The Capital Issue

August-September 2016 

Opportunity is an easy word to build a theme around. We’re always looking for them, we’re excited when we find them and there are always more right around the corner. As we were compiling this edition of The Capital Issue, it quickly became clear that opportunity was the underlying current in all of the articles.

In our feature, we discuss how the low interest rate environment and subsequent changes in bond structures have resulted in the opportunity for nonprofit organizations to realize significant interest expense savings. With our hospital article, we detail the commissioning process and how its emergence presents a great opportunity for hospitals to achieve efficient facilities, save money and better serve their patients. In our senior living piece, we describe the recent growth in both the need and supply of memory care services and the opportunity providers have to fill this demand. For housing, we provide an update on two existing HUD programs—both of which could result in big opportunities for developers to fund renovations to their properties. Finally, in our After the Financing feature, we profile Golden Valley Memorial Healthcare, a hospital in Missouri that successfully capitalized on an opportunity to expand its services by approximately 100,000 square feet and provide its community with top notch health care.

Thanks for being a reader of The Capital Issue. And, as always, if you have any questions or comments please don’t hesitate to reach out.


Nick Gesue, CEO

Opportunities Abound: Health Care Tax-Exempt Capital Markets Update

Opportunities Abound: Health Care Tax-Exempt Capital Markets Update

In an increasingly regulated health care industry with its fair share of challenges, organizations are always on the lookout for opportunities to access low-cost capital to improve and/or expand their facilities.

Commissioning in Health Care

Commissioning in Health Care

Energy usage accounts for more than half of a typical hospital’s annual budget, according to the American Society for Health Care Engineering (ASHE). As the health care industry continues to face pressure to cut costs, hospitals are relying on the commissioning process to ensure that operational expenses and procedures are optimal.

Is Memory Care Mandatory? Providers Build and Expand to Keep Up With Demand

Is Memory Care Mandatory? Providers Build and Expand to Keep Up With Demand

According to the Alzheimer’s Association, one in eight people over the age of 65 has some form of Alzheimer’s. Further, nearly half of seniors age 85 and older have it. Compounding this trend is the fact that by 2030, the population of seniors is expected to double, reaching nearly 74 million.1 This is a message to senior living providers that existing residents who are not necessarily considered to have cognitive impairment may very well need some level of memory care (MC) programing and related assistance. As such, is MC becoming a necessary component of all seniors housing and care facilities? A look at current development trends coupled with rapidly changing demographics suggests the answer is yes.

Small Changes, Big Benefits: HUD Programs Move Forward

Small Changes, Big Benefits: HUD Programs Move Forward

As housing developers well know, the U.S. Department of Housing and Urban Development (HUD) has a litany of programs, provisions and notices designed to improve the availability of housing for low-income residents. Some programs hum along requiring little maintenance, some undergo major transformations regularly and some simply spin their wheels—often as a result of a gridlocked political process.

A Healthy Expansion: Golden Valley Memorial Healthcare

A Healthy Expansion: Golden Valley Memorial Healthcare

Located in west central Missouri, Golden Valley Memorial Healthcare (GVMH) is a nonprofit health care organization that consists of a 56-bed hospital, a home health service and physician and outpatient clinics that offer more than 40 providers and 15 specialties. GVMH aims to provide its largely rural patients with big city services, living up to the Truman Lake-adjacent community’s slogan, “great people, by nature.” GVMH was named one of the “150 Greatest Places to Work in Healthcare” in 2014 by Becker’s Hospital Review and won the Missouri Quality Award in 2013.

The Capital Issue: August-September 2016

Senior Living
After The Financing