Table of contents Note: This document is just a sample of a credit policy review document with only the sections in red displayed.

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1 Business credit sector strategy: Aged Care Table of contents Note: This document is just a sample of a credit policy review document with only the sections in red displayed. 1.0 Description and composition 1.0 Description 1.2 Composition 2.0 Bank s current position 3.0 Sector position 4.0 Sector profile 4.1 Entry barriers 4.2 Suppliers 4.3 Buyers 4.4 Product substitutes 4.5 Market competition 4.6 Regulation 4.7 Key Success Factors 4.8 Sector Outlook 5.0 Business Justification 5.1 Target Market 5.2 Comparative advantage 5.3 Key risks 5.4 Marketing strategy 6.0 Problem Exposures 6.1 Details 6.2 Common themes (summary) 7.0 Sector Policy Recommendations 8.0 Conclusion 9.0 Approvals Business credit sector strategy: Aged Care Page 1

2 1.1 Description Aged Care services include community care programs (i.e. care provided to the elderly in their own home) and residential care services which comprise: Low care: Once referred to as Hostels, includes the provision of suitable accommodation and related services (e.g. cleaning, laundry, meals) as well as personal care services (e.g. assistance with dressing, eating, etc). High care: Once referred to as Nursing Homes, includes the same services as low care and in addition provides nursing care. There is an increasing trend of ageing in place where operators offer a mix of low and high care. Retirement Villages comprise accommodation where assistance may be accessible and recreational facilities may be offered. Entry is more of a lifestyle choice. The two sectors are very different in terms of legal structure and legislation applicable, governing bodies, income streams, and operations. However there are some commonalities (e.g. demand determinants). This review focuses mainly on Aged Care. Business credit sector strategy: Aged Care Page 2

3 1.2 Composition There are approximately 2,800 Aged Care facilities in Australia* Consolidation of the industry has been evident and is expected to continue, reducing the total number of establishments. Private for profit operators account for approximately 28%of all providers Other providers include charitable (15%), community based (17%), local government (2%), religious (29%) and state government bodies (9%). There are approximately 1860 Retirement Villages in Australia. * As at 30 June 2009 Business credit sector strategy: Aged Care Page 3

4 4.6 Regulation The industry is legislated, funded and regulated by the Commonwealth Government (Department of Health and Ageing) under the Aged Care Act The act is designed to ensure that a high level of quality and affordable care is available to cater for ageing Australians. State governments license and enforce regulation through the Aged Care Accreditation Agency. Operators are subject to: Accreditation: Imposes standards around management systems, staff development, health and personal care, resident lifestyle, physical environment and safety. Certification: Imposes standards around the quality of accommodation for residents (i.e. building standards such as maximum resident to room ratios). Bed licensing: The number of available care places is regulated by the Federal Government and is represented as a ratio of licenses (or beds) per 1000 people aged over 70. Business credit sector strategy: Aged Care Page 4

5 4.7 Key Success Factors Managing staff costs, attracting and retaining staff Staff costs are the most significant expense representing around 70% of total expenses. In the not-for-profit space there is some reliance on volunteers. Qualified /skilled staff can be difficult to secure and retain in this industry, due to a shortage of nurses and because of more attractive rates for nurses in the acute care hospital sector. This is particularly an issue in regional areas. Location Operators should have a thorough understanding of their target demographic and their demands, as well as existing and proposed competition. Overall demand for this sector is high, however demand is driven by the geographic spread of the older population, and there are pockets of oversupplied areas. Experience / strong management skills Operators must have a strong knowledge of the issues involved in aged care from a legislative as well as an operational perspective. Operators must maintain accreditation and certification standards, whilst they also maintain sound clinical practices. Good marketing skills are required to attract residents and the right mix of residents is required to ensure satisfactory cashflows. Strong business and financial acumen is also necessary to ensure that profitability is maintained in a low profit sector. Business credit sector strategy: Aged Care Page 5

6 5.3 Key risks for St.George The key credit risks that we have identified in lending to the industry are: Collection of bonds / sale receipts There is a risk that income from bonds are used to fund operations / losses rather than amortise debt. Similarly, some types of retirement village accommodation do not represent real property, they represent an agreement (e.g. lease) and so it is difficult to strictly control incoming contributions. Appropriate processes have been implemented to mitigate this risk. Market risk This risk relates to the variability in bond values and future going concern value. Competition may emerge from other aged care providers whilst the facility is being planned / constructed leading to reduced occupancy levels. Substitution may also arise from increasing Community Aged Care Packages leading to reduced occupancy in low care Construction Risk A common feature amongst past problem exposures in this sector relate to property development. Construction term may be delayed, increasing market risk and / or leading to reduced profitability due to cost overruns and increased interest costs. Business credit sector strategy: Aged Care Page 6

7 6.2 Problem exposures common themes Common themes evident form our problem exposures in the aged care and retirement village sectors are: Lack of experience, business acumen and / or marketing skills Unrealistic expectations of trade-up, occupancy, demand and / or bond prices / sale price Inability to complete project within timeframes, feasibility becoming obsolete, cost overuns (i.e. construction risk) Business credit sector strategy: Aged Care Page 7