Summit Smith helps healthcare providers identify ownership and financing alternatives for their projects and real estate holdings.

We thoroughly analyze different ownership and financing solutions to determine the effect that different structures have on our clients’ balance sheet, income, cash flow and overall financial picture.  We prepare cost benefit analyses and make recommendations that meet our clients’ goals and objectives and then create and implement ownership and financing structures that fulfill the needs of our clients. 

Our goal is to help clients make informed decisions on ownership structure and financing issues, to feel comfortable with the decisions they make and then properly follow through and implement those decisions.

Facility Ownership

We are often asked by our clients to take the position of both developer and owner of medical office buildings and other ambulatory care facilities.  Our approach to building ownership includes many forms of operating lease, structured finance, off-balance sheet and off-credit alternatives.

In the challenging capital environment that most healthcare providers face today an off-balance sheet, off-credit ownership and financing approach often achieves the strategic objectives of hospitals and healthcare systems looking to preserve cash and debt capacity when developing new facilities. Through an affiliated entity, Summit Smith is prepared to develop, own, and manage to-be-built medical office buildings and other outpatient healthcare facilities based only on the credit of the individual tenant leases – without the need for master leases, credit support agreements, or other direct or indirect guarantees from a hospital or healthcare system.

Unlike traditional debt or equity funding sources, an off-balance sheet and off-credit financing approach does not appear on an organization’s balance sheet or negatively affect credit ratings as ownership of the real estate, the risk of real estate ownership and 100 percent of the responsibility for the debt and equity are assumed by Summit Smith while the hospital or healthcare provider realizes 100 percent of the strategic benefits of the new facility.