An Alternative Investment For Indiana Hospitals: Seniors Housing

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1 An Alternative Investment For Indiana Hospitals: Seniors Housing Chris Blanda Vice President NI & KY Market Head Lancaster Pollard & Co. IRHA Annual Conference Offering Financial Advice and Solutions to Health Care, Senior Living, and Housing Providers.

2 Agenda Observations on the Opportunity Seniors Housing Market Overview Project Considerations Non-Recourse Financing Options 2

3 Observations Our Perspective Investment Banking Lancaster Pollard & Co. Buy & Sell-Side M&A Advisory Debt Underwriting Financial Consulting Financial Derivatives Private Placements Remarketing Mortgage Banking Lancaster Pollard Mortgage Company FHA-Insured Mortgage Loans GNMA Issuer/Servicing Mortgage Loan Servicing USDA-Guaranteed Mortgage Loans Fannie Mae Multifamily & Affordable & Seniors Housing Lender/Servicer Private Equity Propero Seniors Housing Equity Fund, LLC Senior Living Focused Partnership with Best-in-Class Operators New Development and Acquisitions 100% Equity Investment Triple Net Lease with Pre-Negotiated Purchase Options Balance Sheet Lending Lancaster Pollard Finance Company Construction Financing Term debt Bridge Loan Financing Mezzanine Debt Preferred Equity Investment Advising Lancaster Pollard Investment Advisory Group Arbitrage Assessment Asset-Liability Management Capital Structure Optimization Fiduciary Investment Consulting Project Fund Management Risk Management Advising

4 Observations Our Perspective Financier / lender to hospital and seniors housing sectors for over 25 years Over 1,000 seniors housing projects funded Service over $4 billion of loans (majority are seniors housing) Owner / investor of seniors housing properties (through a private real estate fund, Propero ) Upper Payment Limit ( UPL ) program is already widely used in Indiana 4

5 Observations Logical Fit Demand for seniors housing in rural communities based on aging demographic and lack of modern supply ACA s promotion of fee-for-value rather than fee-forservice Focus on re-admissions, care coordination, etc. Hospital s unique profile One of stronger balance sheets in community Core margins are being compressed Conservative investment policies Access to non-recourse, below market funding options Seniors housing median margins and sales prices relatively high 5

6 Senior Housing Market - Fundamentals Demographics (growing senior age populations and fewer children to care for their parents) Ratio of Caregivers (age 45-60) to those over 80 projected to shrink from 7:1to 4:1 by 2050 (AARP study) Occupancy and rents continue to trend higher Strong capital in-flows with growing institutional interest Seniors Housing Returns have outpaced other core property types per NCREIF national property index (NPI) 6

7 Senior Housing Market - Returns NCREIF National Property Index Return Data 7

8 Seniors Housing Market Performance 2013 State of Seniors Housing "Same Store" Analysis - PUPA - 3 Year Trend IL Only AL Only AL & ALZ Only Occupancy 91% 86% 91% 87% 91% 86% Revenue 32,347 31,233 47,915 47,028 58,765 56,515 Expense 19,936 20,810 32,852 32,094 39,588 37,936 NOI 12,411 10,423 15,063 14,934 19,177 18,579 NOI Margin 38% 33% 31% 32% 33% 33% 2013 State of Seniors Housing Operating Margin* by Community Type IL AL AL/ALZ Lower Quartile 20% 16% 18% Median 37% 31% 33% Upper Quartile 50% 44% 42% *EBITDAR/Revenue 8

9 Seniors Housing Market - Quarterly Trends *National Investment Center NIC Data 9

10 Seniors Housing Market - Performance 10

11 Price Per Unit Averages 11

12 Key Factors Driving Price & Value Asset Type (Class A, B, etc.) Primary Market dynamics Rents and competitive advantages in market Size (# Units) Age of Property 12

13 Seniors Housing Market AL Development 13

14 Seniors Housing Market Construction Starts 14

15 Construction Data - Cost 15

16 Common New Construction Features Proximity to public transportation and medical services Large Multi-purpose rooms Library/Information Center Dedicated Meeting Spaces/Conference Rooms Coffee Shop/Grab n Go and Bistros Salons Spiritual Centers Fitness, Indoor Pool and Rehab Space 16

17 3 Keys to a Successful SL Project 1. Operator proven operator for fill-up and maintaining stabilized margins in similar market / project scope 2. Market demonstrated need by a reputable third party market study analyst 3. Equity traditional 20% equity plus working capital until operation is stabilized 17

18 A Hospital s Role Operator Lease or JV Market Rely on third party analyst s report and operator s perspective (assuming operator is appropriately tied in) Equity Sole owner (lease) or JV Propero model 18

19 Non-Recourse Funding Options FHA/HUD 232 Program New construction or purchase Up to 40 year term/am Fixed all-in rate below 4.50% Non-recourse (no guarantee from hospital; silo financing) Over 500 projects financed per year USDA CF NP, new construction, rural 40 year term/am <4.00% fixed Current over supply of funding 19

20 QUESTIONS? Lancaster Pollard 65 East State Street, 16th Floor Columbus, OH Phone (614) Fax (614)

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