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Pitch Book
January 2018
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Pitch Book January 2018 Strictly Confidential 2 Disclaimer This - - PowerPoint PPT Presentation
Strictly Confidential Strictly Confidential 1 Pitch Book January 2018 Strictly Confidential 2 Disclaimer This document may contain forward - looking statements as defined in the Private Securities Litigation Reform Act of 1995. These
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This document may contain “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. These forward-looking statements concern and are based upon, among other things, the possible expansion of the company’s portfolio; the sale of properties; the performance of its operators/tenants and properties; its ability to enter into agreements with new viable tenants for vacant space or for properties that the company takes back from financially troubled tenants, if any; its occupancy rates; its ability to acquire, develop and/or manage properties; the ability to successfully manage the risks associated with international expansion and operations; its ability to make distributions to shareholders; its policies and plans regarding investments, financings and other matters; its tax status as a real estate investment trust; its critical accounting policies; its ability to appropriately balance the use of debt and equity; its ability to access capital markets or other sources of funds; its ability to meet its earnings guidance; and its ability to finance and complete, and the effect of, future acquisitions. When the company uses words such as “may,” “will,” “intend,” “should,” “believe,” “expect,” “anticipate,” “project,” “estimate” or similar expressions, it is making forward-looking statements. Forward- looking statements are not guarantees of future performance and involve risks and uncertainties. The company’s expected results may not be achieved, and actual results may differ materially from expectations. This may be a result of various factors, including, but not limited to: material differences between actual results and the assumptions, projections and estimates of occupancy rates, rental rates, operating expenses and required capital expenditures; the status of the economy; the status of capital markets, including the availability and cost of capital; issues facing the healthcare industry, including compliance with, and changes to, regulations and payment policies, responding to government investigations and punitive settlements and operators’/tenants’ difficulty in cost-effectively obtaining and maintaining adequate liability and other insurance; changes in financing terms; competition within the healthcare, seniors housing and life science industries; negative developments in the operating results or financial condition of operators/tenants, including, but not limited to, their ability to pay rent and repay loans; the company’s ability to transition or sell facilities with profitable results; the failure to make new investments as and when anticipated; acts of God affecting the company’s properties; the company’s ability to re-lease space at similar rates as vacancies occur; the failure of closings to occur as and when anticipated, including the receipt of third-party approvals and healthcare licenses without unexpected delays or conditions; the company’s ability to timely reinvest sale proceeds at similar rates to assets sold; operator/tenant or joint venture partner bankruptcies or insolvencies; the cooperation of joint venture partners; government regulations affecting Medicare and Medicaid reimbursement rates and operational requirements; regulatory approval and market acceptance of the products and technologies of life science tenants; liability or contract claims by or against operators/tenants; unanticipated difficulties and/or expenditures relating to future acquisitions and the integration of multi-property acquisitions; environmental laws affecting the company’s properties; changes in rules or practices governing the company’s financial reporting; the movement of U.S. and foreign currency exchange rates; and legal and operational matters, including real estate investment trust qualification and key management personnel recruitment and retention. Finally, the company assumes no
forward-looking statements.
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Capitol CRE specializes in self managed fully-integrated healthcare real estate that acquires, owns and/or finances real estate properties that are leased to hospitals, doctors, healthcare systems or other healthcare service providers located in geographic areas primarily outside of major MSA’s.
Focus on the acquisition of licensed, state-of-the-art, purpose-built healthcare facilities and the leasing
increasing, reliable rental revenue by leasing each of our healthcare facilities to a single market-leading
lease.
healthcare real estate transactions.
2016 IPO listed on the NYSE
debt and CMBS loans combined with a $250M line of credit through syndicated banking relationships.
transactions Net Leased to 41 tenants
Now is an exciting time in the transformation of the U.S. healthcare market, and more specifically the U.S. healthcare real estate market.
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We believe healthcare providers will need to invest a significant amount of capital in non-urban areas over the next several decades in order to provide lower cost healthcare in the patients’ local communities than they can by transporting the non-urban population to high cost urban centers, and ramp up their services as there are natural population increases in the non urban areas and as the Affordable Care Act brings more of the non-urban population base into some type of insurance coverage.
