First River Advisory L.L.C. is an independent financial advisor which, since its formation in 1995, has fashioned innovative and cost-effective capital formation and debt management solutions for non-profit health care organizations.  First River Advisory is registered as a Municipal Advisor (MA) with the U.S. Securities and Exchange Commission (SEC) and the Municipal Securities Rulemaking Board (MSRB), as required by Section 975(a) of the Dodd-Frank Wall Street Reform and Consumer Protection Act.

First River Advisory stands firmly on its clients' side.   First River Advisory is not affiliated in any manner with a bank, investment banking firm (broker/dealer), other financial institution or investment manager, and does not engage in any form of underwriting, trading, marketing or investing in securities.  As an independent MA, First River Advisory is singularly focused on being an advocate for its clients, and is accountable solely to its clients.  Although Dodd-Frank requires that an MA maintain a fiduciary duty standard only to certain types of clients, First River Advisory routinely applies this standard to all clients.

First River Advisory is a member of the National Association of Municipal Advisors (NAMA), an organization of independent MA firms which are not affiliated with broker/dealers.  First River Advisory is the only NAMA member that specializes in serving health care organizations.  Visit the NAMA Web Site for more information on the high ethical and professional standards to which First River Advisory adheres.

First River Advisory Services

  • Capital Formation: usually in connection with the development of a significant capital improvement project, the identification and analysis of financing alternatives (which might include paying cash), together with leadership of the financing plan's implementation
  • Debt Management: continual management and oversight of an organization’s existing debt, encompassing compliance with financial and continuing disclosure covenants, refinancing and restructuring of that debt, and negotiation with investors and lenders to resolve covenant non-compliance and events of default
  • Disclosure Advisory drafting of obligors' disclosure sections of Official Statements (usually "Appendix A") in connection with public offerings of bonds, outside the context of a comprehensive financial advisory engagement
  • Mergers & Acquisitions (M & A) development of affiliation strategies, evaluation of proposals and arrangement for disposition of outstanding debt
  • Derivatives Advisory origination, restructuring and termination of interest rate swaps and caps
First River Advisory, Capitol Formation and Debt Management Solutions for Health Care Organizations
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