National Healthcare Law

Representative Transactions

The following transactions represent Nelson Mullins’ attorneys experience in healthcare finance (aggregating nearly $5 billion):

Representations of Lead Arranger/Administrative Agent in Syndicated Credit Facilities

  • $345,000,000 syndicated revolving and term loan facility for a long-term acute care hospital operator (including a second lien term loan tranche).
  • $230,000,000 syndicated revolving and term loan facility for addiction treatment centers.
  • $120,000,000 syndicated revolving and term loan facility for hospice services company (including a $35,000,000 second lien term loan facility).
  • $110,000,000 syndicated revolving and term loan facility for long-term acute care hospital system. Documentation included equity co-investment by certain lenders.
  • $101,000,000 of credit facilities for a long-term acute care hospital system (consisting of a $69,000,000 syndicated revolving and term loan facility and a $32,000,000 issuance of senior subordinated notes). Documentation included equity co-investment by certain lenders.
  • $100,000,000 syndicated revolving and term loan facility for group purchasing organization.
  • $100,000,000 syndicated revolving and term loan facility for a long-term acute care hospital operator.
  • $95,500,000 syndicated revolving and term loan facility (including a $30,000,000 second lien term loan facility) for group purchasing organization.
  • $90,000,000 syndicated revolving and multiple tranche term loan facility for addiction treatment company.
  • $85,000,000 syndicated revolving and term loan facility for a home healthcare provider (including a second lien term loan tranche).
  • $65,000,000 syndicated revolving and term loan facility for hospice services company. Documentation included warrants issued to certain lenders.
  • $60,000,000 syndicated revolving and term loan facility for behavioral treatment centers.
  • $55,000,000 syndicated revolving and term loan facility for home healthcare services company.
  • $45,000,000 syndicated revolving and term loan facility for hospice services company. Documentation included equity co-investment by certain lenders.
  • $40,000,000 syndicated revolving and term loan facility for healthcare staffing company.
  • $30,000,000 syndicated revolving credit facility for a medical device manufacturer.
  • $18,500,000 syndicated revolving and term loan facility for cardiology services company.
  • $17,500,000 syndicated revolving and term loan facility for medical equipment manufacturer.

Representations in Subordinate Lender Credit Facilities

  • $9,820,000 mezzanine loan facility with a warrant kicker for a healthcare staffing agency.
  • $2,000,000 mezzanine loan facility for a skilled nursing facility.
  • $4,120,000 mezzanine loan facility for skilled nursing facility.
  • $3,600,000 mezzanine loan facility for series of skilled nursing and assisted living facilities.
  • $3,600,000 mezzanine loan facility for a series of assisted living facilities.
  • $2,250,000 mezzanine loan facility for a skilled nursing facility.
  • $6,000,000 mezzanine loan facility with a warrant kicker for a series of rehabilitation hospitals.
  • $1,050,000 mezzanine loan facility for an institutional pharmacy.
  • $3,000,000 mezzanine loan facility and a $3,000,000 equity investment for several independent living facilities.
  • $2,000,000 mezzanine loan facility for assisted living facility.
  • $2,250,000 mezzanine loan facility for a skilled nursing facility.
  • $2,500,000 mezzanine loan facility for a skilled nursing facility.
  • $1,600,000 mezzanine loan facility for an institutional pharmacy.
  • $3,000,000 mezzanine loan facility for a skilled nursing facility.
  • $2,000,000 mezzanine loan facility for a nursing staffing company.
  • $11,700,000 mezzanine loan facility for an Alzheimer’s care facility.
  • $600,000 mezzanine loan facility for a skilled nursing facility.
  • $3,500,000 mezzanine loan facility to a home health agency.
  • $3,000,000 mezzanine loan facility for a skilled nursing facility.
  • $4,000,000 mezzanine loan facility for a skilled nursing facility.
  • $8,000,000 mezzanine loan facility for a skilled nursing facility.
  • $4,750,000 mezzanine loan facility for a skilled nursing facility.
  • $4,120,000 mezzanine loan facility for a specialty hospital.

Representations in Single Lender Credit Facilities

  • $88,000,000 of credit facilities ($13,000,000 for standby letters of credit and $75,000,000 for standby bond purchase arrangements) for a hospital system.
  • $38,000,000 revolving and bridge loan facility for hospital.
  • $30,000,000 revolving loan facility for pharmacy management services company.
  • $27,000,000 revolving and term loan facility for troubled youth treatment services provider.
  • $25,000,000 revolving and term loan facility for behavioral treatment centers.
  • $25,000,000 revolving and term loan facility for managed care company in connection with subsequent issuance of $7,500,000 of subordinated debt.
  • $24,000,000 letter of credit facility to secure tax exempt bond financing for a nursing home.
  • $20,000,000 revolving loan facility for a Medicare/Medicaid cost recovery provider.
  • $15,000,000 letter of credit facility for hospital.
  • $12,000,000 revolving loan facility for pharmacy management services company.
  • $9,000,000 revolving, construction and term loan facility for an oncology practice with multiple locations in the Southeast.
  • $8,500,000 revolving loan facility for hospital.
  • $8,000,000 letter of credit and revolving loan facility for a nursing home operator with multiple locations in the Southeast.
  • $3,000,000 refinancing of a medical office building.
  • $4,250,000 mezzanine loan facility for home healthcare agency.
  • $1,020,000 senior loan for a skilled nursing facility.
  • $1,650,000 senior loan for a 510(k) licensed drug testing company.
  • $15,000,000 mezzanine loan and $3,750,000 senior loan for several skilled nursing facilities and independent living facilities.
  • $3,000,000 senior loan for a skilled nursing facility.
  • $1,000,000 senior loan and AR line for a radiologist staffing company.
  • $1,100,000 senior loan for an Alzheimer’s care facility.
  • $2,000,000 senior loan for an Alzheimer’s care facility.
  • $275,000 senior loan for a long-term care management company.
  • $2,500,000 mezzanine loan and $520,000 senior loan for several skilled nursing facilities.
  • $16,261,000 senior and mezzanine loans to several skilled nursing facilities.
  • $530,000 mezzanine loan and $100,000 senior loan for several skilled nursing facilities.
  • $4,000,000 senior loan for a skilled nursing facility.
  • $3,400,000 mezzanine loan purchase relating to a loan for a skilled nursing facility.
  • $4,120,000 senior loan for a physical therapy company.
  • $11,500,000 senior loan for several skilled nursing facilities and several assisted living facilities.
  • $3,700,000 senior loan and $1,000,000 equity investment for an assisted living facility.