Capitol CRE is investing outside of major MSA’s where we can develop strategic alliances with financially sound healthcare providers that offer high quality healthcare services in sustainable non-urban markets.
Healthcare reform and policy has led to specialty healthcare playing a significant role in this current political environment. Issues from the ACA repeal efforts to payment reform to the demographic growth of the Medicare
delivery and transactions. No matter how healthcare policy changes on the Hill the delivery of care by providers and systems will continue to be based on patient focused care, quality outcomes and lower cost.
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From 2014 to present Capitol CRE principles have completed over $350 million in healthcare real estate acquisitions. These acquisitions have consisted of high quality purposed built healthcare facilities. Over 50 facilities the majority of which are NNN sales leaseback transactions covering over 1 million sq. ft. of Class A space.
Purpose Built Medical Office Surgery Center Rehab Hospital Acute Care/SNFs
Debt Equity Traditional Mortgage Angel Funding CMBS Convertible Debenture LOC Capital Markets Investor Notes Op Units
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To allow healthcare providers to leverage their real estate assets to redirect the subsequent cash infusion to be utilized in the development of the physician group practice, building maintenance, lease escrows, furthering community healthcare and improving operational
greater deal flexibility combined with the elimination of capital market volatility. Sourcing
these Non-Urban assets from existing REITs and institutional buyers than for comparable assets in urban areas, thereby increasing the potential for attractive risk-adjusted returns.
Focused
Major MSAs
Deals
Escalations
Operational Cost
Leases
Renewal
to Entry
This model has been proven through management experience and effective strategic implementation.
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❖ High Barrier to entry / limited competition ❖ Strong Employment Base ❖ Population Demographics ❖ Sale-leaseback transactions ❖ Secondary and Tertiary markets across the U.S.
❖ $1M – $10M ❖ Campus Setting ❖ Predictable, stable rents ❖ Strong and diversified payor mix ❖ Long term lease terms ❖ Purpose-built real estate ❖ Patient loyalty and strong market share ❖ Focus on the future of healthcare ❖ Rent coverage in excess of peers
We are Bullish on Healthcare despite uncertainties with the ACA there is continued compelling reasons to invest in US Healthcare given the fact that it accounts for a large portion of the GDP. Historical good returns, aging population and healthcare demand continues to rise.
We are seeing cap rates in the range of 5% to 7% on average across the REIT market. We feel very strongly that we can acquire in the range of $1M to $10M and achieve a bended rate upwards of 9% delivering a respectful ROI. This combined with sound underwriting will provide for multiple exits. Replacing Equity with traditional mortgage, long term equity and M&A portfolio sale to REITs or Institutional Investors.
❖ Demonstrated clinical leaders ❖ High market share ❖ Stable and competent management ❖ Robust and durable payor contracts ❖ Prominent local physicians ❖ Strong EBITDARM / rent coverage ❖ Guarantors with strong credit ❖ Subordination of profits to rent ❖ Operators with regional or national footprint
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We maintain a pipeline of approximately $100M in active deals in order to deploy proceeds from investment efficiently thereby providing immediate returns.
