care Checklist standards to all sections on the inpatient mental health unit and monitors for compliance.

The Facility Director uses VHA guidelines to develop a facility-specific policy for the use of restraint chairs.

The Facility Director directs staff to comply with Mental Health Environment of Care Checklist training requirements and monitors for compliance.

The Facility Director establishes a mental health executive council that operates in accordance with Veterans Health Administration requirements.