莱坊+2023全球医疗保健报告-Global Healthcare Report

Global

Healthcare

Report

knight

Frank

2023

Ageingdemographicsandtheneedforlongtermcarepresentthemselvesaskeyfactorsintheinterestforhealthcareglobally.

/research

Contents

Introduction

4

Howartificialintelligenceis7

transforminghealthcare

Europe

9

Overview

10

BruceWalkerQ&A

11

UK

12

France

13

Belgium

14

Germany

15

Ireland

16

Spain

17

Netherlands

18

NorthAmerica

19

Overview

20

Debt&Financing

21

MarketTrends

21

SalesTrends

22

Hospitals&Medical

OfficeBuildings

23

AsiaPacific

25

Overview

26

Singapore

28

Australia

29

India

30

MiddleEast

31

Overview

32

Keydemanddrivers

34

Africa

35

Overview

36

MedicaltourisminAfrica

38

Keytakeaways

40

Summary

41

Howwecanhelpyou?

42

Ourpeople

44

Ourglobalnetwork

46

ACUITYLEVEL

Introduction

Globalflowsintocarerelatedrealestateinthe12monthstoJune23

amountedtocirca$38bn.

Thecaresectorencompassesalloperationalcare-relatedassets

spanningelderlycare,adultcare,

primarycare(GPsanddentalsurgeries)andchildcare/specialeducational

needs,essentiallyanyperson-centredoperationalbusiness.Thesesub-

sectorscanthenbefurthersplitbasedonacuitytoincludemorespecialist

settingssuchasdementiacare

homes.Thegraphicbelowpresentsa

visualrepresentationofthemarket’sbroadness,includinganyrelevant

overlapsrespectivetoacuitylevels.

INVESTMENTCASE

Broadinitscoverage,thecaseforinvestmentremainsconsistentnotonlyacrossthevarioussub-sectorsbutalsoacrossgeographicborders.Firstly,theemergenceofaglobalpandemichighlightednotonlythe

“Asprivateequity,REITS

andinstitutionalinvestors

continuetochasethe

strong,longincome

generated,thereisgrowing

interestinhealthcare’s

capabilitiestoaidESG

investingstrategies.”

High

A

BC

Specialisteducation

(SENschools)

EARLY

LONDON&

INTERNATIONAL

MARKET

Supportedliving

accommodation

Pharmacies

Seniorlivingand

assistedliving

Low

ELDERLYCAREHEALTHCARESERVICESCHILDCARE

Primarycare(GPclinics)

UK

PRIVATE

HOSPITALS

Acutecare(hospitals)

ONSET

DEMENTIA

CARE

MENTAL

HEALTH

FACILITIES

Children’snurseries

Personalcarehome

Nursingcarehome

Adultcarehomes

CHILDREN'SRESIDENCES

ADULTCARE

DEMENTIACARE

ABI

REHAB

Dentists

4GLOBALHEALTHCAREREPORT2023

robustnessofhealthcareasanasset

classbutalsoitsgenuinesignificanceasasector.Asprivateequity,REITS

andinstitutionalinvestorscontinue

tochasethestrong,longincome

generated,thereisgrowinginterest

inhealthcare’scapabilitiestoaidESGinvestingstrategies.Globally,across

theboard,thefundamentalsthatcreatethecaseforinvestmentflowsinto

healthcareareevident.Thegraphic

belowhighlightssevenfactorsthat

continuetocontributetowardsthecaseforhealthcare.

Fig.1highlightssomeofthemanyformsthatcapitalisbeingallocatedtohealthcarerealestateglobally.Whilsttherearedifferencesindeployment

style,withsomeinvestorsoptingfor

anindirectandthereforemorepassivestrategy,itisclear,thatthereisaglobalappetiteforthesector.

Thecasefor

healthcareas

aninvestment

Demandforsafehavens

Healthcare'slong-termandoftengovernment-supportedincomeoffersfurtherdefence.

