Industry Associations

  • Ambulatory Surgery Center Association (ASCA)
  • American Health Lawyers Association

Bar & Court Admissions

  • State Bar of New York
  • State Bar of New Jersey
  • U.S. Court of Appeals for the Second and Third Circuit
  • U.S. District Court for the District of New Jersey

Community Involvement

Andrew Glover Youth Program 


New York Law School, J.D.

St. Johns University, New York, B.A. 

Photo of Mark H. Zafrin

Mark H. Zafrin

New York
T: 212.730.7700
F: 212.730.7725
Representative Matters
Full Bio

Mark Zafrin is a partner working out of M&R’s New York and Los Angeles offices. He is an corporate lawyer specializing in mergers and acquisitions, financing of complex transactions, and debt restructuring, with a focus on the HUD and healthcare spaces.

With an in-depth understanding of HUD, Freddie Mac and Fannie Mae financing as well as conventional mortgages, mezzanine and private equity financing, and health care Certificate of Need and Change of Ownership applications, Mark advises a wide range of entities – many in the senior care sector – in connection with a variety of transactions. He does so to facilitate clients’ acquisitions, renovations, construction, and restructuring, and routinely assists with loan preparations, equity securitization deals (some involving REITs), equity funds, and partnership syndications of health care facilities.

As mentioned, Mark regularly handles HUD-insured loans on behalf of borrowers (including Delaware Statutory Trusts). Likewise, he counsels clients regarding conventional and tax credit financing, mezzanine loan originations, and restructuring and debt securitization transactions (those involving Real Estate Mortgage Investment Conduits, among others). Mark is particularly adept at structuring transactions that add value to these transactions by working hand-in-hand with M&R’s tax attorneys to ensure that clients maximize their tax benefits on every deal. In addition, he is well versed in 1031 exchanges and the newly emerging area of Qualified Opportunity Zones.

Beyond his transactional practice, Mark is a sought after regulatory lawyer. Corporate medical practices and health care facilities retain him to craft corporate structures that meet their needs and are compliant with federal, state and local regulations. In addition, he helps health care facility owners and builders tackle zoning and code issues. Mark also represents clients in CMS and OIG audits and CMS and Department of Justice investigations. Mark is currently a member of M&R's Strategic Planning Committee.

Community Involvement

Mark was involved with the Andrew Glover Youth Program (now known as Avenues for Justice), a New York-based nonprofit developed to keep young people out of prison.

Awards and Recognitions

Mark has been named to the New York Metropolitan Super Lawyers list every year since 2014.

Representative Matters

Acquisition: Handled the purchase of a condominium unit at Dab Hammerskold Plaza for Medical Forefronts and the establishment and syndication of the membership interests in the Surgery Center through the use of a private placement memoranda.

Acquisition: Closed a leveraged buyout of a 499-bed nursing home in Manhattan (Dewitt Rehab) for $105 million, including a $90 million bridge to HUD from KeyBank. The property is located on the Upper East Side of Manhattan and has always been looked upon as the most significant site in Manhattan available for eventual redevelopment into condominiums. 

Acquisition: Represented Absolute Facility Management in the acquisition of the operating leases on 13 skilled nursing facilities in Buffalo, New York in a transaction valued at over $70 million.

Acquisition: Represented Medical Forefronts in the contract to purchase Westchester Ambulatory Surgery Center.

Acquisition: Represented the JOPAL Group in the $120 million transfer of physical assets (TPA) of Workmen’s Circle MultiCare Center, a 560-bed nursing facility, to a Delaware business trust — the first time the U.S. Department of Housing and Urban Development (HUD) has granted approval for the use of a Trust as a Borrower .

Ambulatory Surgery License: Represented Medical Forefronts, a California Corporation, in the transfer of an ambulatory surgery license in the City of New York for the creation of the most successful surgeon-owned multi-specialty ambulatory surgery center in the State of New York. Midtown Surgery Center has over 30 surgeons and an annual income in excess of $45 million.

Credit Facility: Structured and closed a $13,000,000.00 credit facility for a large emergency and inpatient medical group. The complex and challenging transaction involved thirty-three separate entities, four different banks, across seven states, and the avoidance of a potential $100,000.00 contractual penalty.  

Financing: Represented Marx Development, its regional center, and affiliated companies in the financing of the construction of a new Medicaid-reimbursed assisted living facility in Brooklyn, New York, which is being fully financed using the Immigrant Investor Program (EB-5) in a transaction valued at over $40 million.

Financing: Representing Marx Development and affiliated companies in a transaction using EB-5 financing to develop, construct and lease to an operator as a “replacement facility” a 325-bed skilled nursing home in Nassau County, New York.

Joint Venture: Representing the tenant and developer in developing a new 160-bed nursing home in White Plains, New York, a joint venture of two not-for-profits and one proprietor.

Nursing Home & Rehabilitation Facility - Refinance: Counseled client in the $13 million refinance of Peninsula Nursing Home and Rehabilitation Facility in New York. This was a rather complicated matter in that a previous purchaser acquired a hospital and nursing home, broken up as two parcels, and kept the hospital while putting the nursing home, which was physically attached to the hospital, up for sale. Our client purchased the nursing home. During this process, we encountered several legal obstacles, not the least of which was an environmental issue related to construction debris and chemical traces at the nursing home site. Mr. Zafrin worked diligently with an environmental study company to revisit their report in light of new facts, thereby clearing any environmental roadblock and enabling the client to refinance.

Rehabilitation Facility - HUD Refinance: Closed the largest HUD-insured loan ever on a single building in the United States. The loan, having a principal amount of $126,925,400.00, was in connection with the refinancing of health care facility in New York City. Notably, the refinance transaction was threatened at the 11th hour given a Certificate of Occupancy issue. Nevertheless, after days of diligent research and negotiation by our attorneys, the matter was resolved and the closing was able to proceed as scheduled.

Residential Long-Term Care - HUD Refinance: Helped client close on the refinance of Middletown Park Manor Rehabilitation and Health Care Center, consisting of a $23,240,000 mortgage insured by the Department of Housing and Urban Development (HUD). This matter commenced with the purchase of the 240-bed facility by one of our long-time clients. After two refinances and a workout of the original purchase money financing, the project finally stabilized and was able to obtain a 35 year self-amortizing HUD mortgage with no personal guarantees and, most notably, a return of a substantial portion of the client’s original equity.