Tenet Healthcare To Acquire 92 Ambulatory Surgery Centers For $1.2 Billion

Tenet Healthcare and subsidiary United Surgical Partners International are expanding their ownership of ambulatory surgery centers, buying 92 from SurgCenter Development.

The $1.2 billion deal expands USPI’s reach into high-growth regions in Arizona, Florida and Texas and includes an attractive case mix of service lines, including musculoskeletal care for total joint and spine procedures, Tenet said in a statement. The transaction will further diversify Tenet’s mix with a larger portion being produced by its higher-margin ambulatory portfolio.

SurgCenter Development owns a minority interest of approximately 39% on average in 86 of the ambulatory surgery centers and a majority interest of approximately 55% on average in six of the ASCs, Tenet said in a released statement.

Tenet plans to finance the transaction through the issuance of first-lien secured notes. The transaction is expected to close in the fourth quarter.

United Surgical Partners International and SurgCenter Development will enter into a five-year partnership and development agreement to provide continuity and support for SCD’s facilities and physician partners, Tenet said. Going forward, USPI also has the exclusive option to partner with SCD on new development projects over the life of the agreement.

The centers to be acquired are located in 21 states. They include 65 mature centers, as well as 27 that have either opened within the last year or will start to perform their first cases in 2022.

Why This Matters

Since 2009, USPI has acquired 67 SurgCenter Development centers. Additionally, in the coming months, USPI plans to acquire a portion of equity interests in the ASCs from physician owners for up to $250 million. Following the addition, USPI will have more than 440 facilities in 35 states.

The terms of the transaction include entry into a new development agreement under which USPI will partner with SCD on the future development of a minimum target of at least 50 centers over a period of five years.

With each center, USPI will have the exclusive option to obtain an immediate ownership position at the time of development with an additional option to purchase SCD’s ownership stake 18 months after the opening of such facilities.

Tenet said it expects the transaction to generate strong financial returns and to realize at least $45 million of annual run-rate synergies over the next three to four years.

The Larger Trend

Tenet Healthcare Corporation, headquartered in Dallas, includes United Surgical Partners International. It operates 60 hospitals, more than 460 other healthcare facilities and Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients.

On Aug. 2, Tenet announced it had completed the sale of its five hospitals and related operations in Florida’s Miami-Dade and Southern Broward counties to Steward Health Care for a reported $1.1 billion. But Tenet’s ambulatory facilities operated by United Surgical Partners International in these markets remained with Tenet and were not included in the transaction.

On The Record

“We are extremely pleased to announce this transformative transaction and partnership, which builds upon USPI’s position as a premier growth partner and SCD’s track record of developing high-quality centers with leading physicians,” said Dr. Saum Sutaria, who took over leadership of Tenet as  CEO this September. “By welcoming these centers into our company, USPI will maintain its reach as the largest ambulatory platform for musculoskeletal services, a high-growth service line. We are also creating a pathway for further expansion through a partnership that pairs the expert development and operational capabilities of our two organizations.”

 

Source: Healthcare Finance

New Health Care Real Estate-Focused REIT Plans To Deploy $2 Billion Over Next 36-48 Months

Since its founding in 2004 as an acquirer and developer of student housing properties, Chicago-based CA Ventures LLC has branched out into other property types, including residential, industrial and senior housing.

Over the years, the firm that was originally known as Campus Acquisition – the “CA” in CA Ventures – grew into what it calls a “global, vertically integrated real estate investment management company with more than $13 billion of assets across North America, South America and Europe.”

In early 2020, the investment firm made its move into healthcare real estate (HRE) with the launching of a medical office and life science division.

In recent months, the company announced that the healthcare division had evolved into a new entity, CA Health and Science Trust Inc. (CAHST), a private real estate investment trust (REIT) focused on acquiring and developing value-add and core-plus medical office and life science facilities across the country.

Leading the private REIT are: as president, Russell Brenner, a 24-year commercial real estate (CRE) veteran with a strong background in acquiring and developing medical office buildings (MOBs) and ambulatory surgery centers (ASCs); and, as chief investment officer, Jesse Ostrow, also a CRE veteran with a strong background in real estate private equity, investment banking and consulting.

The two executives were previously with well-known Chicago-based HRE firms, as Mr. Brenner was a partner from 2012 to 2019 with Stage Equity Partners and Mr. Ostrow was the chief investment officer with MedProperties Group, a medical real estate investment, development and operating platform. He was with the firm from 2011 to 2018.

In announcing the launching of CAHST in September, the REIT also announced an initial equity commitment of up to $245 million from three partners; New York-based Davidson Kempner Capital Management LP, New York-based Monarch Alternative Capital LP and CA Ventures.

The new REIT has certainly gotten off to a fast start.

According to Mr. Brenner: “The REIT plans additional follow-on equity raises in the coming 24 months. With leverage, we will seek to deploy roughly $2 billion over the next 36 to 48 months.”

 

Source: HREI

New 35-Acre Health And Wellness District At Frisco Station Takes A Step Forward

A 35-acre health and wellness district is coming to the nearly $2B Frisco Station development.

An aerial view of the location of a planned health and wellness district at Frisco Station (IMAGE CREDIT: Debra Hale at Hillwood)

Dallas-based Cambridge Holdings just entered into an exclusive agreement with Frisco Station Partnership to develop healthcare and health and wellness-related projects within the fast-growing 242-acre development situated at the crossroads of the Dallas North Tollway and Warren Parkway, near the Dallas Cowboys’ world headquarters, The Star.

Cambridge specializes in the development, financing, acquisition and management of healthcare projects, mixed-use campuses and corporate offices with a focus on sustainable, “healthy, mindful living” development projects.

Though the company didn’t provide exact details of what would be included in the district, it has previously developed dozens of facilities on hospital campuses across North Texas and is behind oneC1TY, a health-focused project in Nashville, Tennessee. The Nashville Post described the 19-acre oneC1TY as a “mixed-use urban node” home to healthcare, life sciences and technology companies and set to eventually comprise more than 1M SF of Class-A research, office, retail, residential and green spaces.

“Cambridge is excited to bring healthcare and the health and wellness component to life at Frisco Station,” Cambridge Chairman and CEO Jean-Claude Saada said in a release. “Our mindful, healthy development principles focused on sustainability and convenient access to fresh food, open space, daily activity and community engagement make the healthy choice the easy choice for people who live, work, and visit. We think these concepts will be embraced in a community like Frisco that is already focused on addressing the total wellbeing of the community and individuals.”

Saada said he hoped to make the district a model for healthy living that would be emulated around the world.

Launched in 2015, Frisco Station was one of the nation’s first communities to be built from the ground up with AT&T’s 5G platform. It is also home to one of the world’s first vertiports to support flying taxis and is partnering in Texas’ first pilot project to test autonomous vehicles on public roadways.

“With Cambridge joining our team, we are reaching the full potential of Frisco Station as a globally recognized Smart, Creative, and Healthy mixed-use neighborhood,” said Trey Sibley, general manager of The Rudman Partnership, one of the three partners in the Frisco Station Partnership, alongside Hillwood and VanTrust Real Estate. “We couldn’t be more pleased to have them join us as we execute what’s considered to be the crown jewel of the project — the place where residents and visitors can experience ways to live healthier, more active and longer lives.”

Frisco Station’s master plan also calls for 2,400 residential urban living units, a 55-acre corporate campus, a dining, shopping and entertainment district, 3M SF of mid- and high-rise office space, and 30 acres of programmed trails, parks and open space.

Source: Bisnow