Tuesday, August 16, 2011

Gentiva May Breach Loan Covenant

Richard Bravo of Bloomberg reports that cuts in Medicare payments may force Gentiva Health Services, Inc., to breach a loan covenant this year, Credit Suisse AG said, as trading prices drop for debt of the largest U.S. home-health and hospice company by sales.

Bloomberg says that the federal Centers for Medicare & Medicaid Services last month proposed a 3.4% reduction to home health payments for 2012 to promote greater payment accuracy. New Medicare cuts issued in November forced the company to trim its projected 2011 sales by as much as $150 million to a range of $1.8 billion to $1.85 billion, Atlanta-based Gentiva said in its second-quarter earnings announcement on August 4.

According to Bloomberg, Medicare may be subject to further cuts if Congress fails to agree on alternative measures to remain in compliance with the debt-ceiling agreement struck this month. Gentiva receives 85.3% of its revenue from the program, and a further reduction in the company's sales could cause it to fall out of compliance with its debt-to-earnings loan covenant. Its loans have fallen 3.5% since July 27.

Gentiva Health Services, Inc., provides home health services throughout the United States. Gentiva is a producer of hospice services in the southeast United States. The Company operations include Home Health segment and Hospice segment.

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

Tenet Names CEO for East Cooper Medical Center

Tenet Healthcare Corporation announced that East Cooper Medical Center has appointed Jason Alexander as its new chief executive officer . As CEO, Alexander will oversee strategic, operational and clinical activities for the 140-bed acute-care hospital in Mount Pleasant, S.C.

"We are pleased that Jason is re-joining our organization.  He is a proven leader who has consistently demonstrated an ability to develop and execute sound strategies, improve operations and clinical quality and work collaboratively with physicians," said John Holland, senior vice president of operations for Tenet's Southern States region.  "His skill set and 15 years of experience in health care management will be integral in enhancing the success of East Cooper Medical Center."

Previously, Alexander served as executive vice president and chief operating officer for Providence Healthcare in Mobile, Ala., where he was responsible for the day-to-day operations of more than 2,350 employees at the 349-bed acute care hospital.  During his five year tenure at the hospital, Alexander created and implemented operational initiatives that generated savings of $14 million, raised patient satisfaction from the 60th to 80th percentile, and improved employee satisfaction from the 50th to the 80th percentile. 
Prior to joining Providence Healthcare, Alexander served as the director of business development and physician operations for Tenet's 602-bed Brookwood Medical Center where he oversaw strategy development, managed ambulatory care centers, and recruited and managed employed physicians. 

Tenet Healthcare Corporation is an investor-owned company that operates in one line of business: the provision of health care services through the operation of acute care hospitals and related health care facilities.  All of Tenet’s operations are conducted through its subsidiaries and affiliates.  Its business includes inpatient care, intensive care, cardiac care, radiology services and emergency medical treatment.

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

Kindred Healthcare Acquires Professional HealthCare for $51 Million

Kindred Healthcare, Inc., announced that its subsidiary has signed a definitive agreement to acquire the equity of Professional HealthCare, LLC, a portfolio company of Mainsail Partners, for $51 million in cash.  Professional HealthCare is a provider of home health, hospice, private duty nursing services and durable medical equipment.  The Company expects to finance the transaction with operating cash flows and proceeds from its revolving credit facility.  Professional HealthCare will have no outstanding long-term debt at closing.

Professional HealthCare operates 27 locations in northern California, Arizona, Nevada and Utah that currently generate annualized revenues of approximately $53 million.  Kindred currently operates 21 nursing and rehabilitation centers and four long-term acute care hospitals within Professional's service areas.  In addition, Kindred's Peoplefirst home health and hospice business currently provides home health services in San Francisco and southern California.

The transaction is subject to several regulatory approvals and other conditions to closing and is expected to close by the end of the third quarter of 2011.  The Company expects that the transaction will be slightly accretive to earnings in 2012.


Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

IPC Inks New $75-Million Wells Fargo Credit Agreement

IPC The Hospitalist Company, Inc., has entered into a new $75 million, five-year secured revolving credit agreement with Wells Fargo Bank, National Association and Comerica Bank as lenders and with Wells Fargo as lead arranger and sole book runner and as administrative agent for the lenders.  The credit agreement will mature on August 4, 2016 and contains an "accordion" feature that allows an increase of $25 million to the facility with lender approval.  Interest rate options for each borrowing include LIBOR plus a margin of either 0.75% or 1.25% based on a leverage ratio, or the lender's prime rate. This new credit agreement replaces IPC's existing $30 million credit agreement that was scheduled to mature on September 15, 2011. At the time of closing there were no borrowings under the existing credit agreement.

Devra Shapiro, Chief Financial Officer of IPC, commented, "The successful completion of this larger five-year credit facility demonstrates the confidence of the financial community in the strength of our financial performance and credit profile.  In addition, we are pleased to develop a new financial relationship with Wells Fargo, while continuing to maintain our long term relationship with Comerica Bank.  We believe that this facility, along with our cash position and positive cash flow from operations, provides us with sufficient capital to continue to fund our organic and acquisition growth strategy."

IPC The Hospitalist Company, Inc., is a leading physician group practice company focused on the delivery of hospitalist medicine and related facility-based services.  IPC's physicians and affiliated providers practice exclusively in hospitals or other inpatient facilities, including acute, sub-acute and long-term care settings.  The Company offers its providers the comprehensive training, information technology, and management support systems necessary to improve the quality and reduce the cost of patient care in the facilities it serves.

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

Tuesday, August 2, 2011

Duke LifePoint Acquires Maria Parham Medical Center

Duke LifePoint Healthcare, a joint venture of Duke University Health System, Inc. and LifePoint Hospitals, and the board of directors of Maria Parham Medical Center (MPMC) have signed a definitive agreement to jointly own and operate MPMC.  The transaction is expected to close within the next 60 to 90 days, subject to review and approval by the Attorney General of the State of North Carolina and the satisfaction of other customary closing conditions.

Under the terms of the agreement, Duke LifePoint will own 80 percent of the new joint venture.  The retained assets of MPMC and the proceeds from the transaction will eliminate MPMC's debt, and the remaining assets -- approximately $30 million -- will be used to create a locally governed charitable foundation that will fund new programs and services in the community.  Duke LifePoint also has committed to investing $45 million in capital improvements at the hospital over the next 10 years.

Duke LifePoint will own 80 percent of all MPMC operations and equipment, and MPMC will retain 20 percent ownership.  To maintain a strong community voice in the governance of the hospital, a 10-member board will be equally represented by Duke LifePoint and MPMC appointees.  A separate hospital advisory board consisting of physicians, local community leaders, MPMC President and CEO Robert Singletary and a representative from Duke LifePoint also will be established.

Maria Parham Medical Center is a private, non-profit, full-service regional hospital serving the people of north central North Carolina and Southside Virginia.  With a team of more than 150 physicians and 700 clinical and support staff, Maria Parham offers a wide range of services and the latest technology to meet the healthcare needs of the community.   Maria Parham, located in Henderson, N.C., is fully accredited by both The Joint Commission and CMS.

Duke LifePoint Healthcare, a joint venture of Duke University Health System, Inc. and LifePoint Hospitals, was established to build a dynamic network of hospitals in North Carolina and the surrounding areas.  The joint venture, which brings together LifePoint's experience in community-based hospital management and Duke's world-renowned leadership in clinical service, is strengthening and improving healthcare delivery by providing community hospitals the clinical, quality and operational resources they need to grow and prosper.

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

Omega Healthcare Closes Four Nursing Homes in Connecticut

Omega Healthcare Investors, Inc., will close four skilled nursing & rehabilitation centers in Connecticut and ultimately lay off a total of 575 workers at the facilities. 

