Public Finance: Health Care

Representative Transactions

• Represented a New York community hospital system finance and refinance the replacement of two antiquated hospitals with a $300 million replacement hospital, the first new hospital to be constructed in New York State in over 20 years. Representation included: the sale of non-core real estate assets; the sale/leaseback of a large medical office building to a commercial developer; application for and receipt of approximately $50 million in State grant funds to support the development of the replacement hospital and to retire debt associated with the existing hospitals; the retirement of outstanding debt on the existing hospitals; the sale/leaseback (during construction of replacement hospital) of the two antiquated hospital facilities to two separate newly created non-profit community development corporations; the long-term bond financing and refinancing of a portion of the costs of the replacement hospital and the long-term bond financing of a new medical office building on the replacement hospital campus.
• Represented a California community hospital finance a $250 million replacement hospital for seismic purposes.
• Represented a hospital located in one of the pandemic epicenters in New York City – designated as Level IV (highest level of hospital emergency in New York State) – in a major modernization project. Utilized bond financing and CARES Act monies including special COVID-19 reimbursement enhancements and sequester/health care reduction reversals, as well as special Medicare advances through CMS, all as additional support. Notable aspects include the first tax-exempt HUD mortgage-insured project in the country in 10 years, the release of multiple properties from existing HUD mortgage liens, the ability to substitute real estate for cash collateral and SEC recommended forward-looking disclosures in light of the pandemic.
• Over the span of a decade, we have represented a regional nonprofit CCRC organization. We have assisted with several financings in 3 states. The financings have included both public and private, tax-exempt and taxable refundings, often involving construction. During the course of our relationship, we also aided in work-out discussions, disclosure issues, private use questions as well as general operational, nonprofit, and other legal issues.