Structuralchangeinrealestate

Realestateinvestorsalreadyde-riskingfrom

traditionalsectorssuchasretailintoalternativeslikehealthcare.

Socialimpact

TheinfluenceofimpactorESGinvestinginrealestateisgrowingatafasterpacethanever.

Arangeofinvestorsarenowfocusingonsocial

infrastructureinvestments,andhealthcareispartofthis.

Secureincome

Operatorrevenueisreinforcedbyahealthymixofself-fundedcareandpublicly-fundedcare.

Incomeissupportedbyhighoccupancyandpatientdemandacrossthehealthcarearena.

Long-termincome

Weightedaverageunexpiredleaseterms(WAULT)average25-30yearsintheresidentialcareand

hospitalsectors.

Leasesarecommonlyindexed-linkedtoinflation.

Demographicshift

Anageingpopulationmeansincreasingdemandforresidentialcare,primarycareandacute

hospitalservices.

Investmentperformance

Returnsarehistoricallystable,offeringinvestorsprotectionanddiversification.

Fig1:Globalperspective

Australiaaveragedealsize

$1–3m

Whatthislookslike

Apharmacyoroptometrypractice,orasmallmedicalcentre

UKaveragedealsize

$2.5–17m

Whatthislookslike

40–100beds

Spainaveragedealsize

$2–20m

Whatthislookslike

100bedsforelderlycaresettingsorclinicsinmulti-ownerassets

Singapore

Usuallyinvestedindirectly

Source:KnightFrankResearch

GLOBALHEALTHCAREREPORT20235

Table1:TopBuyers(byacquisitionvaluein2022)

GEOGRAPHY

INVESTOR

RANK

HealthcareRealty

TrustInc(fmrHTA)

Welltower

RemedyMedical

Properties

PrimonialREIM

NREP

KayneAnderson

PiervalSante#SCPI

EQTAB

MontecitoMedicaL

USA

1

2

USA

3

USA

FRANCE

4

SWEDEN

5

6

USA

FRANCE

7

8

SWEDEN

9

USA

10

BELGIUM

Aedifica

Source:RealCapitalAnalytics

SECTORUPDATE

NorthAmericancapitalwasthe

variousbuyertypes.However,onanet

Globallycapitaldeployedintocare

biggestcontributertothesector,

buyerbasiscross-border,institutional

relatedrealestateequatedtocirca.

accountingforalmost68%offunds

andREITSemergedasnetbuyers.

$38bnforthefourrollingquarters

deployedlastyearwhilstFranceand

Keycontributorstothemarket

toJune23asperFig.2,which

Belgiumreceivedthemostcross-

includethelikesofHealthcareRealty

accountedforapproximately4.3%

borderinflows.Privatecapitalwas

Trust,WelltowerandAedifica.Thetop

ofallglobalrealestateflows.

overallthemostactiveamongstthe

10canbeseeninTable1.

