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Bankruptcy Judge Approves ProCure Sale

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A federal bankruptcy judge approved the sale of ProCure on Thursday, despite objections by the losing bidder and doctors at the cancer treatment center, NewsOK.com reported. The final details of the sale were not available, but the initial bid by David Raubach's Oklahoma Proton Center LLC included more than $17.3 million in cash to take on the struggling business. ProCure faced financial uncertainty primarily because insurance companies often refused to pay for proton therapy, which is a different type of radiation treatment for cancer patients. Instead of using X-rays that pass through the body, hitting both sick and healthy tissue, ProCure and other proton therapy centers are able to target cancerous masses and limit a person's radiation exposure. Raubach confirmed the judge's ruling on Friday; a final order was not yet available on the court's website. After the sale is closed, Raubach and two partners will manage the Oklahoma City facility. The plan is to keep it open and begin taking new patients in early 2019. Read more

Examine how current challenges facing the health care industry will lead to future opportunities. Don't miss ABI's “Disruption, Consolidation and Innovation in the Health Care Industry” Program scheduled for January 17 at Georgetown University Law Center. Register here

Judge Denies Washington, D.C.’s Request to Force Providence Hospital to Stay Open

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A D.C. Superior Court judge yesterday denied the District’s request for a temporary restraining order to stop Providence Hospital from shutting down most of its services, the Washington Post reported. The city’s oldest continuously operating hospital, owned by Missouri-based Ascension, began reducing operations last Friday. The medical campus in Northeast Washington, D.C., serving some of the city’s neediest residents, ended outpatient services, closed its operating room and drastically scaled back acute and critical care. The city had claimed that the hospital failed to secure approval from regulators for its closure plans and that its move to shutter most of its operations had violated the terms of its operating license. The attorney general’s office filed the lawsuit after the closures began Friday, citing recently passed legislation that clarifies the city’s ability to challenge hospital closures. While the judge denied the city’s request for a temporary restraining order, the lawsuit is still pending. The hospital said it needed to close because it had been struggling financially and maintained that Washingtonians had enough options for acute care at other hospitals and facilities. In filings with the city, the hospital said it had lost $145 million over the past decade and cited a competitive market, declining patient volumes and aging facilities as factors. Read more

Examine how current challenges facing the health care industry will lead to future opportunities. Don't miss ABI's “Disruption, Consolidation and Innovation in the Health Care Industry” Program scheduled for January 17 at Georgetown University Law Center. Register here

Waco Urology Clinic Spared in Little River Healthcare Closures

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Central Texas Urology will remain open in Waco after severing ties with the bankrupt Little River Healthcare, which has abruptly closed facilities all over Central Texas and eliminated an estimated 300 jobs in Bell, Williamson and Milam Counties, the Waco Tribune reported. The clinic, located in Six West Medical Plaza at Sanger Avenue and State Highway 6, was still seeing patients on Monday and will continue to do so, staffers said. They referred further questions to doctors, who were preparing a statement but had not released it as of early Monday evening. A WARN statement from the Texas Workforce Commission listed Central Texas Urology among the medical providers affected by Little River Healthcare’s decision to shutter facilities following a bankruptcy filing in July. Central Texas Urology was formed in 1980 with two physicians. The CTU website, which features a Little River Healthcare logo at the top of the page, says the office features the services of six urologists “with 75 years’ experience” among them, two physician assistants, nurses and staffers. Read more

Examine how current challenges facing the health care industry will lead to future opportunities. Don't miss ABI's “Disruption, Consolidation and Innovation in the Health Care Industry” Program scheduled for January 17 at Georgetown University Law Center. Register here

December ABI Journal Article Examines Unique Role Government Plays in Health Care Bankruptcies

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Alexandria, Va. —Due to risks surrounding the vulnerability of patients, health care bankruptcies present federal, state and municipal agencies with a unique set of challenges and responsibilities, according to a December ABI Journal article. “Health care bankruptcies are more than financial disputes: They impose life-and-death consequences on the public at large, whose interests are frequently not otherwise represented before the bankruptcy court,” writes Bradley D. Jones of Odin, Feldman & Pittleman, PC (Reston, Va.) in his article “The Government’s Perspective on Health Care Bankruptcies.” “The U.S. Trustee and other state and federal entities typically take a more active posture in order to fill this void.”