Projected Average ROI (%) Fund Category # Deals 1 Year 3 Years 5 Years $1M - $5M 10 15% 17% 20% $5M - $10M 4 13% 15% 17% $10M - $15M 2 12% 14% 16% $15M - $20M 1 10% 12% 14% $25M - $30M 8% 10% 12% $30M - $50M 6% 8% 10% Note: Number of Deals represent deals under LOI or Contract during the period
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Asset Type: Surgery Center Leasable Area: 20,000 Rent Coverage: 5x Lease Expiration: 2028 Purchase Price: $6M Cap Rate: 9%
➢ Development First right of refusal from practice growth ➢ Facility was developed in 2012 - 6 years ➢ Purpose Built for Specialty practice with CON ➢ Class A property ➢ Stable Local / Economic demographics
Revenue*
Implied Cap Acquisition $540K 9.0% Year 1 $556K 13% 9.3% Year 2 $573K 14% 9.5% Year 3 $590K 15% 9.8% Year 4 $608K 16% 10.1%
➢ New single tenant 10 year NNN lease with renewal options ➢ AA2/AA rated Tenant guarantee ➢ Subordination of profit and distributions to rent payment ➢ Excellent rent coverage EBITDARM/Rent ➢ Lease Net Worth , Minimum liquidity and capital reserve covenants * Annual Rent Increase 3%
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Adventist Health (Roseville, Calif.). Genesis Health System (Davenport, Iowa). Ochsner Health System (New Orleans). Adventist Health System (Altamonte Springs, Fl.). Greenville (S.C.) Health System. OhioHealth (Columbus). Advocate Health Care (Oak Brook, Ill.). Gundersen Health System (La Crosse, Wis.). OSF HealthCare (Peoria, Ill.). Alegent Creighton Health (Omaha, Neb.). HCA Midwest Health System (Kansas City, Mo.). Palmetto Health (Columbia, S.C.). Ascension Health (St. Louis) Health First (Rockledge, Fla.). Partners HealthCare (Boston). Aurora Health Care (Milwaukee). Henry Ford Health System (Detroit). Presbyterian Healthcare Services (Albuquerque, N.M.). Avera Health (Sioux Falls, S.D.). Indiana University Health (Indianapolis). ProMedica (Toledo, Ohio). Banner Health (Phoenix). Inova Health System (Falls Church, Va.). Providence Health & Services (Renton, Wash.). Baptist Health Care (Pensacola, Fla.). Intermountain Healthcare (Salt Lake City). Riverside Health System (Newport News, Va.). Baptist Health South Florida (Coral Gables). Jackson Health System (Miami). Rochester (N.Y.) General Health System. Bassett Healthcare Network (Cooperstown, N.Y.). Kaiser Permanente (Oakland, Calif.). Roper St. Francis Healthcare (Charleston, S.C.). BayCare Health System (Clearwater, Fla.). KentuckyOne Health (Louisville). Saint Francis Health System (Tulsa, Okla.). Baylor Health Care System (Dallas). Lancaster (Pa.) General Health. Sanford Health (Sioux Falls, S.D., and Fargo, N.D.). Baystate Health (Springfield, Mass.). Legacy Health (Portland, Ore.). Scripps Health (San Diego). Beaumont Health System (Royal Oak, Mich.). Lehigh Valley Health Network (Allentown, Pa.). Sentara Healthcare (Norfolk, Va.). Bon Secours Virginia Health System (Richmond). MaineHealth (Portland). Sharp HealthCare (San Diego). Broward Health (Fort Lauderdale, Fla.). Mayo Clinic (Rochester, Minn.). Spectrum Health (Grand Rapids, Mich.). Carilion Clinic (Roanoke, Va.). McLaren Health Care (Flint, Mich.). SSM Health Care (St. Louis). Carolinas HealthCare System (Charlotte, N.C.). MedStar Health (Columbia, Md.). Steward Health Care System (Boston). Catholic Health East (Newtown Square, Pa.). Memorial Hermann Healthcare System (Houston). Sutter Health (Sacramento, Calif.). Catholic Health Initiatives (Englewood, Colo.). MemorialCare Health System (Fountain Valley, Calif.). Texas Health Resources (Arlington). Catholic Health Partners (Cincinnati). Mercy (Chesterfield, Mo.). TriHealth (Cincinnati). Catholic Health System (Buffalo, N.Y.). Mercy Health System (Janesville, Wis.). Trinity Health (Novi, Mich.). Christus Health (Irving, Texas). Mercy Springfield (Mo.) Communities. Trinity Mother Frances Hospitals and Clinics (Tyler, TX). Cleveland Clinic. Methodist Healthcare (Memphis, Tenn.). UC Davis Health System (Sacramento, Calif.). Community Health Network (Indianapolis). Mountain States Health Alliance (Johnson City, Tenn) UnityPoint Health (Des Moines). Covenant Health (Knoxville, Tenn.). MultiCare Health System (Tacoma, Wash.). University Hospitals (Cleveland). CoxHealth (Springfield, Mo.). NewYork-Presbyterian Healthcare System (N.Y.). University of Michigan Health System (Ann Arbor). Dignity Health (San Francisco). North Mississippi Health Services (Tupelo). University of Pittsburgh Medical Center. Fairview Health Services (Minneapolis). North Shore-Long Island Jewish Health System (N.Y.). WellSpan Health (York, Pa.). Fletcher Allen Health Care (Burlington, Vt.). NorthShore University HealthSystem (Evanston, Ill.). WellStar Health System (Marietta, Ga.). Franciscan Health System (Tacoma, Wash.). Northwestern Memorial HealthCare (Chicago). Wheaton Franciscan Healthcare (Glendale, Wis.). Geisinger Health System (Danville, Pa.). Novant Health (Winston-Salem, N.C.). Yale New Haven (Conn.) Health System.