Fig2:Globaltransactionvolume

$

ROLLING4-QUARTERVOLUMEQUARTERLYVOLUME

60bn

50bn

40bn

30bn

20bn

10bn

201320142015201620172018201920202021202220230

Source:RealCapitalAnalytics

Fig3:Globalbuyercomposition

CROSS-BORDERINSTITUTIONALREIT/LISTEDPRIVATEUSER/OTHER

18.2%

22.2%

11.2%

15.0%

39.1%

19.7%

32.3%

25.0%

47.7%

41.9%

41.1%

36.5%

33.6%

30.8%

28.9%

3.7%

2023YTD

Source:RealCapitalAnalytics

7.7%

56.7%

20.3%

29.4%

22.4%

28.3%

25.4%

23.6%

25.3%

32.7%

41.2%

18.9%

14.3%

31.4%

14.4%

19.4%

12.4%

13.8%

12.6%

19.2%

15.6%

15.6%

27.3%

13.3%

23.1%

11.0%

17.0%

12.1%

11.7%

2020

4.0%

2.0%

4.4%

3.0%

3.2%

3.8%

2022

5.6%

3.7%

3.7%

3.7%

2018

2014

2016

2019

2015

2013

2021

2017

6GLOBALHEALTHCAREREPORT2023

MARKETVIEW

Howartificialintelligenceistransforminghealthcare

ROBERTALLMAN,

SVPEMEA,TTECDIGITAL

Today,youcan’treadthenewswithoutseeingaheadlineaboutartificial

intelligence(AI).AIiscreatingabuzz,

butthetruthisthatAIitselfisn’treallynew.Generativeartificialintelligence

enteredourcollectiveconsciousnessin2022whenChatGPTwasintroduced,butotherformsofAIandmachine

learning(ML)havebeenaroundforalongtime,makingapositiveimpactinmanyareas–especiallyinhealthcare.

Therearemultiplecomplexitiesintroducedbyageingpopulations,changingworkforcedemands

andincreasinglydiversepatient

requirementsthatplacepressuresonthehealthcaresector.The

socio-economicenvironmentfor

personalised,proactive,propensity-

andpredictive-basedgainsinpatientcareandorganisationalproductivitywillbeaddressedprofoundlybyAI.

ThefoundationalAIusecasesarealreadyouttheretomakediagnoses

moreaccurate,caremoreaccessible,andmedicationsmoreeffective.Inthisarticle,we’llsharefourwayshospitals

andclinicscanimprovetheircareand

patientoutcomesthroughAIadoption.

1.AI-enabledConditionDiagnosisand

EarlyDetection

Frombreastcancertokidneyinjuries,

AIishelpinghealthcareproviders

identifyat-riskgroups,andbothtrack

andtreattheirhealthovertime.For

example,mammogramsoftenruna

riskofproducingfalsepositives,whichcanleadtounnecessarybiopsies.

ByusingAItoassessdatarelated

tohormones,genetics,andbreast

density,doctorscanreachaverdict

fasterandwithgreateraccuracy

Implementing

Projectexecution

Innovating

Managed

innovationservices

Education

Trainingand

awarenesscontent

Discovery

AI-CXqualificationguide

Roadmap

AI-CXmaturityworkshop

AIreadinessassessment

Readiness

GLOBALHEALTHCAREREPORT20237

—reducingtheneedforavoidablebiopsies.Beyondbreastcancer,

AI-enabledscreeningsolutions

canparsepatientdatatofind

patientswhoareatgreaterriskformanyconditions.

2.PromotingExpedientCarewithAI

Inemergencymedicalsituations,AIishelpingdoctorspredictandprepare

forunchartedterritory.Atsome

hospitals,predictiveAItechniquesarehelpingtoimprovetheefficiencyof

patientoperationalflow.Bycalculatingpeaktimesofdayandpeaktimes

throughouttheyear,aswellascloselymonitoringpatientadmittanceand

lengthofstay,medicalteamsare

betterpredictingwhenbedswillopenupandadjustingstaffinglevelsto

meetpatientneeds.

AIisalsoshiftingsomeofthe

intakeburdenfromclinicalteams.

Virtualassistantscantakeonsomeoftheinitialhospitaldocumentation,triage,andnotetaking—freeing

nurses,medicalassistants,andotherclinicalstafftofocusonhigh-touchpatientcare.

3.AI’sImpactonHealth

ProgramAdherence

Oncediagnosedwithadisease,

manypatientsroutinelystruggle

tokeepupwiththeirnewchronic

caremanagementplans.Across

thehealthcarelandscape,lapsesinprogramadherenceresultinover

125,000deathsayearaspatient

conditionsworsen.AIisoneway

doctorscankeeppatientsengagedwiththeircareplans.Through

personalizedappsandgamification,patientscancompletetheircare

regimeandtickeachboxontheirhealthcareto-dolist.

Hospitalsandclinicscanalsouse

AItohelpat-riskpatientsre-engage

withthehealthcaresystemafter

notedlapsesintheircareplan.For

example,patientswithhypertension

orType2Diabeteswhomeet

specificsegmentationparameters

canbenotifiedtoscheduleanew

appointmentorsentaremindertorefillanoutstandingprescription.

