California Health Facilities Financing

Featured Projects



Cedars-Sinai Health System
8700 Beverly Boulevard
Los Angeles, CA 90048

Cedars-Sinai Health System (the System), whose original Cedars-Sinai Medical Center campus was incorporated in 1961, is a California nonprofit academic healthcare organization that provides a full complement of primary care, specialty and subspecialty services. The System, which primarily serves the Los Angeles region, has grown to include Cedars-Sinai Marina Del Rey Hospital, Torrance Memorial Medical Center, and Huntington Hospital.

Project:

On October 28, 2021, CHFFA approved the System’s request to issue up to $1.6 billion in fixed-rate, tax-exempt bonds. The proceeds will be used to finance the costs of the construction of the Marina Del Rey replacement hospital. The new nine-story, 258,500 square-foot, seismically compliant replacement hospital will provide 160 patient beds and feature new or enhanced services, such as cardiac catheterization and gastroenterology labs and suites for complex procedures. In addition, the bond proceeds also will be used to refund various outstanding bonds and construct a two-story energy center building, corresponding parking lots and other supporting structures.

Sutter Health

Sutter Health
2200 River Plaza Drive
Sacramento, CA 95833

Sutter Health (Sutter), a California nonprofit public benefit corporation, operates primarily in Northern California and provides a broad range of health care services, including acute, sub-acute, long-term, home health, and outpatient care, as well as physician delivery systems. Sutter delivers a full range of health care products and services to the communities it serves through an integrated health care delivery approach.

Project:

On July 7, 2016, CHFFA approved Sutter’s request to issue up to $1.026 billion in fixed-rate and variable rate, tax-exempt bonds. The bond proceeds were used to finance, including reimbursement for, the costs of acquisition, construction, and expansion of two new replacement hospitals located in San Francisco. One replacement hospital included the construction of a new 765,000 square foot, 274-bed hospital along with a 250,000 square foot parking structure. The new 12-story hospital includes women’s, children’s, cardiology, oncology, transplant, and emergency departments. The other replacement hospital included the construction of a new 237,000 square foot, 120-bed hospital that provides an expanded emergency department and obstetrics and a full range of inpatient services. The bond proceeds were also used to refund various CHFFA and California Statewide Communities Development Authority bonds.

Sutter Health

Kaiser Foundation Hospitals
One Kaiser Plaza
Oakland, CA 94612

Kaiser Foundation Hospitals (Kaiser), incorporated in 1948, provides medical, hospital, and other health care services and coverage. Kaiser Permanente is the trade name for the integrated health care delivery system that delivers health care services through an integrated system of health plans, hospitals and physician groups that are related through parent/subsidiary relationships or contractual affiliation relationships.

Project:

On March 23, 2017, CHFFA approved Kaiser’s request to issue up to $4.4 billion in tax-exempt bonds. The bond proceeds were used to finance and/or reimburse costs of construction, expansion, remodeling, renovation, furnishing, equipping, and/or acquisition of various health facilities. Notable projects included the construction of the San Diego Medical Center, a nearly 565,000 square foot facility with 450 hospital beds and 39 emergency department beds; Skyport Medical Office, a 4-story, 153,000 square foot, LEED NC Silver certified building serving 85 – 95 provider offices for three primary and six specialty care modules as well as surface and structured parking; Baldwin Hills-Crenshaw Medical Office, a four-story LEED Gold certified 100,000 square foot building serving over 50,000 members; Murrieta Medical Office, an 80,000 square foot LEED Gold certified facility providing outpatient services; and the purchase of the Daly City Medical Office, which included 160,000 square feet of space containing 74 provider offices, a 350-space parking structure, and 2.65 acres of land. Bond proceeds were also used to refinance taxable commercial paper to refund various CHFFA and California Statewide Communities Development Authority bonds. The Kaiser bond won The Bond Buyer's 16th annual Deal of the Year award, which recognizes innovation in municipal finance, as its project represented the largest aggregate financing (taxable and tax-exempt bonds) by a 501(c)3 healthcare institution and the largest Green Bond issuance by any healthcare organization.

