Health care reform creates uncertainty for bankers

If you want to know how physicians are preparing for the implementation of the Affordable Care Act, or the state of health care industry in Southern Nevada, don’t ask your doctor, ask her banker.

“Right now it is uncertain and difficult,” said Daline Januik, executive vice president and regional president of Bank of Nevada’s Healthcare Banking Group.

Januik attributed the local medical community’s uncertainty to health care reform and its “ever-changing direction.”

“A lot of physicians are not spending cash, they are sitting back waiting to see what happens,” Januik said. “We also see a lot of physicians joining each other for economies of scale, so you don’t have as many solo practitioners nowadays as you used to.”

Januik said larger medical companies and hospitals in Las Vegas are recruiting doctors or acquiring physician groups.

“They are unsure,” the veteran banker said. “So the need for equipment loans or building loans is just softer than it was six years ago.”

Since launching the Healthcare Banking Group more than six years ago, Januik and her team — Ali Moosa, Kathy Taylor, Kim MacClafferty and Tamie Heiss — have been busy generating new business and serving existing clients.

Each specialty banker is in a different office throughout Southern Nevada. Januik began discovering lending opportunities in the medical community when she joined Bank of Nevada in Henderson.

In an interview, Januik dismissed the idea that doctors or dentists were more of a risk than other businesses.

“They have a built-in revenue source,” Januik said. “The challenge they have is that their reimbursements aren’t increasing, but their expenses are increasing. It’s just how they manage how they do things, which translates into seeing more patients and doing it more efficiently.”

She said that although the health care lending business is soft, Bank of Nevada was still lending. She described the business as “very competitive.”

Bank of Nevada, which was the recipient of net affiliate loan sales and participations, reported loans increased by $115 million during the second quarter to $2.42 billion. Loan growth came primarily from a rise in commercial real estate, construction and land development loans.

The bank’s parent company, Western Alliance Bancorp, did not release figures for health care lending in the second quarter. Bank of Nevada offers medical loans for working capital, business debt consolidation, equipment, real estate and startups.

“We are all competing for a certain amount of dollars,” Januik said, “This is the only industry where reimbursements are regulated.”

She said the bank lends as little as $25,000 or enough to purchase medical facilities or surgical centers. Januik said that the bank is “doing more owner-occupied SBA loans.”

“What they need is what they get,” Januik said. “It depends on their needs. We do equipment financing, electronic medical records or just replacing equipment.”


Eleven banks and bank holding companies with branches in Las Vegas have been named as some of the top-performing banks in the United States, according to Bank Director magazine.

U.S. Bancorp, Wells Fargo & Co., Northern Trust Corp., JP Morgan Chase & Co., Zions Bancorp, Citigroup Inc., and Bank of America Corp. made the list of the top 19 banks for 2013 for banks with assets of more than $50 billion.

For example, U.S. Bancorp ranked third; Wells Fargo fifth and Bank of America was 19th, according to the magazine. Zions Bancorp., the parent of Nevada State Bank, was ranked 15th among banks with at least $50 billion in assets.

Cathay General Bancorp of Los Angeles, which owns Cathay Bank, placed 24th among banks with assets of $5 billion to $50 billion. City National Corp., parent of City National Bank, ranked 41st, while Western Alliance Bancorp., owner of Bank of Nevada, was 56th, and Washington Federal Inc. placed 66th in that category.

The magazine graded banks in five categories including profitability, capital strength and asset quality. The rankings were based on banks’ performances in 2012.

In all, 289 of the nation’s more than 7,000 banks made the magazine’s list.

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First Foundation Inc. has expanded to Las Vegas.

The Irvine, Calif.-based lender and financial advisory company opened an office at 6725 Via Austi Parkway, southwest of McCarran International Airport.

The company offers investment management, wealth planning, consulting insurance, trust and banking solutions. The Las Vegas location is the company’s seventh office and first outside of Southern California.

“Nevada offers unique estate planning opportunities that do not exist in many states, including California,” First Foundation CEO Scott Kavanaugh said. “Two primary examples are Nevada asset protection and dynasty trust.”

Kavanaugh said in a high tax environment these types of trusts “can be powerful tools to preserve and protect family wealth over several generations.”

First Foundation was founded in 1990 as an investment management firm. First Foundation Bank was opened in 2007 and has been involved in real estate lending.