A rising number of cases of HIV/AIDS in Atlanta led Grady Health System to plan a full renovation of their Ponce De Leon Center (Ponce Center for short). Then another deadly virus and more than $200 million in hospital projects diverted attention and resources. Anthony Saul, chief financial officer at Grady, called on Truist to bring the right team at the right time to secure the right financial tools to get the job started. The new center, now midway through construction, will support 9,000 patients a year—a 50% increase—and provide a healing garden, quiet spaces, and other amenities that promote healing and well-being.
Grady Health System
Atlanta, Georgia—founded in 1892
A history of partnership plus leading-edge solutions add up to future success
Atlanta is home to one of the largest HIV/AIDS clinics in the country: The Ponce De Leon Center, an arm of Grady Health System.
“Grady Health System is one of the leading academic, safety-net health care systems in the country,” says Anthony Saul, executive vice president of finance and chief financial officer for Grady. Safety-net health care systems, which exist in every major American city, are committed to treating patients regardless of their ability to pay.
“The treatments for HIV/AIDS have gotten better, but they still have to begin being administered early to save lives,” Anthony explains. “So our efforts to expand access are paramount to our communities, especially those that are hardest hit.”
“Truist knows where Grady is going, and they’re walking this walk with us. And we know that we can count on them.”
CFO, Grady Health System
“What makes Grady and the Ponce Center unique is that we have a deeper sense of community, and we deliver services with compassion at its core, so everyone’s welcomed, and everyone’s treated the same,” he says.
Anthony saw the same welcoming, caring approach from Truist when he was invited to a getting-to-know-you luncheon by the Truist team, including Chris Leutzinger, who specializes in the New Markets Tax Credit (NMTC) program, and Tammy Hughes, who specializes in not-for-profit and government banking.3
“My first impression was that they were warm, open, and easy to talk to,” says Anthony. “They were interested in not just Grady and where we’re taking our health system, but also in me and how they could help my transition into my new role.” All that helps Truist be a better partner.
Challenges with the Ponce Center renovation
The Ponce Center renovation was one of the first projects that Anthony worked on with Truist.
“The Ponce Center needed more space. They needed more workers. So obviously they needed more money to fund that,” says Tammy.
The goal was simple, but the plan wasn’t. The center, founded in 1986, moved to an office building that had been donated to Grady in the early ’90s. Anthony says they did the best they could to “refresh” the space enough to get it up and running, and added a pharmacy and lab. Aside from bringing in more services, like dental care and diagnostic imaging, not much else had changed in 30 years.
“With the renovation, we want to turn the Ponce Center from just a place of care into a place with a more restorative environment, including a healing garden and quiet spaces,” says Anthony. “We couldn’t attain that easily in the existing space because it wasn’t built with that in mind.”
It wouldn’t be cheap, either. The full renovation would cost $40 million, which their existing capital couldn’t support. What’s more, Grady was simultaneously building a new walk-in care center for $40 million and a new advanced surgery center with a price tag of $180 million.
“Our fingers were crossed, and our toes were crossed because a number of things could have gone wrong,” says Anthony. “Truist came to the table and brought the partners we needed to make things work.”
Solution: The right team at the right time
Tammy serves as Anthony’s main point of contact, or “my one-voice machine,” says Anthony. “I can make one call to her, and she gets the right experts at the table, whether we need investments, a line of credit, creative capital solutions like NMTCs, or new products like insurance. That saves me time from having to talk to different entities. And their teams work together seamlessly, so we don’t feel as though we’re talking to several different companies.”
Anthony says she also helped coordinate and communicate with the “ton of lawyers and consultants” outside of Truist who were necessary to ensure Grady was in compliance with the complex laws related to NMTCs
Solution: New moves with New Markets Tax Credit
The New Markets Tax Credit Program, established in 2000, provides a federal tax credit to investors who make equity investments in projects benefitting qualified low-income communities, sometimes referred to as distressed communities4, 5
“As a public hospital that operates on very slim margins, utilizing NMTC funds, which results in a subsidy to the project, is a very attractive tool for their capital stack,” says Chris Leutzinger, a Truist NMTC relationship manager. “It reduces the overall debt they need to support projects like these.”
Ron Alston, not-for-profit and government banking leader at Truist, says leveraging NMTC investments isn’t something every bank can do. “It’s very complicated, and it takes a lot of time to get the client comfortable with the process,” he says.
Fortunately, the Ponce Center was the fourth NMTC deal Truist helped Grady with. The first three involved expansions of the Grady Hospital System emergency department and waiting area and the new construction of the surgical center. “We were able to offer the client education to help Grady get that first project done, and that snowballed into other projects, which increased their confidence in us,” says Ron.
“As a public hospital that operates on very slim margins, utilizing New Markets Tax Credit funds, which results in a subsidy to the project, is a very attractive tool for their capital stack.”
NMTC Relationship Manager at Truist
Learn more about the program in the Truist article “New Markets Tax Credit: What you need to know.”
Solution: Backup plans for long-term success
Over the past two years, Grady Health System has moved a number of banking needs over to Truist. That includes managing a corporate investment portfolio and providing a $60 million line of credit.
“We like our backup plans to have backup plans,” says Anthony. “Our ongoing partnership with Truist allowed us to get a backup line of credit that is double the $30 million line we had with our previous banking partner. We haven’t tapped into it yet, but it helps to know we have some
liquidity during these times when our crystal ball is a bit muddy. Every bit of financial security helps me get an extra 30 minutes of sleep at night.”
While Grady is in a more mature stage of its business life cycle, expansion is still the name of the game.
“We operate at 105% every day, so for us, the ability to expand access and to take care of more patients is at the forefront of our five-year outlook,” says Anthony. “Truist knows where Grady is going, and they’re walking this walk with us. And we know that we can count on them.”
How your business can get there
Anthony’s advice: Working with a partner with the span of reach of Truist—as well as the expertise in our industry, in not-for-profits, in the financial world, and more—allows them to understand our broad range of needs so they can bring about a broad range of products and opportunities to help us in any new venture that we may have.