Showing posts with label Notes. Show all posts
Showing posts with label Notes. Show all posts

Monday, June 4, 2012

Report card on provincial health systems notes spotty progress for home care

OTTAWA - The latest report card on provincial health policy shows some improvement in offering home care and mental health services, but progress is spotty across the country.

The Health Council of Canada's 2012 progress report says the provinces are generally living up to their 2003 commitments to boost home care, increase the number of doctors and nurses, and develop indicators to show the public how well they are doing.

But the report says progress far from uniform across the country, and is underwhelming.

"The accords have not brought about the large-scale change that was envisioned when they were created," the report says.

The health council puts the blame on the vagueness of the 2003 agreements, and the emphasis on creating a common ground rather than pushing each jurisdiction toward improvement.

Instead of working together to share and implement great ideas, each province has worked by itself to meet poorly defined goals, the report says.

The health council questions whether the provinces are on solid enough footing to proceed with a meaningful plan for the future.

"While these accords were intended to deal with the health care challenges at the time, the country is still grappling with many of the same challenges today."

The provinces are in the midst of hashing out their own joint plan for the future of health care, now that the federal agreement has signalled it does not want to get deeply involved in such policy-setting.

The aim is for the provinces to pool their ideas on innovation so that each province can cut costs, improve service, and avoid creating a patchwork of public health-care services across the country.

When the 2004 accord expires in 2014, Ottawa will continue to increase its health transfers to the provinces for the next decade, but at a lower rate of increase, and with no strings attached.

Cash-strapped provinces are struggling to keep their health-care costs down, even as demand for technology soars, drug costs rise, and the population ages.

"In order to understand where Canada's health-care system should be headed, there must be an understanding of where it is today," the report says.

Specifically, the health council found that many provinces are implementing mental health strategies, but that they don't always include them in their plans for home care.

The council also found inconsistencies in the way provinces were providing coverage for end-of-life care.

The report also notes that the number of doctors grew 12 per cent from 2006 to 2010, while the number of nurses rose six per cent, and the number of pharmacists was up 16 per cent. But the report notes that provinces are challenged in dealing with the huge costs associated with human resources.

The territories also have major problems attracting and retaining health care professionals, the report says.

As for tele-health, the assessment found huge growth. Tele-health services have expanded by 35 per cent a year for the last five years, now encompassing 1,175 communities.

The report also notes a major shortage of national, comparable indicators that allow the public to easily compare one jurisdiction to another.

The council said the provinces would be wise to heed the findings of its report card, and previous assessments, as they strike out on their own to reform health care in Canada.

"Real progress is made when comprehensive strategies with concrete targets are put in place," said council chairman Dr. Jack Kitts.

"An improved approach to goal-setting and performance measurement in the health system will provide greater impetus to change and achieve higher levels of progress."


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Monday, April 2, 2012

Vanguard Health Systems Announces Closing of $375.0 Million Senior Notes Offering

Vanguard Health Systems, Inc. (NYSE: VHS) (“Vanguard”) announced today that its wholly-owned subsidiaries, Vanguard Health Holding Company II, LLC (“VHS Holdco II”) and Vanguard Holding Company II, Inc. (together with VHS Holdco II, the “Issuers”), closed their private placement of an aggregate principal amount of $375.0 million of 7.750% Senior Notes due 2019 (the “New Notes”). The New Notes were issued pursuant to the indenture, dated as of January 26, 2011 (the “Indenture”), governing their existing 7.750% Senior Notes due 2019 (the “Existing Notes”). The New Notes were issued at an offering price of 99.25% plus accrued interest from February 1, 2012. The New Notes will be treated as a single series with the Existing Notes, except that (i) the New Notes are subject to a separate registration rights agreement and (ii) unless and until the New Notes are registered, the New Notes will have a different CUSIP number from that of the Existing Notes and will not be fungible with the Existing Notes.

