www.mbrehealthcare.com CHICAGO: 312.726.1700 | NEW YORK: 212.350.2300 | ATLANTA: 404.367.3620
FO UN D ED IN
1982
300
E MP L O Y E E S H E AD Q U ARTE RE D I N
CHICAGO
22 MILLION SF
L EA SED + MA N A GED
M O R E T H AN
7 MILLION
SQ U AR E F E E T D E V E L O P E D
$1 BILLION
HEAL T HC ARE A CQ U IS IT IONS
3 MILLION SF
HEA L T HCA RE ASSE TS U ND E R MANAG E ME NT
EXPERIENCE IN 36 STATES
ACQUISITIONS +
DEVELOPMENT +
PROJECT FINANCING
PROJECT MANAGEMENT
MB Real Estate (MBRE) acquires healthcare facilities across the United States from a variety of sources, including health systems and physician groups, institutional owners, and local developers. MBRE has acquired more than $1B in properties since 2012, making it one of the largest private buyers/owners in the country. MB Real Estate has a team of experienced professionals who are agile enough to execute a variety of acquisitions - ranging from complex, $100M+ multistate portfolios with assumable financing to straightforward, single-tenant properties of $5M. MB Real Estate has ample experience in acquiring both core and value-add property types, on and off-campus, across the country.
MBRE leverages in-house development and project management team to tackle ground-up development projects across the country in a cost effective manner. The firm understands the needs of health systems to continually drive costs downward and passes on its very low cost of capital to its clients directly. The firm is outfitted to provide siteselection, entitlement services, feasibility studies, LEED consulting and ground-up construction services to healt hcare and life science companies alike. MBRE is able to provide clients with confidence in project execution and optimal buying power to deliver an efficient project without incurring unnecessary costs. The team has 30+ years delivering healthcare projects and working through the nuances of the development process (deals ranging from $10–200 million).
LEASING +
CONSULTING
PROPERTY MANAGEMENT With more than 3 million square feet of healthcare facilities currently under management (in addition to 22 million square feet of real estate across 36 states), MB Real Estate has the resources and infrastructure to manage property effectively and efficiently. Managing healthcare facilities involves unique challenges, but MBRE’s experience and knowledge of the property type and its 30 year history of managing institutional grade properties, allows it to successfully navigate these challenges. Applying a hands-on approach to management, the group strives to enhance value, ensure low operating costs, and maximize tenant satisfaction. On the leasing front, MBRE has represented some of the most discerning health systems in the country. MBRE prides itself on understanding healthcare as an industry; its strengths, challenges, and trends, and incorporates this understanding into its leasing efforts.
PEPP | PHYSICIAN EQUITY PARTICIPATION PROGRAM
An amalgamation of all service lines, the consulting efforts of MBRE’s healthcare group is rooted in our extensive knowledge of healthcare as an industry. In fact, MB Real Estate is comprised of former healthcare executives - in addition to a team of real estate professionals. This knowledge of the healthcare industry translates into better real estate solutions for both tenants and clients. The team is equipped to formulate and implement strategies and to ensure operations are as efficient and well planned as possible. Programming, design, and integration are crucial in this service line and MBRE has more than 30 years successfully executing implementation plans.
MB Real Estate’s Physician Equity Participation Program (PEPP) is designed as a way for healthcare systems and physicians to monetize their assets and participate in the equity ownership of real estate. MBRE inserts the PEPP participants into a highly favorable ownership position within the capital structure of real estate projects. In addition to benefiting from the most attractive returns any project can deliver, MBRE alleviates participants from guaranteeing any debt instrument that may be placed on the property. As a result, participants in PEPP are able to leverage MBRE’s capital and expertise, minimize downside risk, and achieve strong investment returns created by the value of their tenancy.
