Case Study:Care Initiatives

1611 West Lakes Parkway Des Moines, IA 50266

Created in 1989, Care Initiatives, a non-profit corporation, owns and operates 44 skilled nursing care locations and eight assisted living locations throughout Iowa. Care serves the special needs of nearly 2,800 elderly adults and is the largest single operator of nursing homes in Iowa.  All of Care’s facilities provide 24-hour professional nursing care in addition to regular medical, nursing, social and rehabilitative services.

Project Overview

Wye River has served as financial advisor to Care Initiatives since 2006. We provide Care Initiatives with strategic planning and advisory services and have facilitated six financing transactions totaling $190 million, The proceeds of those transactions have been used to fund (1) improvements to existing facilities, (2) the acquisition or construction of new facilities and (3) the refinancing of outstanding debt for savings.

Wye River Group’s Role

Throughout Wye River Group’s ongoing engagement, we have been fortunate to provide a wide range of services to Care Initiatives, including:

  • Assessment of financing alternatives and identification of opportunities for debt service savings,
  • Development of the Plan of Finance for each transaction
  • Solicitation of qualified firms to underwrite the financings
  • Evaluation of financing proposals and recommendations of lenders
  • Development of credit rating presentations to Standard and Poor’s
  • Support of selected underwriting firms in the development of bond investor presentations and related discussions
  • Negotiation of key covenants and structures of the bond issues resulting in significant debt service saving and flexibility for the development of Care’s future projects

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