- Details
- By Tribal Business News Staff
- Health Care
San Carlos Apache Healthcare Corporation closed on $46.25 million in taxable revenue bonds to finance a 100-bed long-term care and skilled nursing facility on the San Carlos Apache Tribe's reservation in Arizona.
The transaction, which closed Sept. 17, marks what is believed to be the first credit rating for a tribal healthcare operator in the lower 48 states, according to a KeyBanc deal summary. Fitch Ratings assigned an A- rating to the bonds, among the highest ratings ever achieved by a Native American tribe or tribally chartered corporation.
KeyBanc Capital Markets served as sole initial purchaser for the Series 2025 bonds, which will fund construction of the facility adjacent to the corporation's existing 12-bed critical access hospital, located approximately 130 miles east of Phoenix. The corporation will contribute additional equity to the project.
The corporation broke ground on the Sadie Kniffin Long Term Care and Skilled Nursing Facility in November 2024. The 135,167-square-foot project carries an estimated total cost of $134 million and is expected to open in December 2026. The facility is named after Sadie Stevens Kniffin, the first San Carlos Apache registered nurse.
The financing structure relies solely on revenues and assets from the corporation's health system, with no third-party guarantees. This approach could establish a pathway for other tribal health systems to access capital markets independently for infrastructure projects, according to the deal summary.
The bond terms allow the corporation to issue additional debt without lender consent if certain financial covenants are met. The bonds can be called at par after seven years. Once operational, the facility will be eligible to enter a Section 105(l) lease with Indian Health Services, enabling the corporation to receive federal reimbursements for project costs, including bond debt service.
The facility will create more than 150 permanent jobs and will include long-term care, memory care, skilled nursing and hospice services. Willmeng Construction serves as general contractor and Cuningham as architect. Both companies are based in Phoenix.
San Carlos Apache Healthcare Corporation, known as Izeé Baa Gowáh, operates as a nonprofit subsidiary of the San Carlos Apache Tribe. The corporation currently runs health facilities on approximately 220 acres across two campuses in Peridot and Bylas, Arizona, serving the tribe's 17,270 enrolled members.
