Energy as a Service at South County Hospital

Modern energy for modern medicine

A hospital never closes — and neither can its heating, cooling, and power. South County Health, the Rhode Island nonprofit health system anchored by South County Hospital in Wakefield, needed to renew the energy infrastructure serving its campus without diverting capital from patient care.

Through the Madrone Health Foundation, Madrone serves as the nonprofit owner and borrower for a comprehensive Energy-as-a-Service partnership: upgrading and replacing central utility plant assets, replacing electrical distribution infrastructure, upgrading building automation systems, and implementing energy savings measures across the hospital and its related facilities — with no upfront capital cost to the health system.

The structure

The Rhode Island Health and Educational Building Corporation issued tax-exempt Series 2026A and taxable Series 2026B revenue bonds, with proceeds loaned to Madrone – South County Hospital EaaS I, LLC, a single-purpose entity whose sole member is Madrone Health Foundation. The bonds are secured by South County Health's obligation to pay a capacity charge sized to debt service — an unconditional payment obligation, without right of setoff — and the financing also refinanced certain existing indebtedness of the health system.

Optimum Energy Co, LLC serves as the project's energy services partner, bringing deep engineering expertise in hospital central plant optimization and long-term energy performance. Stifel served as underwriter.

Highlights

• $72,970,000 in tax-exempt and taxable revenue bonds issued by the Rhode Island Health and Educational Building Corporation
• Comprehensive modernization: central utility plant, electrical distribution, building automation, and energy savings measures
• Energy-as-a-Service delivery — no upfront capital cost to the health system
• Nonprofit ownership through a single-purpose Madrone Health Foundation entity
• Financing closed September 30, 2026