Sanford Health $736,975,000 Series 2019 Bonds

December 5, 2019

Cain Brothers served as Sole Manager for $736,975,000 of fixed rate bonds (the “Bonds”) for Sanford Health (“Sanford”), comprised of $352,375,000 Series 2019A tax-exempt bonds and $384,600,000 Series 2019B taxable bonds rated “NR/A+/A+”. Sanford is headquartered in Sioux Falls, SD and owns or manages 40 hospitals in western Minnesota, Iowa and the Dakotas with a service area covering more than 250,000 square miles. Sanford employs over 24,000 full time employees, including approximately 1,450 physicians and reported revenues of $4.8 billion and $2.7 billion in net assets for the 2018 fiscal year.

On January 2, 2019, Sanford affiliated with Evangelical Lutheran Good Samaritan Society (“ELGSS”) assuming approximately $630 million of tax-exempt bonds and other liabilities. The addition of ELGSS provides Sanford a post-acute care presence in 24 states at 375 facilities with more than half of the facilities in Sanford’s footprint acute care markets.

In June 2019, Sanford closed on a $655,006,000 bridge loan (the “Bridge) with KeyBanc Capital Markets (“KBCM”), structured and closed over a one-month period, to preserve “Acquisition Financing” treatment by refinancing the ELGSS bonds. The Bridge represents one of the largest non-syndicated bridge financings ever completed for a not-for-profit health care credit and is an illustration of the balance sheet lending that Cain Brothers can provide its clients as a division of KBCM.

Proceeds of the Bonds were used to refinance the Bridge, Sanford Series 2009 Bonds, Sanford Series 2014C and E Bonds, and several bank loans. The “Acquisition Financing” provisions which allowed for tax-exempt proceeds to essentially advance refund the ELGSS bonds.  Sanford also modernized its Master Trust Indenture and received a new credit rating of A+ (positive) from Fitch. The permanent financing and Bridge generated $146.3 million in total cash flow savings, with $90.9 million in NPV savings or 12.9% of refunded par. The 2049 tax-exempt maturity with a 5.00% coupon priced at a spread of 60 basis points to MMD for a yield to the 10-year call of 2.73% and the 2049 taxable maturity priced at a 155 basis point spread to the 30-year Treasury, resulting in a yield of 3.85%. Investor demand was significant with approximately 100 accounts participating in the two order periods with orders of approximately $3.4 billion.

For more information, please contact:

Bart Plank

Managing Director
Co-Head Healthcare Public Finance
(212) 981-6915