The U.S. Department of Housing and Urban Development (HUD), Office of Inspector General, reviewed Blue Mountain Hospital (Hospital) based on a request from the Office of Healthcare Programs. The objective of our review was to determine whether the Hospital had adequate written procedures for collecting, dispersing, and accounting for project funds. The Hospital did not have adequate written procedures for collecting, disbursing, and accounting for project funds. The Hospital had only a general finance policy manual, which was developed after operations started.