Associate Engagements

CCA routinely collaborates with associate resources in connection with providing financial advisory and transactional support services. The following represents select project activities involving such associate relations.

Financial Advisory – Development of a 76 unit Assisted Living Facility in southern New Hampshire representing a capital investment of $12MM. This project was specifically designed and operated to serve a dementia and memory impaired resident population in a residential setting. Further campus development has included the strategic integration of added assisted living and independent living products representing capital investments aggregating in excess of $25MM.

Replacement Project Development – Turnaround management associated with a 112 bed skilled nursing facility controlled by the City of Cambridge in Massachusetts and experiencing deteriorating operating losses exceeding $2MM annually. The strategic plan included stabilization of existing operations, introduction of replacement owners and divestiture of the asset. This plan concluded with the development of a replacement nursing facility representing a capital investment of $15MM and introducing an assisted living component to the project.

Property Acquisition – Successful acquisition bid for a 164 skilled nursing facility in bankruptcy and located in Massachusetts. Served as operators and advisers associated with repositioning, recapitalizing and renovating this asset. Strategic initiatives included the successful renegotiation of specialized Pediatric program rates, labor union contract concessions, elimination of nursing agency and material census improvements. Current efforts include the further expansion of the project campus representing over 12 acres of developable property.

Property Divestiture – Engaged in an operations improvement capacity to a regional hospital provider in the Cape Cod area of Massachusetts involving a distressed 82 bed skilled nursing facility. This engagement evolved into a full scope management capacity. Material operating losses were eliminated and regulatory compliance was restored while this asset was positioned for divestiture. This asset was recapitalized on an interim basis, subsequently sold and is currently operating as a premier sub-acute nursing facility in its market area.

Operations Improvement – Engaged as strategic advisers and replacement managers for a 123 bed skilled nursing facility located in Boston, Massachusetts experiencing severe challenges in both clinical care and financial management. Owned by a major hospital health system provider, this asset was stabilized and achieved EBITDAR improvement from a $2MM operating loss to a $1MM operating profit within twenty four months. This facility was successfully purchased by interests representing the replacement managers.

Clinical Consulting – Engaged as clinical consultants and turnaround managers to a 164 bed non-profit skilled nursing facility owned by a university hospital and healthcare system in New England. Situated on the university campus and medical school, this facility was experiencing operating losses exceeding $3MM annually and was threatened with closure by regulatory authorities. The facility has achieved regulatory compliance evidenced by a deficiency free survey and near break-even operating performance. This asset was subsequently sold to a locally based skilled nursing provider.

Strategic Advisory – Engaged as strategic advisers and operational consultants associated with a family owned nursing and assisted living facility located in New Hampshire. Strategic initiatives achieved included a recapitalization of the project with HUD financing; Medicare and Medicaid certification to achieve maximum skilled nursing capacity; marketing and census development of the ALF component to exceed 92% occupancy; and the development of improved financial and clinical practice standards.