4 West Holdings filed Chapter 11 in the Northern District of Texas on March 6, 2018, setting up a restructuring for affiliated skilled-nursing operators doing business under the Orianna name source filing. CRO Louis Robichaux said the debtors operated 41 skilled nursing facilities and managed one more across Georgia, Indiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia, with about $415 million of 2017 revenue and roughly 5,000 employees source filing.

The opening posture was creditor-driven and liquidity-constrained: about $14.2 million was outstanding under the Sterling senior credit facility, while Omega affiliates were owed roughly $52 million of unpaid rent under master leases and about $15 million on an Omega working-capital loan source filing. The court quickly authorized interim access to up to $30 million of DIP financing from OHI Asset RO, LLC, plus cash-collateral use, after finding the debtors lacked working capital to keep operating, meet payroll, preserve vendor relationships, and fund resident-care operations source filing.