SAMPLE
PROJECTS
ACQUISITIONS + PROJECT FINANCING
PEPP | PHYSICIAN EQUITY PARTICIPATION PROGRAM
LEASING + PROPERTY MANAGEMENT
CONSULTING
DEVELOPMENT + PROJECT MANAGEMENT
MBRE HEALTHCARE’S PROPERTY MANAGEMENT PHILOSOPHY
HEALTHCARE LEASING AND MANAGEMENT ASSIGNMENTS
We utilize all corporate resources at our disposal to deliver best-in-class service to our tenants. We use a hands-on approach to meet business plan goals while creating strategic solutions designed to realize tenant satisfaction, optimize operating efficiencies, reduce costs, and ultimately achieve higher asset value. Our Property Management team is involved throughout the development process. Their involvement includes evaluation of building systems, long-term maintenance and cost-effective building operations. They are present at critical times during construction to ensure a smooth transition from development to building management.
With more than 3 million square feet of healthcare real estate management and leasing assignments, MBRE represent some of the most discerning health systems in the country headquartered in Chicago. MBRE has experience and senior level staff locally. Sample assignments include: Trussville Clinic
Desert Oasis
Orange Regional Medical Pavilion
Alabama; 23,270 SF
California; 96,710 SF
New York; 100,496 SF
Desert Professional Plaza
Fox Valley Medical Center
Central Medical Park I
California; 44,304 SF
Illinois; 20,388 SF
North Carolina; 80,395 SF
Desert Oasis Medical Office Building
Yorkville Medical Office Building
Brier Creek Medical Park I
We feel one of the greatest measurements of tenant satisfaction is tenant retention and expansion. To achieve that, we focus on impeccable tenant service. Our managers meet with tenants regularly to discuss specifically how we are meeting their expectations related to: cleaning; engineering; security; concierge services (if applicable); temperature comfort; amenities; space utilization; environmental; and their business success. Operations are modified according to our tenants’ feedback, if necessary.
California; 78,482 SF
Illinois; 19,885 SF
North Carolina; 60,074 SF
Piedmont West
Lakeshore Medical Office Campus
Denton Medical Office Building
Georgia; 257,528 SF
Michigan; 117,190 SF
Texas; 78,482 SF
Terrace Park Medical Center
East Paris Medical Building
Tomball Professional Atrium Building
We also keep track of the timeliness of our tenant request response times. Our 360 Facility and Angus Anywhere work order systems allow us to produce reports to analyze our response times and to see repeat incidents or lack thereof. We also read all comments to ensure tenants are satisfied with their service.
Georgia; 127,442 SF
Michigan; 111,777 SF
Texas; 53,645 SF
Gwinnett Center I & II
Leonard Street Medical Office Building West Pearland Professional Center
Georgia; 59,623 SF
Michigan; 56,043 SF
Texas; 40,100 SF
Conyers Medical Park
Metro Health Park East
Physicians Plaza of Lebanon
Georgia; 25,883 SF
Michigan; 41,000 SF
Michigan; 73,638 SF
St. Elizabeth Medical Office
Sierra I & II MOB
Webb Medical Plaza
Kentucky; 62,092 SF
Nevada; 53,445 SF
Arizona; 71,515 SF
MBRE HEALTHCARE’S APPROACH TO MEASURING AND ACHIEVING SUPERIOR TENANT SATISFACTION
Our company structure allows our managers to focus resources on the building and its tenants. We can customize our programs to meet the tenant’s needs. We encourage our managers to be entrepreneurs and to share their problems and successes with fellow team members and in our in-house departments in many forums. Our buildings are communities and our tenants are our citizens and neighbors and we treat them as such. Our medical office building portfolio enjoys a 95 percent tenant retention rate.
MBRE HEALTHCARE’S LEASING PHILOSOPHY We pride ourselves on understanding healthcare as an industry; its strengths, challenges, and trends, and incorporating this knowledge into our leasing efforts. Applying a hands-on approach to leasing, we strive to enhance value through maximum occupancy and ensuring a top quality tenant roster. Our firm provides all of its services with professionalism and accountability. We use a hands-on approach to meet business plan goals while creating strategic solutions designed to meet leasing goals and ultimately achieving a higher asset value. Leasing healthcare facilities involves unique challenges, but our experience and knowledge of the asset class as well as a 30-year history of leasing institutional grade properties, allows us to successfully navigate these challenges.