Source: The Becker's Hospital Review editorial team selected health systems based on rankings by healthcare analytics company IMS Health
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Sources: Data used to create this ranking were collected from the U.S. Census Bureau, Bureau of Labor Statistics, Council for Community and Economic Research, The Commonwealth Fund, Urban Institute, Centers for Medicare & Medicaid Services, Health Resources & Services Administration, ProPublica, Association of American Medical Colleges, Centers for Disease Control and Prevention, American Telemedicine Association, Urgent Care Association of America, Convenient Care Association, Kaiser Family Foundation, Amnesty International USA, Trustees of Dartmouth College, Social Science Research Council, Trust for America's Health and Robert Wood Johnson Foundation.
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Hospital Systems, Physician Groups, Rehab, Ambulatory Surgical Center
Typically funded pre- defined acquisition process takes 60 days.
Off-Market Broker M&A
Equity/Funding Asset Acquisition Closing Cost Dividend/Debt
JV, Private Equity and/or
Funding, Commercial Mortgage, LOC.
Physical Inspection Executive Interviews Audit Review
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Utilize our Market niche approach.
Complexity
Motivation
Credibility
Credit worthy local dominate tenant is the key.
Provider
Expertise
Post close governance and policy safeguards the asset.
accounting & audit
/Asset Management Systems
reporting
Our goal is to acquire with the exit in mind.
through Network of Lenders
Package to REITs
Investor
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Maintain steady contact with deal potential through PE, M&A, Brokers, Site Visits and Conferences
Select Most Accretive Opportunities
Run our Model to develop a realistic LOI to avoid re- trading
Execute & Initiate Underwriting after Funding is Secured
Review Deal Flow to eliminate Stale LOIs and or out of Contract Deals
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estate sector.
estate, healthcare related tenants and service providers.
matters and their impact on our medical providers.
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Four of the most common PE exit strategies are: trade sale, initial public offering, secondary buyout, leveraged recapitalization and/or dual track.
Identify Strategy Timing, performance and valuation review Due Diligence Fund the Closing
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Inter-American Management | Global Medical REIT | American Housing REIT Chief Financial Officer | Treasurer Showcase executive leadership abilities to drive financial decisions and profitable growth. Review, evaluate and approve all Investment Memo Deal Flow, Contracts, Acquisitions and Closings. Build and strengthen relationships with key stakeholders including auditors, fund managers, and investment bankers leading to new business opportunities. Streamline operations and facilitate efficiency by creating policies, procedures and internal controls. Led debt structuring process organization wide. Enforce and promote outsourced corporate and REIT tax compliance as well as compliance with bank covenants, GAAP, IFRS, and federal law. Coordinate all transfer agent correspondence reporting and dividend declaration proformas. Trigger improvements by reviewing financing and capital management related to debt portfolio, liquidity, and treasury. Lead technical accounting and audit processes. Create and implement internal control SOX process narratives and RCMs. Quantum Real Estate Management Chief Financial Officer | Comptroller Spearheaded accounting operations for 40 non-profit subsidized properties financed by LIHTC/Bonds. Prepared GAAP financial statements including reconciliations and occupancy projections with a dedication to
Served as treasury management contact, communicating with banking and investment institutions. Prepared financial work papers and coordinated interim and YE audits; produced OMB Circular A-133 annual auditable
process including bi-weekly, quarterly, and annual reporting. Washington REIT Accounting Manager Developed the property accounting department by hiring, training and managing staff. Steered daily
reconciliation to fixed assets. Reported on monthly Funds Available for Distribution (FAD). Created balance sheet account roll-forwards for executive management and led property level income statement and balance sheet variance reporting. Led onboarding of property acquisitions.