Practice Areas: Public Finance

Hospital and Health Care Financings

Healthcare and hospitals are big business. They’re in an industry that is growing rapidly. They have unique risks and opportunities. And they operate in a distinct regulatory atmosphere, as the way they are viewed by the FTC and IRS constantly evolves. As a result, healthcare financings have become increasingly complex.

Continuing care facilities and nursing homes face their own sets of challenges, as the industry matures and investors are becoming more interested in their operations.

To thrive in this ever-changing world, hospitals and other healthcare facilities need the counsel of an experienced firm that keeps up with the changes. At McGuireWoods, our experience spans more than 30 years and includes participation in transactions for organizations ranging from large teaching hospitals like the University of Virginia, The Vanderbilt University Hospital, Duke University Health System, the Medical University of South Carolina and the Greenville Hospital System, to small nursing home facilities. Our services in this practice area include:

• Serving as bond counsel, underwriter's counsel, lender's counsel and borrower's counsel
• Drafting and negotiating complex financing structures, including master indentures with obligated groups and negative pledges on property, as well as more traditional security interests and mortgages
• Structuring innovative financing techniques including Internet auctions, variable rate issues, letter of credit backed issues, demand and "soft put" bonds, and auction reset securities

We also have substantial experience with FHA-insured hospital mortgage bond financings and with derivative products, both of which are growing financing techniques among healthcare providers, and we have undertaken numerous public and private offerings, both tax-exempt and taxable.

McGuireWoods has been at the forefront of financings for the growing sector of retirement housing as well, including continuing care retirement communities and assisted living facilities. Our experience includes orchestrating multijurisdictional financings such as Sunnyside Presbyterian Homes and Virginia Baptist Homes. We have also participated in a series of transactions for outstanding stand-alone facilities such as Friends Homes, Baptist Retirement Homes of North Carolina, Deerfield Episcopal Retirement Community facilities in North Carolina, and the five Westminster-Canterbury facilities in Virginia. In addition, we have extensive experience in the use of federal low income and rehabilitation tax credits on financing tools for senior living projects.

Representative Clients

Wake Forest University Health Sciences
Howard Hughes Medical Institute
Duke University Health System
Beth Israel Medical Center, NY
St. Luke's-Roosevelt Hospital Center, NY
The New York Hospital, NY
New Hanover Regional Medical Center, NC
University Health Systems of Eastern Carolina, Inc.
The Vanderbilt University Hospital
The Long Island College Hospital
The Virginia Hospital Center
Medical College of Virginia Hospital
University of Maryland Medical System
North Carolina Baptist Hospital
WakeMed, NC
The Moses Cone Health System, NC
Novant Health, Inc., NC
Carilion Health System, VA
Inova, VA
Augusta Health Care, VA
MediCorp Health System, VA
Richland County Memorial Hospital, SC
Anderson Area Medical Center, SC
Greenville Hospital System, SC
North Arundel Health System, MD
Nash Health Care Systems, NC
Iredell Memorial Hospital, NC
Rex Healthcare, NC
Southeastern Regional Medical Center, NC
Martha Jefferson Hospital, VA
Winchester Medical Center, VA
Halifax Regional Health System, VA
Lexington Memorial Hospital, NC
WestCare, NC
Halifax Regional Medical Center, NC
Morehead Memorial Hospital, NC
Maria Parham Medical Center, NC
Onslow Memorial Hospital, NC
Stanly Memorial Hospital, NC
Wayne Memorial Hospital, NC
Stonewall Jackson Hospital, VA
Page Memorial Hospital in Virginia,
Loris Community Hospital, SC
Beaufort Memorial Hospital, SC
The Kendal Corporation
Erickson Retirement Communities, Inc.
The Piedmont Foundation, Inc.
United Housing, Inc.