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The Handbook of Municipal Bonds by FRANK J. FABOZZI, SYLVAN G. FELDSTEIN

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CASE STUDY 13
Niagara Falls Memorial Medical Center
Herman R. Charbonneau Senior Vice President & Manager Public Finance Department Roosevelt & Cross, Inc.
 
 
 
This case study discusses a creative financing plan that was developed by a regional banking firm for a client that presented a challenging financial profile.
The Niagara Falls Memorial Medical Center is a 107-year-old facility with 195 certified beds located in the city of Niagara Falls, New York. It is the largest health care provider in Niagara County, with 7,500 admissions annually, 80,000 outpatient visits, and 25,000 emergency room visits. The hospital’s child advocacy center has cared for nearly 1,300 physically and sexually abused children since 1995. The hospital, which employs a staff of 1,200, has had an affiliation with the Buffalo School of Medicine for over 25 years, and provides onsite training for 12 family practice residents. The hospital is a vital part of its community, and provides a disproportionate share of care for indigent, elderly, and otherwise medically underserved constituencies.
The New York State Department of Health granted the hospital approval in 2004 for a $13 million capital project to correct code deficiencies and improve operating efficiencies in its emergency department and noninvasive cardiac services units. My firm undertook the task of financing this improvement. This represented a significant challenge for the firm, as the hospital was viewed by investors as a below-investment-grade ...

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