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Health · Sub-expertise

Creation and sale of a healthcare establishment.

The creation and sale of healthcare establishments combine administrative authorisation issues (ARS, regional health agency), capital structuring and continuity of activity. These are complex transactions requiring rigorous legal oversight. We support operators, investors and specialised healthcare funds throughout the entire process.

→ What we cover

Our scope of intervention.

ARS authorisations

Application for authorisation of a care activity, five-yearly renewal, substantial modifications. Alignment with the regional health-organisation scheme (SROS) and the identified health needs.

Capital structuring

Choice of corporate form (SAS, SCI, SEL for certain structures), structuring of holding companies, alignment with sector-specific and ethical constraints.

Establishment acquisition

Specific due diligence (authorisations, pricing agreements, ARS litigation, quality, leases, practice agreements), structuring of the transaction, transfers of authorisations.

Sale & transfers

Preparation of the sale (legal clean-up, vendor due diligence), negotiation, management of the transfers of authorisations and agreements, continuity of activity.

Pricing agreements

Pricing agreements with the ARS, negotiation of tariffs, alignment with activity-based pricing (T2A), management of regulatory changes (flat-rate payments, allocations).

Build-up and group strategy

External growth strategies for healthcare groups: multiple acquisitions, integration of support functions, harmonisation of medical and administrative practices.

→ Our approach

A proven methodology.

01

Strategic scoping

Analysis of the project (creation, acquisition, sale, build-up), validation of regulatory feasibility, legal and capital structuring.

02

Authorisations & due diligence

Preparation of the ARS authorisation files, due diligence on the target (regulatory, legal, social, patient base), risk assessment.

03

Documentation

Drafting of the SPA and the contribution or sale deeds, alignment with the transfers of authorisations, management of the ARS conditions precedent.

04

Closing & integration

Closing after obtaining the authorisations, effective transfers, operational integration, alignment with the medical and administrative teams.

→ Who we help

Typical engagements.

Acquisition of a clinic by a fund

Support for a specialised healthcare fund in acquiring a clinic: ARS due diligence, structuring through a SAS, transfer of authorisations, alignment with the independent practitioners.

Creation of a new establishment

Oversight of the creation of a new establishment: ARS file, choice of the legal vehicle, negotiation of pricing agreements, recruitment and contracting of practitioners.

Build-up in the dental sector

Support for a dental group in a build-up strategy: multiple acquisitions of practices, legal harmonisation, ethical and tax compliance.

Sale to a strategic operator

Sale of a group of nursing homes (EHPAD) to a strategic operator: structuring of the sale, transfers of authorisations, management of the tripartite agreements.

→ Q&A

Frequently asked questions.

Yes for most care activities (medicine, surgery, obstetrics, home hospitalisation, dialysis, imaging). The authorisation is granted for 5 years, renewable subject to conditions. It falls within the regional health scheme (SROS) which determines the needs.

The transfer of an authorisation to a buyer requires a specific application to the ARS, which verifies the buyer's compliance with the requirements (quality, organisation). It is generally a condition precedent to the sale. The timetable must allow for the review period.

The healthcare sector benefits from specific tax regimes (VAT, payroll tax for structures not subject to VAT), which must be analysed on a case-by-case basis. Tax structuring is essential to optimise a sale or acquisition transaction.

The practice agreements of independent practitioners are not automatically transferred with the sale of the establishment. Coordination is necessary: information, negotiation, sometimes renegotiation. Retaining the key practitioners is often a major issue in the transaction.

→ Go further

Explore other sub-expertises.

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