Towards a a New E Era i in Ambulatory C Care C Centres - PowerPoint PPT Presentation

Novem vember er 2019 Towards a a New E Era i in Ambulatory C Care C Centres

NorthWest - The Largest Owner, Developer and Manager of Healthcare Real Estate in Canada  NorthWest focuses its understanding of long-term ownership and management of medical and hospital buildings into design and construction within financial realities.  NorthWest actively works with a broad range of service providers from Family Health Teams to Hospitals to develop, own and manage the next generation of healthcare facilities.  For a more detailed review of NorthWest please go to the following link: https://vimeo.com/320525404/d5376295a3

NorthWest’s Key Investment Principles Secure predictable, long horizon and inflation-protected cash flow at acceptable yields through:  Strong healthcare-oriented tenancies  Longer term (~25-year) leases  Market rental rates  Market lease terms  Well-designed and well-constructed buildings  Partnering approach

Jerry Coughlan Health & Wellness Centre Mark Murphy, Senior Director, Capital Planning and Development November 26, 2019

About Lakeridge Health: 2018/19 One System. Best Health. 5

By The Numbers: 2018/19 One System. Best Health. 6

Key Principles  Expedite development to establish presence in high growth, underserviced area of Durham Region  Strengthen partnerships with community health providers (e.g. physicians) in Ajax and Pickering communities  Flexibility of design and services to be provided for future requirements  Reduce financial risk to Lakeridge Health  Minimize any operating cost requirements One System. Best Health. 7

About the Site  2.3 acre zoned, serviced property  Projected high growth area  No significant health facilities in area  Significant opportunity  Service new market  Expand ambulatory capacity  Establish community presence  Support from City of Pickering One System. Best Health. 8

Lakeridge Health Objectives  Ambulatory care day clinics  Outpatient procedures/surgeries  Healthcare hub for community  Ancillary healthcare services  (Lab, DI, Pharmacy)  Defined scope to structure:  RFQ/RFP Competitive approach  BPS (Plexxus) compliant  Evaluation criteria defined  Objective scoring One System. Best Health. 9

Lakeridge Health Model  Long-term land lease (50+ years)  Anchor tenant on competitive market terms  Private sector ~50% leasing risk  Gain share opportunity  Leasehold improvements One System. Best Health. 10

Risk Sharing Model  Fixed Ground Rent payments  Gain share above specified Returns  Lakeridge Health leasehold improvements = flexibility  Development & construction risk transfer  Partnership in base building structure = Scope of Lakeridge Health services  Defined Operating standards & maintenance transfer One System. Best Health. 11

Introducing the Jerry Coughlan Health and Wellness Centre  60,000 square foot Ambulatory Care Centre for Lakeridge Health developed, owned and managed by NW on Lakeridge owned land  30,000 square feet for Lakeridge’s ambulatory departments, including 4 surgical suites and pre & post recovery  15,000 square feet for physicians aligned with Lakeridge  15,000 square feet of allied health services including Urgent Care, Imaging, Lab and Pharmacy

Ambulatory Care Centre Development: Outcomes Aligned With Objectives KEY TIMELINES KEY NWH Achieved Objectives: RFP Issu RF ssued Oct 2018  Establish innovative landlord-tenant hospital facility and NWH Se Selected Jan 2019 relationship using NorthWest’s global experience and Waive Con onditions on on Apr 2019 best practises Agreements  Implement conceptual new era Ambulatory Care Centre Desi sign Development to actual project with th La Lakeridge Drawing / Permit Q2 – Q3 2019  Develop core GTA asset with long-term hospital tenancy Finalization Construction Tender Q4 2019 NWH Follow on Outcomes: Construction Financing  Established a mutually agreeable precedent health authority joint venture with aligned interests Const struction Star Start Q1 2020  Building design & spec’s and deal structure that both meets hospital’s needs and fits NW proforma metrics Q2 2021 Su Substa tantial Completion  Generated a template ACC for duplication in part or whole for other hospitals Stab Stabilized Occupancy Q2 2022

The Stage Is Set For Future Partnership Developments Precedents are now set:  Process  Design  Agreements  Timing

Ambulatory Care Centre Development: The NorthWest Advantage NorthWest will work with healthcare operators and providers to:  Confirm full development potential, constraints and accelerated timing with municipalities on development sites  Determine candidates for decanted and new ambulatory functions  Assess market demand for non-hospital space in specific markets  Engage architects and engineers on massing, base building design and costing  Share its global experience and intellectual capital regarding design and costing for ambulatory departments, including surgical centres  Draft initial terms of a deal structure  Find solutions in an ‘open - book’, transparent way

NorthWest – A Unique Canadian Partner in Healthcare Facilities  Focused expertise on healthcare real estate with critical mass and global best practices in the development, ownership and management of hospital buildings (unique in Canada)  Specific expertise with ambulatory care buildings for hospitals (leaders in the field)  Deep understanding of ground lease and sale lease back structures for win – win relationships  Publically traded REIT bringing transparency, professional disciplines and access to capital  Alignment with hospitals, bringing certainty as long-term owners/managers, seeking REIT level returns  Relationships with a broad range of allied health service providers  Ability to underwrite additional space and include allied health service providers that the hospital will benefit from (e.g. Urgent Care, Imaging, Physio, Lab, ALC, Pharmacy, Physicians, and Food Service) while creating future hospital expansion space  Speed in delivery relative to hospital-owned facilities (4 - 5 years)  Flexibility in the relationship and the deal structures  Ability to undertake full design, construction and funding of a hospital’s space build out

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