AHLA Health Care Finance: A Primer (AHLA Members)
Health Care Finance: A Primer addresses all the basics, from a discussion of the particular needs of various types of health care entities, to specific financial arrangements and and the attending documents that are integral to them.
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For those involved with the health care industry, an understanding of the underlying principles of health care finance is a must. The Third Edition of Health Care Finance: A Primer addresses all the basics, from a discussion of the particular needs of various types of health care entities, to specific financial arrangements and the attending documents that are integral to them. In addition, the publication includes sample documents for various types of loans, and sample representations and warranties for life sciences companies and health care facilities.
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Published October, 2015.
Table of contents
Chapter 1 Introduction
1.1 Health Care Finance is More Important than Ever
1.2 Cost of Capital
Chapter 2 Legal and Economic Issues in Health Care Lending
2.1 Health Care Laws
2.2 Payment Issues
Chapter 3 Types of Potential Health Care Providers Needing Capital
3.2 Long-Term Care Facilities
3.3 Life Science Companies
3.4 Medical Device and Equipment Manufacturers
3.5 Other Health Care Providers and Service Companies
Chapter 4 Various Financing Concepts and How They Work
4.1 Cash Flow Financing
4.2 Asset-Based Financing
4.3 Lockbox Lending
4.4 Real Estate Financing
4.5 Equipment Financing and Capital Leases
4.6 HUD Lending for Long-Term Care Facilities
4.7 FHA Section 242 Mortgage Program
4.8 Construction Loans
4.9 Sale-Leaseback Arrangements
4.10 Vendor Financing
4.11 Bond Financing
4.12 Mezzanine Financing<
4.13 Special Issues with Acquisition Financing
Chapter 5 Legal Concepts and Documents Relevant to Most Health Care Transactions
5.1 Term Sheet; Commitment
5.2 Due Diligence
5.3 Structure of the Transaction
5.4 Credit Agreement/Loan Agreement
5.5 Promissory Note
5.6 Legal Opinions
5.7 Deposit Account Control and Restriction Agreement
5.8 Pledge Agreements
5.9 Landlord Waivers
5.10 Commonly Negotiated Loan Provisions
5.11 Post-Default Complications Unique to Health Care
5.12 Special California Rules
Chapter 6 Four Prototypical Deals and Their Related Documents
6.1 Type 1 – Cash Flow Loans
6.2 Type 2 – Real Estate Based Loans
6.3 Type 3 – Asset Based Loans
6.4 Type 4 – Equity Deals
Chapter 7 Potential Credit Enhancement and Risk Reduction Sources
7.1 Letters of Credit
7.4 Interest Rate Risk Protection for Variable Rate Loans: Derivatives, Swaps, and Other Hedging Devices
7.5 Cross-Default and Collateralization Provisions
7.6 Equity Infusions
7.7 Subordinated and Mezzanine Debt
7.9 Capital Markets & Securitization
Chapter 8 Conclusion
Appendix A A Short Primer on Debt, Equity, and Legal Terminology
Appendix B Sample Opinion Long-Term Care Facility (Real Estate Loan)
Appendix C Sample Asset-Based Opinion of Counsel
Appendix D Example Representations and Warranties for Life Science Companies
Appendix E Example Representations and Warranties for Health Care Facilities
Appendix F Flow of Funds Chart-Revolving Loan
Appendix G Revocable Standing Medicare/Medicaid Deposit Account Service Agreement
Appendix H Government Health Care Receivables Deposit Account Agreement