The skilled nursing & rehabilitation centers -- Bishops Corner in West Harford, Rocky Hill, Soundview in West Haven and University in New Haven -- have been in state receivership since January.

In April, the Superior Court has previously ordered the skilled nursing & rehabilitation centers shut down due to their poor financial condition.  All four skilled nursing & rehabilitation centers previously belonged to Haven Healthcare, which filed for Chapter 11 on Nov. 20, 2007, after suffering financial problems and repeated citations for deficient patient care.  Judge Albert S. Dabrowski of the United States Bankruptcy Court for the District of Connecticut dismissed the Chapter 11 cases of Haven Healthcare Management LLC and its debtor-affiliates on Aug. 15, 2008.

Omega Healthcare Investors, Inc., is a Real Estate Investment Trust (REIT) providing financing and capital to the long-term healthcare industry with a particular focus on skilled nursing facilities located in the United States.  At March 31, 2011, the Company owned or held mortgages on 398 skilled nursing facilities, assisted living facilities and other specialty hospitals with approximately 46,172 licensed beds (44,425 available beds) located in 35 states and operated by 50 third-party healthcare operating companies. 

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php.

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

Ventas Leases to Senior Care 32 Assisted Living Facilities

Ventas, Inc., has agreed to lease to a subsidiary of Senior Care, Inc., a total of 32 assisted living and dementia care communities currently operated by Hearthstone Senior Services, L.P.  Simultaneously with the closing of the Transaction, Senior Care will separately acquire the operations of all 32 Senior Care II Communities directly from Hearthstone and will operate them under its "Elmcroft" brand.  The Senior Care II Communities were acquired by Ventas as part of its acquisition of Nationwide Health Properties (NHP) that closed on July 1, 2011.


The 32 Senior Care II Communities, which contain 2,189 units, are located in Arizona, New Mexico, Oklahoma, Texas, Alabama, Florida, Tennessee, Georgia, Ohio, and Michigan.  Senior Care currently operates healthcare and seniors housing assets in six of these ten states. 

Upon closing of the Transaction, Senior Care will be one of the 20 largest seniors housing operators in the United States.

The Company's lease with Senior Care for the Senior Care II Communities will have an initial term of 15 years with two 5-year renewal options.  The Transaction will not change Ventas's corporate projections for the acquisition of NHP.

Completion of the Transaction is subject to certain conditions, including confirmatory due diligence, lender consents for two properties and regulatory approvals.  The Transaction is expected to close in the third quarter of 2011, although there can be no assurance that the Transaction will occur or as to the timing or terms of the Transaction. 

Louisville, Kentucky-based Senior Care, Inc. -- http://www.seniorcare-corp.com/ -- has been a tenant in 64 seniors housing and healthcare communities owned by Ventas since 2006.  Following the Transaction, Senior Care will operate 109 seniors housing and healthcare real estate assets comprised of 84 independent living, assisted living, and dementia care communities with bed capacity of 8,035 in 20 states and 23 skilled nursing and rehabilitation communities with bed capacity of 2,126 in three states, as well as two inpatient rehabilitation hospitals with an 81 bed capacity.  

Ventas, Inc. -- http://www.ventasreit.com/ -- is a leading healthcare real estate investment trust. Its diverse portfolio of more than 1,300 assets in 47 states (including the District of Columbia) and two Canadian provinces consists of seniors housing communities, skilled nursing facilities, hospitals, medical office buildings and other properties.  Through its Lillibridge subsidiary, Ventas provides management, leasing, marketing, facility development and advisory services to highly rated hospitals and health systems throughout the United States.

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

Downey Regional Medical Center to Emerge from Chapter 11 in September

The Downey Patriot reports that Downey Regional Medical Center is aiming to exit Chapter 11 protection in September.

