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Elsan's inaugural Sustainability-Linked Term Loan: the first of its kind in the private hospital sector in Europe

2-minute read


Elsan inaugural Sustainability-Linked Term Loan shall finance the acquisition of the group C2S. On the occasion of the Add-on, the entire financing of Elsan has been extended and indexed to sustainability targets. It marks the first loan of its kind in the private hospital sector in Europe.  It was structured with the support of Natixis, as Sustainability Coordinator.

Elsan is the leader in the private hospital sector in France for medical, surgical and obstetrics, and has rooted environmental and social responsibility firmly at the center of its strategy. The company has built its CSR (Corporate Social Responsibility) policy on four key ambitions over the past three years:       

  • Proximity to local communities
  • Patient care
  • Eco-performance
  • Investment in its talents.

A new milestone for the private hospital sector and the leverage market

On the occasion of C2S’ acquisition, Elsan has decided to tie its entire financing of €~2bn to ambitious targets based on its CSR pillars. The interest rate of the loan will be indexed to the company’s achievement of three objectives with a premium/discount mechanism:

  • Patient satisfaction
  • Medical waste reduction
  • Improvement in the quality of work life of its employees.

Elsan operates right across France and is firmly established at the heart of the community, with three people out of five in the country living less than 40 km from one of its private healthcare facilities. The planned acquisition of the C2S group will enable Elsan to further strengthen its local presence in the Bourgogne-Franche-Comté and Auvergne-Rhone-Alpes regions, in line with its proximity to local communities ambition.

An innovative structure well received by the market

This Sustainability-Linked Term Loan marks a first in the private hospitals sector in Europe , and has attracted strong interest from institutional investors (subscribed almost five times the original amount targeted), who increasingly seek to incorporate Environmental, Social and Governance (ESG) criteria into their investments. The pool of lenders also enlarged to around 100 through the sustainability-linked loan syndicate, around 20 lenders more than in the previous syndicated loan. With France still facing the effects of the Covid-19 pandemic, this transaction support the extension of Elsan’s coverage across the country and helps to further consolidate the French healthcare system, in coordination with all public and private healthcare stakeholders.

Natixis was honored to be mandated as Bookrunner and Sustainability Coordinator for this transaction under the leadership & full dedication from all relevant Elsan’s teams.