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Kutak Rock LLP has been working with health care providers for decades on a wide variety of projects to help them meet their complex capital financing needs. We have served as bond counsel, underwriter’s counsel, counsel to the financial advisor, counsel to the hospital, special tax counsel, insurer’s counsel and counsel to commercial banks as direct lender or letter of credit provider, in financings for academic medical centers, acute‑care general hospitals, hospital systems, psychiatric hospitals, specialty hospitals, nursing homes and retirement centers throughout the country. Nationwide we have participated in more than 1,650 health care bond issues aggregating more than $43 billion.

As bond counsel, Kutak Rock structured the first major composite issue of hospital revenue bonds. As underwriter’s counsel, we were involved in structuring one of the first public offerings of AAA‑rated, federally collateralized hospital revenue bonds. We also developed the concept of the variable rate lower floater, which is still widely used in the health care area today.

Our attorneys have extensive experience in all aspects of health care financings, including:

  • Taxable and tax-exempt debt financings
  • Lease financings
  • Bank direct purchases
  • HUD 242 financings
  • Fixed rate and variable rate structures
  • Security structures, rated and unrated, based on master indentures, letters of credit and bond insurance
  • Interest rate swaps and derivative products
  • Refundings and advance refundings
  • Disclosure issues
  • Tax and securities law considerations

Our decades of experience allow us to assist our health care clients in successfully structuring, negotiating and completing complex financing transactions to achieve their capital structure goals.