title: The use of debt.
abstract: Stewards of Catholic healthcare organizations must proceed cautiously before embarking on new construction or renovation projects. Many important issues are involved in financing such projects, including business risk, financial philosophy, financial structure, and forms of debt. The proper foundation for any financing structure must begin with financial philosophy. Some healthcare facilities have traditionally used no external financing; others have employed significant levels of debt. To determine a proper level of debt for the project(s) being financed, it is important to look at business risk. If a modest decline in revenues (or a similar increase in costs) would threaten the project's viability, the business risk would be high; therefore prudence would dictate that the level of debt undertaken be relatively small. A separate analysis is required to determine the appropriate mix of floating-rate and fixed-rate long-term debt. As a rule of thumb, fixed-rate debt would typically form two thirds of the debt structure; floating-rate debt, no more than one third. For healthcare, debt can take two forms: tax exempt and taxable. Tax-exempt financing has many constraints, including use of proceeds by a tax-exempt entity, arbitrage rules, tax legislation, and financial disclosure laws. Taxable debt can be issued by private placement or on a publicly traded basis.
authors: W L
authors: WL
authors: Hood
authors: C V
authors: CV
authors: Loughery
mesh_terms: D002410:Catholicism; D005376:Financial Management / Q000379:methods*; D005379:Financing, Construction / Q000379:methods*; D006749:Hospital Design and Construction / Q000191:economics*; D012306:Risk; D013660:Taxes; D014481:United States