4.HealthcareDigitalTwins(HDT)

Digitaltwinsaremakingtheir

Automation

CONNECTEDDEVICEEXPLOSION

THEGREATSHUFFLE

DOMOREWITHLESS

EVOLVEDCONSUMER

EXPECTATIONS

InsightEngagement

wayintothepatientexperience.

Healthcaredigitaltwins(HDT)isa

quicklyemergingtechnologyforbetterunderstandingpatients,healthcare

assetsandbehaviours,providing

healthcareorganizationswithreal-timereportingfordata-drivendecisions.

AIisenablingtwotypesofhealthcaredigitaltwins,whichcanproducethefollowingbenefits:

•DigitalTwinofapatient:Ensuring

thedynamicapplicationofnew

research,policyprocedureandcarestandardstoapatient’scondition.

•DigitalTwinofacommunity:

Adigitaltwinofacommunityhelpshealthcareorganizationscreate

betterdatamodelstopredict

demandsandrequirementsfordefinedpopulationsorgroupingsproactively.

NextStepsforAIIntegration

inHealthcare

Ashealthcareleadersthinkabout

waystoimproveoperationsand

patientoutcomeswithAI,it’simportanttounderstandAI’scurrentrisks,

weaknessesandstrengths,aswellasorganizationalreadinesstoimplementthistechnology.

TolearnmoreabouthowTTECDigitalcanhelpyougetstartedwithyourAIjourney,visitourwebsite:

/services/

artificial-intelligence.

76%

Callsansweredbyat-homeagents

24%

CallsdeflectedbyusingAI

8GLOBALHEALTHCAREREPORT2023

Europe

Overview

EurozoneGDPgrowthslowedto

3.5%in2022from5.3%growthin

thepreviousyear,duetorecordhighinflationandrisingborrowingcosts.Therewas,however,significant

divergenceacrosstheregion.Of

thelargesteconomies,Spain(5.5%)

andItaly(3.7%)outperformedthe

EurozoneGDPaverage,supportedbyastrongtourismseason,whileFrance(2.6%)andGermany(1.8%)expandedmoremoderately.Theeconomic

outlookforEuropeandglobally

isrelativelysoftdrivenbystickycoreinflation,weakeningdemandandtighterfinancialconditions.

Tosupporteconomicgrowth,

Europeangovernmentsmayincreaseexpendituredrivingupfiscaldeficitsthroughincreasedborrowing,puttingpressureonalreadystretchedbudgetsinmanycountries.

TheEurozoneeconomycreated

almost3.7millionjobsin2022and

unemploymentisatthelowestrateonrecord.Thehealthcaresectorisseeingparticularlyacutestaffshortages

whichhavebeenexacerbatedbythepandemic.Europehasalsoseenan

increasingnumberofstrikesamonghealthcareworkersduetochallengingworkingconditions,lowpay,and

insufficientresources.

AssomeEuropeancountriesarefindingitincreasinglydifficultto

attractandretainyoungpeopleinthehealthcareprofessions,nationalhealthcaresystemsarestruggling

tokeepupwiththerisingdemandforhealthcare.

Overthenextdecade,EU

employmentinhealthandsocialworkispredictedtogrowbylessthan3%,downfromdouble-digitgrowthintheprevioustwodecades.Atthesame

time,thepopulationintheEUaged75andoverisexpectedtogrowby26%.

WithEuropeseeingarapidlyageingpopulation,complexcareneeds

areincreasingasdiseasessuchas

dementiabecomemoreprevalent(Fig.4).Long-termcareexpenditurevariessignificantlyacrossEurope,while

therearealsoregulatoryandcultural

3.7m

TheEurozoneeconomycreatedalmost3.7millionjobsin2022andunemploymentisatthelowestrateonrecord

differenceswhichmeaninvestors,

developersandoperatorsofhealthcarerealestatewillneedtohaveacountry-specificapproach.

