Healthcare Finance

Overview

Our invaluable understanding of financial issues in healthcare, combined with our experience with sophisticated health financing techniques—coupled with our knowledge of tax and securities law—enables us to advise clients on the best transaction structure and documentation for their needs. 

We have served as borrower’s counsel, underwriter’s and disclosure counsel, and bank counsel for healthcare providers, issuers, and indenture trustees. We also represent healthcare organizations facing IRS audits or financial distress regarding compliance with financial covenants, and the restructuring of debt obligations.

When it comes to healthcare solutions for healthcare finance, our commitment to client relationships extends beyond the completion of the initial financing transaction. We handle post-issuance compliance and enforcement issues, including program administration, IRS audits, SEC investigations, arbitrage rebate calculation, and investment placement and management. We understand the business of healthcare finance and can guide you through this complex legal landscape.

Representative experience

• Large financial institution Represented in connection with the public offering of over $635 million of tax-exempt and taxable bonds issued on behalf of three different hospitals. The transaction allowed these healthcare systems to refinance existing indebtedness and to construct and equip new healthcare facilities. We advised our clients regarding the structure of each transaction, drafted various public offering documents, and negotiated disclosure and purchase agreements.
• Hospital Represented in connection with its borrowing of over $195 million of tax-exempt bonds issued on its behalf to construct and equip a new general acute care hospital tower
• Underwriters Served as counsel to the underwriters in a $484 million refunding for an Illinois academic medical center and affiliated hospital system
• One of the largest Catholic health systems in the Midwest Represented in a $285 million healthcare financing for a replacement hospital and expansion projects at four other facilities
• Large Catholic health system Represented 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 the remediation of tax-exempt bonds following the sale of certain bond-financed facilities.
• Two local economic development corporations Served as bond counsel to the corporations in a $81 million financing for one of the largest hospital systems in New York
• One of the largest integrated health systems serving the Intermountain West Served as special corporate counsel to the health system with an $80 million variable rate financing requiring no third-party liquidity support

Recognition

• Nixon Peabody has been named a Tier 1 National firm for Health Care Law in the 2025 edition of Best Law Firms® and in consecutive years prior; named “Law Firm of the Year” in Healthcare Law by Best Law Firms in 2016