Over the past three decades, the health care industry has undergone profound transformation. During this period, financial distress among health care providers has remained a persistent reality, driven by changing reimbursement models, demographic shifts, statutory and regulatory developments, workforce shortages, rising labor and operating costs, technological innovation, increasing consolidation, and unprecedented events such as the COVID-19 pandemic. This financial distress has resulted in restructurings across virtually every sector of the industry, including hospitals, integrated delivery systems, physician organizations, skilled nursing and senior care providers, behavioral health facilities, home health agencies, managed care organizations, and other health care enterprises. These restructurings have taken place through chapter 11 proceedings, out-of-court workouts, state law receiverships, assignments for the benefit of creditors, mergers and acquisitions, and other restructuring transactions. The updated Fourth Edition of the ABI Healthcare Insolvency Manual — edited by Leslie A. Berkoff (Moritt Hock & Hamroff LLP) and J. David Folds (Baker, Donelson, Bearman, Caldwell & Berkowitz, PC) — reflects these developments and provides a comprehensive analysis of the legal, financial, operational, and regulatory issues confronting today’s restructuring professionals. It is an essential text for anyone working in the distressed healthcare field.