Our Scope of Practice

Our Practice

  • We focus on financing hospitals. Yet many of our clients also own and operate clinics, long-term care facilities, and senior housing developments, and we’ve financed them all and more.
  • Our typical client is an independent critical access hospital in a small, rural community which is not big enough for an investment-grade rating no matter how strong its management team, medical staff, or financial performance. However, we have also served hospitals affiliated with large health systems; located in major metropolitan areas; licensed for more than 100 beds; and which have qualified for bond ratings in the BBB/Baa category.
  • The majority of our clients are non-governmental not-for-profit organizations. However, we also regularly finance health facilities owned by cities, counties, and special-purpose districts.
  • Our typical engagement involves a construction project, whether a facility replacement, an expansion, or a renovation. However, our approach will also support an acquisition, refinancing, or consolidation, or even a major equipment financing need.
  • Most of our clients have been in Minnesota, Wisconsin, Iowa, North Dakota, South Dakota, Nebraska and Illinois. However, our approach is marketable and legally permitted in virtually every state.
  • Our average transaction size for 2015-present was about $15.39 million. However, we have closed financings as large as $63 million, and yet will assist with needs as small as $1 million or so.
  • Most of our financings are privately placed with commercial banks. However, our experience is far broader than our current practice. Clients have asked us to serve as their financial advisor on engagements for which bank placement was not a suitable solution; to arrange taxable financing where a tax-exempt approach was not legally permitted; and to assist them with private placements for other classes of investors. We are happy to explore creative solutions with you, and to execute them for you when we have the needed expertise.
  • We have served as an Independent Registered Municipal Advisor (IRMA) on a number of derivative transactions designed to mitigate interest rate risk.

Our Solution

We use a non-traditional financing technique which involves elements of both tax-exempt public finance and commercial lending.

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