According to the report, Rob Fuller, executive vice president and chief operations officer of Downey Regional Medical Center, said "[The Company] continued to pay a lot of debt the past two years through financial arrangements with banks, obtained invariably with difficulty, but successfully nevertheless. Although the hospital's dysfunctional financial process has had an overhaul, [The Company] still faced with a tough payment schedule." Mr. Fuller said DRMC has just borrowed an additional $56.5 million, $45 million of which is earmarked for paying off "most of very, very old debts," with the balance going to be used for working capital, notes the report.  The report says Mr. Fuller estimates DRMC's working capital needs right now range from $5 million to $10 million a year.

According to the report, one of the conditions mandated by the U.S. Bankruptcy Court was the preparation of a viable reorganization plan. Mr. Fuller said three inspectors from a medical accreditation group made an exhaustive audit of DRMC facilities and operations, and came away impressed with the process improvements the hospital had instituted following its crafted reorganization plan. Mr. Fuller added that a pre-inspection for DRMC's ISO 9001 certification was already performed and the inspector said he would recommend certification.

Downey Regional Medical Center-Hospital, Inc. -- http://www.drmci.org/Home%20Page -- is a non-profit community hospital.  The Company filed for Chapter 11 on Sept. 14, 2009, with the Bankruptcy Court for the Central Court for California, Case No. 09-34714.  Downey is represented in its Chapter 11 case by Lisa Hill Fenning, Esq., at Arnold & Porter LLP in Los Angeles, Calif.  As of the petition date, Downey listed estimated assets and liabilities of $10 million to $50 million.

Information is provided by the Healthcare Prospector. For more information, please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php.

The Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.

HealthSouth Completes Sale of Hospitals to LifeCare

 HealthSouth Corporation has completed the sale of five of its long-term acute care hospitals (LTCHs) to affiliates of LifeCare Holdings, Inc. for approximately $117.5 million, consisting of cash and retained working capital.

"The sale of these long-term acute care hospitals to LifeCare reinforces HealthSouth's strategic focus on our core inpatient rehabilitation hospitals," said HealthSouth President and Chief Executive Officer Jay Grinney.  "We want to recognize and thank our highly skilled employees at these hospitals for their years of service and wish them the best under LifeCare's leadership."

The Company also announced that pursuant to the indenture governing the 10.75% senior notes, it has issued notice to the trustee that it is exercising its call option on the remaining $164 million of these notes. The call is expected to be completed on or about September 1, 2011, and inclusive of the call premium will require a cash outlay of approximately $175 million.

"We will use the proceeds from the sale of the LTCHs, revolver capacity, and cash on hand to fund the call," said HealthSouth Executive Vice President and Chief Financial Officer Doug Coltharp.  "The sale of the LTCHs has accelerated our plan to eliminate the 10.75% senior notes and positions us to achieve our target leverage ratio of 3.0x during 2011.  The removal of this expensive debt from our capital structure will have a favorable effect on our future free cash flow generation."

HealthSouth is the nation's largest owner and operator of inpatient rehabilitation hospitals in terms of revenues, number of hospitals, and patients treated and discharged.  Operating in 26 states across the country and in Puerto Rico, HealthSouth serves patients through its network of inpatient rehabilitation hospitals, outpatient rehabilitation satellite clinics, and home health agencies.   HealthSouth's hospitals provide a higher level of rehabilitative care to patients who are recovering from conditions such as stroke and other neurological disorders, orthopedic, cardiac and pulmonary conditions, brain and spinal cord injury, and amputations. HealthSouth can be found on the Web at www.healthsouth.com.

Information is provided by the Healthcare Prospector. For more information please follow this link http://www.healthcaredatadepot.com/healthcareProspector.php

Healthcare Prospector identifies healthcare providers and other healthcare entities in transition. Coverage includes hospitals, nursing homes, long-term care facilities, physicians' medical groups, ambulatory care and outpatient centers, mental health facilities, healthcare real estate investment trusts (REITs), and medical laboratory and diagnostic imaging services.