The Issuers intend to use the net proceeds from the offering of the New Notes for general corporate purposes, which may include, but not be limited to, working capital, capital expenditures, acquisitions, the repayment of any outstanding indebtedness under Vanguard’s existing revolving credit facility, and to pay the fees and expenses incurred in connection with the offering.

This announcement does not constitute an offer to sell or the solicitation of an offer to buy the New Notes. The New Notes were offered in a private placement to qualified institutional buyers pursuant to Rule 144A and outside the United States in compliance with Regulation S under the Securities Act of 1933, as amended (the “Securities Act”).

The New Notes have not been registered under the Securities Act, and may not be offered or sold in the United States absent registration or an applicable exemption from registration requirements.

Company Information and Forward-Looking Statements

About Vanguard Health Systems

Vanguard owns and operates 28 acute care and specialty hospitals and complementary facilities and services in metropolitan Chicago, Illinois; metropolitan Phoenix, Arizona; metropolitan Detroit, Michigan; San Antonio, Texas; Harlingen and Brownsville, Texas; and Worcester and metropolitan Boston, Massachusetts. Vanguard’s strategy is to develop locally branded, comprehensive healthcare delivery networks in urban markets.

This press release contains “forward-looking statements” within the meaning of the federal securities laws that are intended to be covered by safe harbors created thereby. Forward-looking statements are those statements that are based upon management’s plans, objectives, goals, strategies, future events, future revenue or performance, capital expenditures, financing needs, plans or intentions relating to acquisitions, business trends and other information that is not historical information. These statements are based upon estimates and assumptions made by Vanguard’s management that, although believed to be reasonable, are subject to numerous factors, risks and uncertainties that could cause actual outcomes and results to be materially different from those projected. When used in this press release, the words “estimates,” “expects,” “anticipates,” “projects,” “plans,” “intends,” “believes,” “forecasts,” “continues” or future or conditional verbs, such as “will,” “should,” “could” or “may,” and variations of such words or similar expressions are intended to identify forward-looking statements. These factors, risks and uncertainties include, but are not limited to: Vanguard’s high degree of leverage and interest rate risk; Vanguard’s ability to incur substantially more debt; operating and financial restrictions in Vanguard’s debt agreements; Vanguard’s ability to generate cash necessary to service its debt; weakened economic conditions and volatile capital markets; potential liability related to disclosures of relationships between physicians and Vanguard’s hospitals; post-payment claims reviews by governmental agencies could result in additional costs to Vanguard; Vanguard’s ability to grow its business and successfully implement its business strategies; Vanguard’s ability to successfully integrate The Detroit Medical Center, Valley Baptist Health System, and hospitals acquired in the future or to recognize expected synergies from such acquisitions; potential acquisitions could be costly, unsuccessful or subject Vanguard to unexpected liabilities; conflicts of interest that may arise as a result of Vanguard’s control by a small number of stockholders; the highly competitive nature of the healthcare industry; governmental regulation of the healthcare industry, including Medicare and Medicaid reimbursement levels in general and with respect to the impact of the Budget Control Act of 2011 and other future deficit reduction plans; a reduction or elimination of supplemental Medicare and Medicaid payments, including disproportionate share payments, indirect medical education/graduate medical education payments and other similar payments, would adversely impact Vanguard’s liquidity, results of operations and financial condition; pressures to contain costs by managed care organizations and other insurers and Vanguard’s ability to negotiate acceptable terms with these third party payers; Vanguard’s ability to attract and retain qualified management and healthcare professionals, including physicians and nurses; the currently unknown effect on Vanguard of the major federal healthcare reforms enacted by Congress in March 2010 or other potential additional federal or state healthcare reforms; potential adverse impact of known and unknown governmental investigations and audits; Vanguard’s failure to adequately enhance its facilities with technologically advanced equipment could adversely affect its revenues and market position; the availability of capital to fund Vanguard’s corporate growth strategy and improvement to its existing facilities; potential lawsuits or other claims asserted against Vanguard; Vanguard’s ability to maintain or increase patient membership in and to control costs of its managed healthcare plans; failure of the Arizona Health Care Cost Containment System (“AHCCCS”) to renew its contract with, or award future contracts to, Phoenix Health Plan would materially affect Vanguard’s business, profitability, financial condition and results of operations; Phoenix Health Plan’s ability to comply with the terms of its contract with AHCCCS, as noncompliance could subject it to fines, penalties or termination of its contract, which would materially affect Vanguard’s business, profitability, financial condition and results of operations; Vanguard’s inability to manage health plan claims expense within its health plans could reduce its profitability and adversely impact its liquidity and financial position; reductions in the enrollment of Vanguard’s health plans could have an adverse effect on its business and profitability; changes in general economic conditions nationally and regionally in Vanguard’s markets; Vanguard’s exposure to the increased amounts of and collection risks associated with uninsured accounts and the co-pay and deductible portions of insured accounts; dependence on Vanguard’s senior management team and local management personnel; volatility of professional and general liability insurance for Vanguard and the physicians who practice at its hospitals and increases in the quantity and severity of professional liability claims; Vanguard’s ability to achieve operating and financial targets and to maintain and increase patient volumes and control the costs of providing services, including salaries and benefits, supplies and other operating expenses; increased compliance costs from further government regulation of the healthcare industry and Vanguard’s failure to comply, or allegations of Vanguard’s failure to comply, with applicable laws and regulations; the geographic concentration of Vanguard’s operations; technological and pharmaceutical improvements that increase the cost of providing, or reduce the demand for, healthcare services and shift demand for inpatient services to outpatient settings; a failure of Vanguard’s information systems would adversely impact Vanguard’s ability to manage its operations; delays in receiving payments for services provided, especially from governmental payers; changes in revenue mix, including changes in Medicaid eligibility criteria and potential declines in the population covered under managed care agreements; costs and compliance risks associated with Section 404 of the Sarbanes-Oxley Act of 2002; material non-cash charges to earnings from impairment of goodwill associated with declines in the fair market value of Vanguard’s reporting units; volatility of materials and labor costs for, or state efforts to regulate, potential construction projects that may be necessary for future growth; changes in accounting practices; and Vanguard’s ability to demonstrate meaningful use of certified electronic health record technology and to receive the related Medicare or Medicaid incentive payments.

