She has had health issues in the past as with her daughter and this caused a financial storm for her I believe. 

With a PHD in a health field and the way you're thinking, I am sure you will be financially free in no time. 

What about other tenants with health concerns like allergies to animals?

The key is to embrace uncertainty - and to get more comfortable with its consequences.Of course, if you had the HELOC, the ethical dilemma of whether to proactively disclose that something changed in your living arrangement (and have to repay the HELOC balance) would be another thing to wrestle with.

They are elderly and in poor health generally.  

Once all the health and safety issues are taken care of, your property manager should have a contact for a contractor to handle the rest.

I am having the same dilemma.

We feel we are finally at a point that we can commit to working on increasing our property porfolio for our future retirement.Now my dilemma is that I have no clue what funding options I should seek out to pay this lease to own contract off and that would not put a road block in our plans of acquiring more properties next year?

.- Health issues- Financial issues- Loss of friends- I can go on and on...To those looking for the "magic bullet," here it is,...work harder than everyone else.

Also keep in mind that if you don't pay and they turn off your water, some towns' rule is the water dept. then calls the Board of Health, and the Board of Health would then deem the property uninhabitable (because there is no water!).