Health Care Financing

Our Approach

We assist clients in all aspects of health care finance, serving as bond counsel and representing health care providers, banks, underwriters, issuers and indenture trustees. As part of one of the largest Public Finance practices in the nation, few firms can match our depth of knowledge and experience.

Access to capital remains necessary for health care organizations to thrive. Our experience as counsel on a wide range of projects and financing techniques—together with our knowledge of tax and securities law—enable us to advise clients on the best transaction structure and documentation for their needs.

After the transactions close, we frequently counsel clients regarding post-issuance compliance matters, including continuing disclosure requirements, arbitrage rebate calculations and review of physician and management contracts for compliance with applicable tax regulations. We also represent health care organizations subject to Internal Revenue Service audits and those in financial distress regarding compliance with financial covenants and the restructuring of their debt obligations.

Our national Health Care practice strengthens our Health Care Finance team. We understand the business of health care and the complex legal landscape that providers face in an industry undergoing reinvention and transformation. Among other rankings and honors, U.S. News/Best Lawyers named Nixon Peabody “Law Firm of the Year—Health Care Law” for 2016.

The attorneys and resources in the Health Care group support the many areas of law affecting health care providers, including licensing and certificates of need; government investigations and compliance counseling; information technology and privacy; reimbursement and managed care contracting; and hospital/physician alignment strategies. This depth of knowledge is valuable in performing due diligence on behalf of our clients and addressing any disclosure or other legal issues that may arise.

We work with

• Hospitals and health systems
• Academic medical centers
• Children’s hospitals
• Hospital districts and other government-owned health care facilities
• Critical access and rural hospitals
• Catholic and other faith-based hospitals and health systems
• Continuing care retirement communities
• Assisted living facilities
• Skilled nursing facilities
• Physician practices

Recent Experience

• Served as counsel to the underwriters in a $484 million refunding for an Illinois academic medical center and affiliated hospital system.
• Represented one of the largest Catholic health systems in the Midwest in a $285 million financing for a replacement hospital and expansion projects at four other facilities.
• Represented a large Catholic health system with the consolidation of the master trust indentures of its pre-merger legacy organizations. We negotiated with bondholders and bank creditors holding approximately $1 billion of outstanding bonds. We also advised this client regarding remediation of tax-exempt bonds following the sale of certain bond-financed facilities.
• Served as bond counsel to two local economic development corporations in an $81 million financing for one of the largest hospital systems in New York.
• Served as special corporate counsel to one of the largest integrated health systems serving the Intermountain West with an $80 million variable rate financing requiring no third-party liquidity support.