Vanguard’s forward-looking statements speak only as of the date made. Except as required by law, Vanguard undertakes no obligation to publicly update or revise any forward-looking statements contained herein, whether as a result of new information, future events or otherwise. Vanguard advises you, however, to consult any additional disclosures Vanguard makes in Vanguard’s other filings with the Securities and Exchange Commission. You are cautioned not to rely on such forward-looking statements when evaluating the information contained in this press release. In light of significant uncertainties inherent in the forward-looking statements included in this press release, you should not regard the inclusion of such information as a representation by Vanguard that the objectives and plans anticipated by the forward-looking statements will occur or be achieved or, if any of them do, what impact they will have on Vanguard’s financial condition, results of operations or cash flows.


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Sunday, April 1, 2012

Health Care REIT, Inc. Announces Pricing of $600 Million of 4.125% Senior Notes

Health Care REIT, Inc. (NYSE:HCN) today announced that it has priced $600 million in aggregate principal amount of 4.125% senior unsecured notes due April 1, 2019. The notes were priced at 99.694% of their face amount to yield 4.176%. Subject to customary closing conditions, the offering is expected to close on April 3, 2012.

The company intends to use the net proceeds from this offering to redeem or settle upon conversion approximately $126 million aggregate outstanding principal amount of its 4.75% convertible senior notes due 2026 at a redemption price of 100% of principal amount plus accrued and unpaid interest or the conversion price specified in those notes, as the case may be, to repay up to $226 million of certain secured indebtedness and, to the extent of remaining proceeds, for general corporate purposes, including investing in health care and seniors housing properties. Pending such use, the net proceeds may be invested in short-term, investment grade, interest-bearing securities, certificates of deposit or indirect or guaranteed obligations of the United States.