Persistenthighinflationisputting

furtherdemandsonoperatingcosts

ofcarehomes,intheformofhigher

utilitybillsandupwardwagepressure,leadingtohighercostsforresidents.Therelaxationofstatecontrolandgrowingcostpressureatbothcentralandlocal

governmentlevelwilllikelyleadtomoreprivatisationintheelderlycaresector,offeringopportunitiesforinvestorsin

thesector.

Sources:WHO,OxfordEconomics,Trading

Economics,KnightFrankResearch

Fig4:Percentageofpopulationover75

20402023

Source:KnightFrankResearch

EU

Netherlands

Belgium

Poland

UnitedKingdom

Italy

0%2.0%4.0%6.0%

Germany

Spain

France

Ireland

20.0%

18.0%

14.0%

12.0%

16.0%

10.0%

8.0%

10GLOBALHEALTHCAREREPORT2023

MARKETVIEW

BruceWalker

UKCountryManager-Aedifica

Q:Inyouropinionwhichcountriescurrentlypresentthegreatest

opportunityorchallengeforhealthcareinEurope?

TheUKisstillfundamentallyan

attractivemarketforhealthcarereal

estateduetotheunderprovisionof

carebedsandtheneedtoupgradethequalityofbedsprovided.

Germanyhassomeheadwindsat

presentduetoincreasedcostswithoutthefeeinflationseenintheUKbutthisshouldpassandreturntostability.

Finlandcontinuestobeagoodmarketasitiswellfunded.

Q:Haveincreasedbuildcosts

impactedthedevelopmentaspectofyourstrategy?

Yes,itismoredifficulttomakenew

buildopportunitiesworkwithincreasedbuildcosts.Uncertaintyoverbuildcostshasalsobeenanissue,howevertherearesomeindicationsthatbuildcosts

maybestabilising.

Q:Whatareyourthoughtsonthesector’spost-pandemicrecovery?

TheUKcareoperatorshavebounced

backwellwithoccupancybackto

pre-pandemiclevels.Costshavebeendifficulttomanageformany–especiallystaffandenergy-butduetostrong

feeincreasesfrombothprivateandlocalauthoritysources,marginshavebeenprotected.Investmentinstaffrecruitment,trainingandretentionisbearingfruitforsomeoperatorswithstaffcostsbeingmoremanageable.

Q:Howareyoucurrentlymanaging

theissueofrisingdebtcosts?Andhasthiscausedtheliquidityrequirementsofyourstrategytochange?

Thecostofcapitalhaschangedforeveryoneandthisflowsthroughthe

wholemarket,evenawell-capitalisedbusinesssuchasours.Thekeyissueisthatinterestrateswillneedtostabiliseandthevolatilityindebtcoststoabatebeforeinvestorsfeelconfidentto

makemajornewcommitments.

Q:Whatisyourcurrentstrategicfocusandhasthischanged

significantlyfromthistimelastyear?Orevenpre-pandemic?

Strategicfocusremainsgenerally

oneofconstantimprovementoftheportfolio,whichisconsistentbutthehowtodeliveritdoeschangewith

thecircumstances.

Q:Whatwouldyousuggestarethe

keyconsiderationsforextractingor

creatingvalueinthecurrentclimate?

Sameaseverinthissector–the

rightpropertyintherightplace

withtheserviceprovidedbytherightcareprovider.

Q:Howwouldyousuggestyour

capitalstructure–e.g.equityvsdebt,supportsyourstrategyduringthe

currentclimate?

Wearefortunatetobeaverywell-fundedlistedREITwithastrong

balancesheetanda125%dividendcover.Wecanbepatient.

Q:Whatareasofhealthcaredo

youfeelpresentthegreatest

opportunityforinvestors?Andwhatsub-sectorsareofmostinteresttoyourcurrentstrategy?

Valueisincreasinglybeing

recognisedincareOpCos,whether

theyarefreeholdorleasehold.Carehomeswiththeabilitytodeliverhighqualitycareforhigheracuitycontinuetobeinteresting.