Representations of Lenders Participating in Syndicated Credit Facilities

  • $841,000,000 syndicated revolving and term loan facility for a health maintenance organization.
  • $495,000,000 syndicated revolving loan facility for a pharmacy services provider.
  • $400,000,000 syndicated revolving loan facility for a pharmacy services provider.
  • $131,000,000 syndicated revolving loan facility for a surgical implant manufacturer.
  • $57,500,000 syndicated revolving and term loan facility for a radiology practice management company.
  • $48,500,000 syndicated revolving and term loan facility for a group purchasing organization.

Representations in Other Healthcare Finance Transactions

  • Representation as issuer counsel in connection with a hospital system’s issuance of over $300,000,000 in aggregate amount of public bonds in a series of five bond offerings.
  • Representation as credit enhancer counsel in connection with a regional hospital system’s issuance of $110,000,000 in public bonds.
  • Representation as issuer counsel in connection with a governmental development authority’s issuance of $100,000,000 in public bonds to fund expansion of a children’s hospital.
  • Representation as issuer counsel in connection with a governmental development authority’s issuance of $87,000,000 in public bonds to fund a general hospital expansion.
  • Representation as bond counsel in connection with a regional hospital system’s issuance of over $77,000,000 in public bonds.
  • Representation as issuer counsel in connection with a governmental development authority’s issuance of $56,000,000 in public bonds to fund the expansion of a spinal injury hospital.
  • Representation of a hospital system in the consolidation and refinance of its existing debt financing through the issuance of $35,000,000 of governmental revenue bonds in preparation for the issuance of $40,000,000 of governmental revenue bonds for capital improvements.
  • Representation of a hospital system in the issuance of $17,500,000 of governmental revenue bonds.
  • Representation of a non-profit hospital system in a $8,500,000 debt financing for infrastructure improvements and renovations.
  • Representation as bond counsel in connection with a primary care facility’s issuance of $8,000,000 of public, tax-exempt, high yield bonds, with a companion issuance of $800,000 of public, taxable, high yield bonds.
  • Representation as underwriter counsel in connection with a radiology practice group’s issuance of $7,395,000 of privately placed demand obligations.
  • Representation as underwriter counsel in connection with an eye surgery center’s issuance of $3,250,000 of privately placed demand obligations.
  • Representation as underwriter counsel in connection with an outpatient rehabilitation facility’s issuance of $2,625,000 of privately placed demand obligations.
  • Representation of a non-profit hospital system in over $1,700,000 in lease financings of medical and hospital equipment.
  • Representation of a public-entity hospital system in a $950,000 lease financing of a CT scanning system.  

Representative Mergers & Acquisitions

The following transactions represent Nelson Mullins’ attorneys experience in mergers and acquisitions in the healthcare industry(aggregating nearly $10 billion).

  • $25,000,000 exchange offer for leading ambulatory surgery center.
  • $8,500,000 acquisition of IDTF freestanding radiology company by public imaging company.
  • $20,000,000 acquisition of software company by healthcare IT company.
  • Acquisition by leading pharmaceutical company of a smaller pharmaceutical company
  • $56,500,000 acquisition of a staffing services company, by another leading staffing company.
  • Acquisition of a durable medical equipment producer by a long term care company.
  • Acquisition of a retail pharmacy by a leading pharmacy company.
  • $41,000,000 acquisition of an online healthcare services company, by a leading internet healthcare company.
  • $207,000,000 acquisition of a staffing services company, by another staffing company
  • Acquisition of a medical supply distributor, by a leading DME company.
  • Acquisition of a medical supply company, by a leading DME company.
  • $12,500,000 acquisition of series of CyberKnife systems.
  • $4,298,000 acquisition of physical therapy company.
  • Acquisition of series of specialty pharmacies by largest public wound care and specialty pharmacy company.
  • Acquisition of DME management company by a medical device supplier.
  • $2,500,000 acquisition by a managed care plan of a PPO.
  • $2,200,000 strategic acquisition of a 510(k) licensed drug testing kit company.
  • $5,000,000 convertible debt offering for a nursing staffing company.
  • $1,000,000 convertible debt offering for an ambulatory surgery center company.
  • $10,000,000 preferred stock offering for an ambulatory surgery center company.
  • $330,000 strategic acquisition by an ambulatory surgery center of another ambulatory surgery center.
  • $27,000,000 preferred stock purchase by private equity group of the largest for-profit hospice company.
  • Acquisition of management agreement of free standing ambulatory surgery center.
  • Majority equity investment in several long term care facilities.