Barclays Capital Inc., J.P. Morgan Securities LLC, and UBS Securities LLC acted as joint book-running managers for the offering.

The offering is being made pursuant to Health Care REIT’s shelf registration statement on file with the Securities and Exchange Commission. A copy of the prospectus supplement and accompanying prospectus relating to the offering may be obtained by contacting Barclays Capital Inc., c/o Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717, by phone (toll free): 888-603-5847 or by e-mail: barclaysprospectus@broadridge.com; J.P. Morgan Securities LLC, 383 Madison Avenue, New York, NY 10179, attention: Investment Grade Syndicate Desk, or by telephone collect at 212-834-4533; or UBS Securities LLC, Attention: Prospectus Specialist, 299 Park Avenue, New York, NY 10171, or by telephone toll free at 877-827-6444, ext. 561 3884.

This press release is not an offer to sell, nor a solicitation of an offer to buy securities, nor shall there be any sale of these securities in any state or jurisdiction in which the offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of such state or jurisdiction.

About Health Care REIT. Health Care REIT, Inc., an S&P 500 company with headquarters in Toledo, Ohio, is a real estate investment trust that invests across the full spectrum of seniors housing and health care real estate. The company also provides an extensive array of property management and development services. As of December 31, 2011, the company’s broadly diversified portfolio consisted of 937 properties in 46 states. More information is available on the company's website at www.hcreit.com.

Forward-Looking Statements

This document may contain “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. When the company uses words such as “may,” “will,” “intend,” “should,” “believe,” “expect,” “anticipate,” “project,” “estimate” or similar expressions, it is making forward-looking statements. Forward-looking statements are not guarantees of future performance and involve risks and uncertainties. The company’s expected results may not be achieved, and actual results may differ materially from expectations. This may be a result of various factors, including, but not limited to, those factors discussed in the prospectus supplement and related prospectus and in the company's reports filed from time to time with the Securities and Exchange Commission. Completion of the proposed offering is subject to various factors, including, but not limited to, customary closing conditions. The company assumes no obligation to update or revise any forward-looking statements or to update the reasons why actual results could differ from those projected in any forward-looking statements.


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Health Care Prices Senior Notes

Health Care REIT, Inc. (HCN) recently announced that it has priced 4.125% of senior unsecured notes for approximately $600 million. These notes are expected to mature on April 1, 2019 and were priced at 99.694% of their face value to generate 4.176%.  The offering is expected to close on April 3, 2012.

The company expects to use the net proceeds from the offering to repay approximately $126 million of its 4.75% convertible senior notes maturing in 2026 at a redemption price of 100% of principal amount, including accrued and unpaid interest to pay off up to $226 million of certain secured indebtedness.  The remaining proceeds will be used for other general corporate purposes, including investments on health care and seniors housing properties.

Health Care reported fourth quarter 2011 FFO (funds from operations) of $154.4 million or 83 cents per share compared with $85.1 million or 61 cents in the year-earlier quarter. Fund from operations, a widely used metric to gauge the performance of REITs, is obtained after adding depreciation and amortization and other non-cash expenses to net income.

During fiscal 2011, Health Care raised over $4 billion capital from debt and equity offering, including $700 million in fourth quarter 2011. At year-end 2011, the company had cash and cash equivalents of $163.5 million and total debt of $7.2 billion.

Health Care is a real estate investment trust (:REIT) that invests across the full spectrum of senior housing and health care real estate properties. Headquartered in Toledo, Ohio, Health Care REIT also provides an extensive array of property management and development services.

Health Care currently retains a Zacks #3 Rank, which translates into a short-term Hold rating. We are also maintaining our long-term Neutral recommendation on the stock. One of its competitors, HCP Inc. (HCP), currently has a Zacks #3 Rank.

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