Hospital Appraisal, Clinic Appraisal

Definition

Hospitals are considered a specialty property type because they are not traditional and have a unique business attached to them. They are defined as an institution that is built, staffed, and equipped for the diagnosis and treatment of disease. Real estate funds are increasingly purchasing hospitals and clinics as part of their portfolios in Latin America and serve as stable, income producing properties suitable for an institutional investor.

LOGAN appraises all types of hospitals and clinics in Latin America including Colombia, Mexico, Peru, Costa Rica, and other markets. Appraisals include general hospitals, clinics, ambulatory clinics, emergency and outpatient centers, and teaching hospitals.

Types

Ownership

– Publicly owned hospitals

– Non-profit hospitals

– For-profit hospitals

 

Service

General Medical & Surgical Hospitals – a hospital that deals with all types of ailments and includes an emergency center and inpatient facilities.

Specialty Hospitals – hospitals that focus on a particular procedure, patient, or condition.

Teaching Hospitals – usually affiliated with a university or educational group.

Clinics – a smaller hospital which provides outpatient services.

Psychiatric Hospitals – specialize in the treatment of mental disorders.

Family Planning – clinics that provide aid and guidance in sexual control methods.

Hospices & Palliative Care Centers – provide symptom relief and pain management for those suffering from life terminating illnesses.

Emergency & Other Outpatient Care Centers – engaged in providing emergency, general, or specialized outpatient care

Sleep Disorder Clinics – treat disorders that affect, disrupt, or more generally involve sleep

Dental Laboratories – facilities dedicated to more advanced dental treatments including dentures, crowns, bridges

Blood & Organ Banks – focused on the donation of biological tissue or an organ of the human body

Approaches, Relevance 

Cost – this is often difficult with hospitals, as they tend to be older properties – but has relevance when the property is relatively new

Sales comp or market approach – carefully applied, as hospitals vary greatly in the income produced by each facility, and thereby value

Income capitalization – hospital properties are sometimes owner-operated but increasingly are considered assets of real estate funds. Rent ranges are applied to certain hospital types, and net operating income can be capitalized to conclude value.

DCF – an appropriate method to determine the value of a hospital or clinic, depending on if the rental rate can be adequately determined. Often the business and property are so intertwined, it is difficult to determine the market rent for a hospital or clinic.

Value Impacting Factors

Market – The size and density of the immediate market can greatly increase the expected rent for the property

Operator – An efficient operator produces a higher income for the business and therefore, can be requested a higher rent for a proper maintenance and adequate condition of the property

Important Inputs

– Rent as % of gross income

– Tenant credit quality of operator

– Services provided and dimension in size and equipment

Recent Trends

Covid-19 and Covid-19 Vaccine side-effects and increased – decreased demand

Sale of owner-occupied hospitals and clinics in Latin America during or shortly after the pandemic

Deliverable

Narrative Appraisal Report

  1. Considerations that impact value – summary
  2. Limitations of the report
  3. Description – Land
  4. Description of the improvements
  5. Scope
  6. HBU
  7. Valuation methods
  8. Reconciliation
  9. Certification statement
La Cima, Hermosillo, Mexico,

La Cima, Hermosillo, México,

La Cima, Escazú, Costa Rica

La Cima, Escazú, Costa Rica

Notable Markets

Colombia

Bogota

Medellin

Cali

México

DF

Monterrey

Guadalajara

Perú

Lima

Arequipa

Callao

CR-CA

San Jose

Ciudad de Panama

Guatemala

Notable Owners – Fund Managers