Q:Whatwouldyousayposesthe

biggestchallengesforcareoperators

andwhatdoyoulookforwhen

consideringastableoperator.

Staffrecruitmentandretention

continuestobethemostchallengingissueformostoperators.Strongqualitycultureandaclearsenseofwhatthe

organisationsvaluesandfocusare.

Q:HowhastheimportanceofESG

withinyourcurrentstrategygrownoverthelastfewyears?

ESGhasalwaysbeenahighpriority

forAedifica.Wemeasureenergy

performanceatanindividualhomelevelandworkcloselywithoperatorpartnersonimprovingtheenergyperformanceonanon-goingbasis.

Q:Whatwouldyousaythatyouare

currentlymonitoringormostconscious/worriedaboutonthemacroside?

Theinterestratecycleinfluences

allinvestmentdecisions,itis

moreimportantthatstabilityand

predictabilityisreachedratherthan

theactuallevelofrates.Themarketwilladjustoncethereisconfidencethat

interestrateswillbestable.

Q:Doyoufeelasthoughthereareany

relevantareasofcautionwithinthe

sector?Ifso,whataretheseandhow

areyoupositioningforresilience?

Therearealwaysareastobewaryof

suchasregulation,quality,operator

leverage.Wemonitorthemarketand

particularlyourtenantswithahigh

degreeofrigour.

Q:WhatisnextforEuropean

Healthcareasasector?

Hopefullysome“normalisation”after

difficultiesinFranceandGermany.

GLOBALHEALTHCAREREPORT202311

UK

BEDSUPPLY

2023hasbenefittedfromanoverspillincompletionsfrom2022,andappearsasmorepromisingintermsofthenumberofsitecompletions.Themajorityof

projectsinthecurrentdevelopment

pipelineissettobeachievedvia

refurbishmentorextensiontoexistingstockasopposedtonewbuilds.This

does,however,presentinvestors,aswellasowneroccupiers,withthechanceto

consideroptimisationoftheirrespectiveportfolios.Withgrowthopportunities

nowmorelikelytostemfromasset

managementratherthanacquisition,theremayalsobefurtherchancestoexploreESGoptions.

2022sawcirca10,000newbeds

grantedviaplanningapplicationswhichwouldbeasubstantialadditiontothe

currentsupplyofcirca480,000beds.

Notonlywillcompletion/buildoutofthesenewbedsbeawelcomeadditiontopureavailability,butalsoimprovethequalityofoverallstockmovingforward.

INVESTMENT

Reportedtransactionshavebeenfairlymuted,withkeymarketparticipantsseemingtobegaugingmarketsand

Fig5:UKnewpurpose-builtcarehomescompleted

SOUTHERNENGLANDMIDLANDSNORTHERNENGLANDEASTENGLAND

SCOTLANDWALES

100

90

80

70

60

50

40

30

20

10

2023(AsatMarch)

Source:KnightFrankResearch

2020

2022

2018

2016

2019

2021

2017

0

pricing.Wehaveseenprivatecapitalfairlyactiveintheyeartodate.A

numberofinvestorswilllikelyusethistimetoexploreassetmanagement

/value-addopportunityacross

theirportfolioswhilstawaitingnewopportunityattherightlevels.Fig.6highlightsthetargetmarketareasfromoverseascapitaloverthelast

twodecades.Focusingonthelocationofcapitalandthesub-sectorit

flowsinto,wecanseethatUS-based

capitalplacementwithintheUKhashistoricallybeensplitbetweenelderlycareandprivatehospitalassets,whilstEuropeancapitalhasseenmorefocusonelderlycare.

