Not-for-profit healthcare

The 32-bed Trinity Regional Hospital Sachse opened in 2021 and was funded through municipal bonds sold through the Wisconsin-based Public Finance Authority.

The state government says community hospitals will be awarded a combined total of close to $300 million of assistance. 

Nashville Senior Care, LLC's Chapter 11 filing impacts bonds sold through conduit issuers in Florida, Ohio and Tennessee.

Not-for-profit community hospitals are drawing scrutiny for questionable business practices.

American Advanced Management signed a letter of intent for a lease-to-buy agreement for Hazel Hawkins Memorial Hospital in Hollister.

Major bondholder Preston Hollow and the trustee for $86 million of debt sold for Mercy Iowa City in 2011 and 2018 pointed to default events.

Extreme temperatures affecting much of the United States add an additional challenge to hospitals still reeling from the pandemic.

Nonprofit assisted living and nursing home bonds continue to be under stress, with defaults and impairments on the rise.

Transactions announced for the second quarter rose to 20 involving $13.3 billion of revenues from 15 in the first quarter and hit a milestone in more closely resembling pre-COVID-19 mergers and acquisition activity, according to Kaufman Hall's quarterly review.

S&P expects improvement although for some borrowers that simply means a reduction in losses, or breakeven to just slightly positive margins.

Clare Oaks' history of fiscal struggles resulted in two bankruptcy filings, the most recent leading to a bond exchange in 2020.

The system is incorporating some floating-rate risk into its fixed-rate debt portfolio to allow for strategic flexibility after its new hospital campus opens.

BJC HealthCare and Saint Luke's Health System signed a letter of intent to form an integrated not-for-profit Missouri-based health system.

Inflation joined supply chain struggles, wage pressures, and the labor shortage — most acutely felt with nursing staff — dragging down the sector's margins.

The system's turnaround efforts include using proceeds of a proposed $710 million deal to sell hospice and home health assets to pay off direct placement debt.

Lawmakers passed a stopgap $150 million loan fund for hospitals in fiscal distress, and will discuss longer-term solutions as the session progresses.

Harris Health System is asking Harris County to place a bond proposition on the November ballot.

Several Midwest hospital mergers that are in the works will contribute to the 2023 numbers while one announced in 2022 just closed.

Moody's Investors Service downgraded Providence St. Joseph Health a notch to A2, following similar moves by S&P Global Ratings and Fitch Ratings.

The acquisition closed Friday and all nine employees, who provide municipal and healthcare advisory services and treasury consulting services, joined PFM.