Section 333 of the Bankruptcy Code requires the court to appoint a patient care ombudsman within 30 days of the commencement of the bankruptcy case unless the court determines that the appointment is not necessary for the protection of patients, according to Jones. The bankruptcy court still typically looks to the U.S. Trustee to provide its recommendations on whether the appointment is necessary. “To aid its assessment, the U.S. Trustee typically will seek early information from the debtor regarding its health care facility,” Jones writes. “This information will include the services they provide, the history of their care, and any existing framework for supervising and protecting patient care.”

The U.S. Trustee will often also contact state regulatory agencies to gain their perspectives on the debtor's facilities to gain an understanding of the findings in the public record, according to Jones. “While it can be difficult for U.S. Trustees, as non-health care professionals, to determine the seriousness of these issues, these records still provide a history of care issues,” Jones writes.

In exchange, state regulators may also benefit from the U.S. Trustee's knowledge of bankruptcy law and procedure. “Particularly, if the facility is large or the community underserved, the state might have an interest in appearing in the case and presenting the bankruptcy court with its concerns regarding the bankruptcy and the facility's future,” Jones writes.

Regarding the appointment of a patient care ombudsman, Jones thinks that it can be beneficial for debtors. “Not only does the ombudsman provide assurance to the court that a professional is monitoring patient care and representing an otherwise-unrepresented constituency in the bankruptcy case, but the ombudsman helps move the case forward by allowing the parties to move past potential care issues in order to focus on the substantive business problems that need to be addressed by the bankruptcy.” He said that if the case is moving toward an asset sale, the existence of an ombudsman can give the buyer or secured lenders comfort and avoid or reduce due-diligence expenses.

“Ultimately, while there might be costs and burdens in ensuring that patient care is addressed, the sooner patient care issues are removed, the more the bankruptcy case will look like a typical one from both the government's and practitioners' perspectives,” according to Jones.

ABI will be holding a special one-day program on Jan. 17 at Georgetown University Law Center to examine how current challenges facing the health care industry will lead to future opportunities. Issues to be discussed at the “Disruption, Consolidation and Innovation in the Health Care Industry” Program include the delivery of health care, private equity’s takeover of the industry, the rationing of health care services and reimbursements, and more. Members of the press looking to attend should contact ABI Public Affairs Manager John Hartgen at 703-739-0800 or jhartgen@abiworld.org

To obtain a copy of “The Government’s Perspective on Health Care Bankruptcies” from the December edition of the ABI Journal, please click here.

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ABI is the largest multi-disciplinary, nonpartisan organization dedicated to research and education on matters related to insolvency. ABI was founded in 1982 to provide Congress and the public with unbiased analysis of bankruptcy issues. The ABI membership includes nearly 11,000 attorneys, accountants, bankers, judges, professors, lenders, turnaround specialists and other bankruptcy professionals, providing a forum for the exchange of ideas and information. For additional information on ABI, visit www.abiworld.org. For additional conference information, visit http://www.abi.org/education-events.

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Synergy Pharma Shares Slide 55 Percent as It Files for Chapter 11, Clearing Way for Sale to Bausch

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Synergy Pharmaceuticals Inc. shares slid 55 percent in premarket trading yesterday after the company filed for chapter 11 protection, allowing Bausch Health Cos. Inc. to serve as stalking-horse bidder for the company in a court-approved auction and sale processes, MarketWatch.com reported. Bausch, the former Valeant, will acquire Synergy's assets in a deal valued at about $200 million that is expected to close in the first quarter of 2019. Synergy specializes in gastrointestinal therapies, including its flagship Trulance product, a once-a-day table approved for adults with chronic constapion and irritable bowel syndrome with constipation.