Fig6:OverseascapitalintoUKhealthcarebysub-sector

Belgium

Canada

France

Malaysia

MiddleEast*

Undisclosed

Hospitalfacility

UnitedStates

Primarycare

Source:KnightFrankResearch

Elderlycare

12GLOBALHEALTHCAREREPORT2023

Fig7:HealthcareinvestmentinFrance

in€million

€2,000

€1,800

€1,600

€1,400

€1,200

€1,000

€800

€600

€400

€200

20152016201720182019202020212022€0

Source:KnightFrankResearch

France

Theenthusiasmforhealthcare

propertyisreflectedinrelativelyhigh

investmentvolumeswhich,unlike

otherassetclassessuchasoffices,

haverisensteadilyoverthepastfive

years.Fromatotalof€700millionin

2017,investmentinFrancehasalmost

doubled,reaching€1.4billionin

2022,boostedbyseveraldisposalsof

mixedportfoliostotallingover€500

million,suchastheHekaportfolio

(12propertiesleasedtoKorianand

Ramsay),soldtoPrimonialREIMfor

€135million.TheFrenchhealthcare

investmentmarkethasremained

buoyantin2023,andthiswillmost

likelycontinueoverthenextfewyears.

Itwillcontinuetobeverypopularwith

investorsseekingtodiversifytheir

portfoliosinfavourofsecureasset

classes.Thishasbeensupportedby

dealssuchasIcaderecentlycompleting

thefirststageofthesaleofIcadeSanté

toPrimonialREIMfor€1.4bn,with

Icade’sremainingstaketobeacquired

beforetheendof2025.Inaddition,

privateoperatorsandclinicscontinue

toholdsignificantassets,providing

investorswithmanyopportunitiesfor

propertyoutsourcing.

Table2:Mainhealthcare

operatorsinFrance

Mainactivities

Nursinghome/Clinics/

Seniorhousing/Homecare

Nursinghome/Clinics/

Seniorhousing/Homecare

Nursinghome/

Seniorhousing/Homecare

Nursinghome/Seniorhousing

Medical,surgicaland

obstetricscentres/Clinics

Medical,surgicaland

obstetricscentres/Clinics

Medical,surgicaland

obstetricscentres/Clinics

Numberofbeds

/facilities

+90,000/+1,200

90,860/+1,000

-/+500

+32,000/350

-/350

-/140

-/91

Numberof

employees

67,000

76,000

+50,000

19,000

36,000

28,000

20,000

Turnoverin2022

€4,534m

€4,681m

>€1,500m

€1,162m(in2021)

€1,300m

€2,600m

€2,200m

Korian

Orpea

DomusVi

Colisée

RamsaySanté

Elsan

VivaltoSanté

GLOBALHEALTHCAREREPORT202313

Fig8:Investedvolumes-Belgiannursingandcarehomes

HEALTHCAREINVESTMENTVOLUMESNUMBEROFBEDS(RHS)

€700m

€600m

€500m

€400m

€300m

€200m

€100m

4,000

3,500

3,000

2,500

2,000

1,500

1,000

500

Source:RCA,KnightFrankResearch

Belgium

Fig.8plotsouttheevolutionof

investmentvolumesinBelgiannursingandcarehomessince2018,whichhadsomewhatcooledonthebackofthe

globalpandemicover2020-2021.

In2022,atleast€492millionwas

investedinBelgianhealthcarereal

estatei.e.morethan€178,000perbed.

Thistotalexcludesacorporate

acquisitionbyAGRealEstateoftheoperatorAnimaCare,whichincludesitsrealestateoffivenursinghomestotalling510beds.Thesalehas

generated€300millionincashfor

Ackermans&vanHaren,theholdingcompanybehindAnimaCare.

Acrossthefirstfivemonthsof2023,threeinvestmentdeals(including

twoportfolios)involvingnursing

andcarehomeshavebeenregisteredforatotalof€149millionallocatedto896beds.

Themostnotableacquisitionsofarthisyearhasbeenthe€100million

purchaseofaportfolioincludingfivenursinghomes(510beds)inFlandersbyBNPParibasREIMfromBaltisseatayieldabove4.50%onatriple-netlease.

“In2022,atleast€492million

wasinvestedinBelgian

healthcarerealestatei.e.morethan€178,000perbed.”

0201820192020