Our goal is to support managerial decision making and strategic initiative development through application of industry awareness and the wide variety of HFS skill sets. Our experience and analytical abilities have supported managerial decision making and strategic initiatives in provider services arenas including, but not limited to:
- Acute care (community hospital through academic healthcare systems)
- Ambulatory surgery
- Radiation Oncology
- Cardiac catheterization
- Skilled nursing and long-term care
- Rehabilitation services
- Physician practice assessment and management
Only through numerous and varied encounters with a variety of healthcare providers does one learn to talk to the appropriate people, ask the right questions, drill down on the meaningful data and to arrive at accurate conclusions. Ultimately, we seek to answer: what are the margins, where are they developed, what sustains them, and where are they at risk?
Crucial to project planning and analysis is the accurate determination of capital requirements and related evaluation of debt capacity and funding alternatives. We evaluate sources of funding to optimize capital structure, address and minimize financial risk and streamline the funding process.
Our experience with the HUD/FHA 242 program and Cal Mortgage financings make us a leader in feasibility analysis in support of those financing sources. In the five years ending in spring of 2012 alone, HFS market and financial feasibility studies have supported 10 acute care tax-exempt bond financings with principal offerings totaling nearly $1.4 billion (1). Approximately $625mm of this total was in support of HUD/FHA 242 program financings, with the remainder dominated by Cal Mortgage financings. This figure of course does not include financings put on hold, terminated or still in process during these years.
(1) Two of these financings are currently under Cal Mortgage review.
The goal is to provide all the above within the framework of the ever evolving, increasingly complex healthcare industry regulatory environment. Our knowledge and experience has assisted clients in evaluation and development of joint ventures, freestanding service establishment, divestiture and acquisition, operational enhancement, re-capitalization and re-configuration of a wide variety of provider services. All of these planning efforts and initiatives must be mindful of Stark Regulations, Anti-Kickback statutes and, of course, ever evolving payment and reimbursement regulations and provisions.