Dallas-Based Senior Center Operator Lands in Bankruptcy

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A large Dallas-based operator of senior care, assisted living and hospice facilities in Texas has filed for chapter 11 protection, the San Antonio Express-News reported. Senior Care Centers attributed its financial troubles to declining reimbursement rates, shrinking occupancies, rising rents and other challenges facing the industry. Each of its 120 affiliated companies also filed for bankruptcy protection. Senior Care Centers operates 97 senior living facilities, nine assisted living facilities and six hospice facilities in Texas and Louisiana. It has about 13,000 beds and 11,300 employees. Senior Care hasn’t made any determination yet regarding which facilities it will seek to transfer to new operators, spokesman Tom Becker said. The company lost about $94 million on $910.4 million in revenue last year. It generated $697 million in revenue in the first 10 months of this year but didn’t report its bottom-line results.

Senior Care Centers Wins Approval to Use Cash

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Senior Care Centers LLC, which operates about 110 facilities in Texas and Louisiana, took its first steps under bankruptcy protection during its debut hearing yesterday, WSJ Pro Bankruptcy reported. Judge Douglas Dodd of the U.S. Bankruptcy Court in Dallas said that he would give a green light to the operator of the hospice, skilled-nursing and assisted-living facilities to begin using its lenders’ cash collateral, pending certain changes, to keep day-to-day operations running smoothly. The Dallas-based company filed for chapter 11 protection on Tuesday, saying that at this time, it doesn’t need any additional financing to help get it through bankruptcy. It said that it plans to tap existing cash collateral from secured lenders that include CIBC Bank USA, CIT Finance LLC, MB Financial Bank NA, Bankers Trust Co., Wells Fargo Bank NA and Compass Bank. Senior Care has total liabilities of $267.9 million. That includes $45.6 million in principal and interest outstanding under a credit facility consisting mostly of more than $33 million owed on a revolving loan on which the group of banks holds liens.

Senior Care Centers Files for Bankruptcy

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Senior Care Centers LLC, which operates about 110 facilities in Texas and Louisiana, filed for bankruptcy, blaming “ballooning” rents and “significant cuts” in reimbursements from government agencies and private insurers, WSJ Pro Bankruptcy reported. The Dallas-based company said that it filed for chapter 11 protection on Tuesday to address what it called “burdensome debt levels and expensive leases” at its skilled nursing and assisted- and independent-living facilities. Senior Care is at least the third major health care-facilities operator this year to seek protection from creditors in bankruptcy court; all have cited lease troubles as one reason for the filing. Senior Care also said it faced declining occupancy rates and tighter credit terms from its lenders. The company said that “the immediate cause” for the bankruptcy filing was “liquidity issues,” noting also that comments made by one of its landlords in an earnings call last month put it under pressure from trade creditors and other landlords. Senior Care has total liabilities of $267.9 million, according to court filings. Last year it lost $94.2 million on $910.4 million in revenues, a court filing said.

Commentary: WSU Medical Group Tries to Thread Chapter 11 Needle

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The sudden bankruptcy filing Nov. 8 of the Wayne State University Physician Group was driven by discovery earlier in the year that financial losses of the 264-physician faculty practice plan were double the $5.5 million expected and a new, more drastic turnaround plan was required, according to a Crain's Detroit Business commentary. Over the next four months, as UPG works with the U.S. Bankruptcy Court in Detroit and the hundreds of creditors to come up with a final plan, the future of the 18-year-old faculty practice plan once designed to be a profit center for Wayne State will be made more clear. What is certain, however, is UPG will never become the large, clinically comprehensive and profitable practice plan envisioned by former Wayne State Medical School Dean John Crissman back in 1999. Beyond the current financial crisis, the reasons include mismanagement, overly ambitious growth plans, competition, lack of teamwork and a common goal among physician faculty members, according to the commentary. For at least the next decade, UPG will be, at best, mildly profitable as a much smaller clinical enterprise of 100 to 200 doctors with top-notch specialists. It will also primarily serve as a vehicle to service the medical education contract at Detroit Medical Center, Henry Ford, and the WSU School of Medicine's other residency program commitments. Read more.

Examine how current challenges facing the health care industry will lead to future opportunities. Don't miss ABI's “Disruption, Consolidation and Innovation in the Health Care Industry” Program scheduled for January 17 at Georgetown University Law Center. Register here