Health Care Finance

Wulff, Hansen & Co. is a Registered Municipal Advisor. Registered Municipal Advisors have a fiduciary duty to their clients, and often they are the only party in a nonprofit financing transaction that has a legal obligation to put the interest of their client ahead of their own interests.

Benefit from our years of experience helping hospitals,
clinics, and a wide variety of service providers with
new facilities, equipment and refinancing.

Healthcare Finance with Expert Advisors

From small equipment purchases to major construction projects, our Advisors can help your organization achieve its capital and infrastructure goals. We have facilitated the issuance of financing to fund healthcare projects ranging from $250,000 to $195 million. We can assist in financing for the following purposes:

Equipment, furnishing for exam rooms, dental services, laboratories, education, counseling services and administrative operations can be financed using tax exempt bonds.
  • Purchase of existing health facilities, construction of new facilities, and expansion of existing facilities
  • Solar, energy efficient and seismic compliant infrastructure
  • New equipment and software
  • Refinancing of existing debt, including tax-exempt bonds, bank loans, and new market tax credits
  • Buy out existing leases
  • Other needs or projects may potentially be financed as well – we’re happy to explore options with you

Sample Projects

In 2020, Clinicas del Camino Real financed $23.5 million for the RSJS Health Center in Oxnard as part of a larger tax exempt Bond issue using the California Municipal Finance Authority. It is an approximately 34,082 square foot facility, including a two-story medical office building and clinic.
In 2021 the California Municipal Finance Authority issued $12,295,000 Insured Revenue Bonds for La Maestra Community Health Centers. The funds were used to finance the acquisition and renovation of three new clinics sites in the San Diego area.

Who is Eligible

  • Acute Hospitals
  • Adult day health centers
  • AIDS clinics and hospices
  • Alcoholism recovery, chemical dependency, and rehabilitation facilities
  • Child day care centers
  • Community clinics
  • Community work-activity programs
  • Community mental health facilities
  • Development disability programs
  • Diagnostic or treatment centers
  • Federally Qualified Health Centers
  • Group Homes
  • Multi-level care facilities
  • Psychiatric facilities
  • Public health centers
  • Skilled nursing and intermediate care facilities


The professionals at Wulff, Hansen are experienced in many aspects of health care financing. We have served as financial or municipal advisor, placement agent, underwriter, or consultant in the structuring of many financings designed to meet the needs of almost every type of health care provider, even when those needs are unconventional. Our experience includes not only traditional hospitals, hospital districts and non-profit corporations, but also extends to clinics, substance abuse treatment facilities and mental health facilities of all sizes throughout both urban and rural California. We take particular pride in our health care practice because it can result in such very direct and personal benefit to individual Californians.

Our health facility clients encompass a diverse range of credit strengths. They have ranged from the very soundest institutions to troubled organizations contemplating or experiencing bankruptcy. We have worked with government to develop credit enhancement programs that meet the needs of our clients while also being acceptable to investors. We draw upon longstanding relationships with rating agencies, credit enhancement providers and investors to support our ability to obtain financing for you at cost-competitive levels.

In some cases a health care financing is best completed as a stand-alone transaction where our client is also the issuer. In other cases, if more favorable terms are available by using a conduit issuer, we are an approved member of the State Treasurer’s current Underwriter Pool and thus, even when not acting as Underwriter, are eligible to assist you with programs offered by the California Health Facilities Financing Authority (CHFFA), California Statewide Communities Development Authority (CSCDA) and other governmental authorities. In connection with some of these programs we can assist you in obtaining below-market interest rates or New Market Tax Credit financing for qualifying projects.

Experience and Knowledge Add Flexibility

We are very flexible in responding to your needs as we help you reach your goals, and sometimes this requires unconventional terms or structures. Our experience and reputation means that conduit issuers, credit enhancement providers, rating agencies and investors have been receptive to innovations and changes we have suggested, and have worked with us to establish new and unique programs for health facilities. These have included working to modify the Cal-Mortgage loan guarantee program with the State of California as well as working with investors and credit providers on flexibility when it comes to modifying the projects to be financed and the required security pledges. For example, in one financing where we served as financial advisor, the health facility was given the option to use bond proceeds for any one of three potential projects. If the scope of the project were later reduced, the unspent bond proceeds could be redeemed without penalty. In that same financing we were able to reduce the scope of property provided as security for the bonds, thus giving the institution more future financial flexibility than had been available with their existing financing package.

Far too often in our industry, we find that certain project and financing costs that could have been recaptured from a financing’s proceeds are overlooked. We can advise our clients on the process required to make such previous costs recoverable from proceeds. We view ourselves as your partner in the financing. It is important to us to be sure you are satisfied with the end result and accomplish your goals for the project.

Regardless of the scope of your project or the size of your organization, Wulff, Hansen can help you understand the credit markets for health care finance and the various financing options and programs available to help you realize your vision. We welcome you to call us or email us at for more information.

Recent Clients Include:

  • ACC Senior Services
  • Becoming Independent
  • Clinicas del Camino Real
  • Community Health Centers of the Central Coast
  • El Centro Regional Medical Center
  • Golden Valley Health Centers
  • La Maestra Community Health Centers
  • Orange County Meals on Wheels
  • Oroville Hospital
  • Tarzana Treatment Centers
  • Tulare Regional Medical Center
  • Valley Health Team
  • Vocational Visions

Contact Our Advisors:

Roy Nelson

Senior Vice President & Municipal Advisor Representative

Ben Levine

Senior Vice President & Municipal Advisor Representative

Rob Pankratz

Vice President & Municipal Advisor Representative

Financially Troubled Facilities

We like the challenge of working with troubled health care facilities. Many finance professionals avoid such situations because, compared with ordinary public financings, they may require a larger amount of effort without a comparable increase in compensation. However, we find that these efforts can be very rewarding, as they require professional creativity and can result in important benefits to the institution and the community it serves.