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

Towards a a New E Era i in Ambulatory C Care C Centres

Novem vember er 2019

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

One System. Best Health.

About Lakeridge Health: 2018/19

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One System. Best Health.

By The Numbers: 2018/19

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One System. Best Health.

Key Principles

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• 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.

About the Site

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• 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.

Lakeridge Health Objectives

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• 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.

Lakeridge Health Model

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• 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.

Risk Sharing Model

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• 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

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

NWH Achieved Objectives:

• Establish innovative landlord-tenant hospital facility and

relationship using NorthWest’s global experience and best practises

• Implement conceptual new era Ambulatory Care Centre

to actual project

• Develop core GTA asset with long-term hospital tenancy

NWH Follow on Outcomes:

• Established a mutually agreeable precedent health

authority joint venture with aligned interests

• Building design & spec’s and deal structure that

both meets hospital’s needs and fits NW proforma metrics

• Generated a template ACC for duplication in part or

whole for other hospitals

KEY KEY TIMELINES

RF RFP Issu ssued Oct 2018 NWH Se Selected Jan 2019 Waive Con

• nditions on
• n

Agreements Apr 2019 Desi sign Development with th La Lakeridge Drawing / Permit Finalization Construction Tender Construction Financing Q2 – Q3 Q4 2019 2019 Const struction Star Start Q1 2020 Su Substa tantial Completion Q2 2021 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

Thank You