Kaiser Foundation Hospital

Tarzana Treatment Centers, Inc
18646 Oxnard Street
Tarzana, CA 91356

Tarzana Treatment Centers, Inc. (Tarzana) is a non-profit full-service behavioral healthcare organization founded in 1972 located in Los Angeles County. Tarzana provides high quality, cost-effective substance abuse and mental health treatment to adults and youth. Additionally, Tarzana operates a psychiatric hospital, residential and outpatient alcohol and drug treatment centers, and family medical clinics.

Project:

On January 31, 2019 CHFFA approved Tarzana’s request to issue up to $13.5 million in tax-exempt and taxable bonds. Tarzana has been expanding its service capacity to meet the ever-growing demand from the community and government agencies that purchase its services. The bond proceeds were used to fund the construction of multiple projects and renovations at multiple sites owned or leased by Tarzana, reimburse previously expended construction costs, and refinance existing debt. One of the more notable projects consisted of a 3,000 square foot expansion to an existing leased outpatient treatment facility. The expansion added a primary clinic and additional office spaces. Tarzana also used bond proceeds to reimburse prior expenditures for the purchase and renovation of a 5,000 square foot facility to provide primary care services, outpatient treatment services, substance use disorder and mental health services; and the construction of 5,200 square feet of additional space on a leased property to provide substance abuse and mental health services.


Marshall Medical Center
1100 Marshall Way
Placerville, CA 95667

Established in 1959, Marshall Medical Center (Marshall) is a nonprofit community hospital licensed to operate 125 beds located in Placerville; with additional outpatient facilities in Cameron Park, Placerville, El Dorado Hills, and Georgetown; and primary and specialty care clinics throughout El Dorado County. Marshall provides a broad range of primary and secondary level acute medical and surgical services at its facility as well as a full range of outpatient services and 24-hour emergency care services. Other services include home health, a rural health clinic, pediatric services, and mental health services.

Project:

On March 26, 2020, CHFFA approved Marshall’s request to issue up to $56 million in fixed-rate, tax-exempt bonds and $26 million in fixed-rate, taxable bonds. The proceeds were used to fund the acquisition, construction, expansion, remodeling, renovation, furnishing, equipping, and reimbursement of multiple facilities. Additionally, bond proceeds were used to refund the CHFFA 2004 Series B bonds. One of the more notable projects was the purchase of a new 3,200 square foot clinic that added cardiac rehabilitation and pulmonary rehabilitation to Marshall’s service. The financed projects helped Marshall modernize its facilities, meet new regulations, and expand capacity for various services.

Marshall Medical Center

Chinese Hospital Association
845 Jackson Street
San Francisco CA 94133

Established in 1924, Chinese Hospital Association (CHA) owns and operates an 88-bed acute care hospital located in the Chinatown neighborhood of San Francisco servicing patients from virtually all communities in San Francisco and Daly City. On April 18, 2016, CHA opened a new 100,000 square foot Patient Tower, an 8-story building that meets all the latest seismic requirements and provides the highest quality care to patients. CHA also operates four outpatient clinics in the San Francisco area, which collectively provide primary care, specialty care, and ambulatory services.

Project:

Chinese Hospital Association

On September 27, 2012 CHFFA approved CHA’s request to issue up to $65 million in fixed-rate, tax-exempt bonds. The proceeds were used to finance and/or reimburse the costs of constructing and equipping a new eight- story hospital and converting the existing hospital into a multi-use facility, including administrative support, an outpatient clinic and a laboratory. The project included the demolition of a 31,740 square foot facility, originally constructed in 1925 and used as office space, to make way for the new eight-story hospital. An adjacent 41,230 square foot hospital building constructed in 1979 was also renovated and converted to house hospital support facilities, administrative offices, an outpatient clinic, and a laboratory.