MARKETING INITIATIVES MBRE and its leasing team, led by Andrew Davidson and Marc Westmeyer, will work closely with the client to successfully lease this project. We fully understand the importance of a balanced building occupied by tenants benefitting from each other’s adjacencies and referral patterns. A successful development hinges on the leasing team’s ability to procure the appropriate mix of medical tenants that serves the needs of the community and patient base while at the same time generating the highest revenue possible for the hospital. The appropriate mix of tenants and services will be determined by a collaborative effort between the client and MBRE. Our leasing and marketing efforts will revolve around hospital affiliated prospective tenants and specialty groups across the country.
PIEDMONT WEST HEALTCARE - ATLANTA, GEORGIA In 2013, MBRE Healthcare acquired one of the largest single asset medical buildings in the country, Piedmont West in Atlanta, a 257,528 Square foot facility anchored by Piedmont Hospital
Y DRIVE 4050 HEALTHWA IS AU R O R A , I L L I N O
E AVAIL ABLE! MEDI CAL OFFIC E SPAC OVER 10,00 0 SF OF
5 07 W EST KE VILLE N DA L L • ILLIN OIS
RES BUILDING FEATU
YO R K
• Newly renovated! proximity to: • Great location & close Center - Rush-Copley Medical - Edward Hospital
DOWNTOW N NAPERVIL LE WESTFIEL D FOX VALLEY SHOPPING MALL
EDWARD HOSPITAL
- Route 88 & 59 Mall - Westfield Fox Valley Shopping demographics • Favorable medical office Group • Anchored by Dreyer Medical
ASKI NG
RUSH COPELY MEDICAL CENTER
SU ITE
8 FEATURED SU I T E 2 0 • 940 Square Feet
LEA SE D LEA SE D
3/ 4 5
SF & 8)
C: (773) 988-9378
P: (312) 558-3817 .com E: MWestmeyer@mbres
3,6 66 1,4 00 3,9 12
12
H VICE PRESIDENT |
SUITE 3 &
SUITE 5
SU ITE 8 (includes 6, 7
ER M A R C W EESA L TTH CMA REE GYR O U P
NNN
1 ST FLO OR SUITE 2
SUITE 4
9
PLEASE CONTACT : FOR MORE DETAILS,
SUITE 1
LEA SE D
10 /1 1
CE AVAILABLE SPA
$12/ SQFT /YEA R
2,287
2
• Aggressive TI
Storage, • Office, Exam Room, In-Suite Restroom
AL VIEW ADDITION CLICK HERE TO
SF
1
FO R MO RE
DETAIL
S, PLE AS E CO NT
MARC WEST MEYE
V I C E PR ESI D
EN
SUITE 9
SUITE 8
* include s suites
90 0
R
2 ND FLO OR
6, 7 & 8
SUITE 10 & SUITE 11 SUITE 12
AC T:
T | HE P: (31 A LT H C 2 ) 558 ARE G -38 1 7 E : M We RO U P C : ( 7 73 stmeye r@mbr ) 98 8 es.com - 937 8
CLICK
TO VIEW
PORT
OUR MEDI CAL
OFFIC E
FOLIO
BUILD ING
DEMAND DEMOGRAPHICS Sizing the Facility When determining the size of the facility, MBRE Healthcare evaluates many factors. Some of the analyses used include: Nielsen Demographic Update 2013.1 Methodology
MARKET
VACANCY
MARKET
July 2012
DEMOGRAPHICS
MA R K E T
DEMAND
MARKET
RENTS
OUTPATIENT DEMAND – MARKET SPECIFIC FORECAST – REFORM ADJUSTED
TRUVEN HEALTH PLANNING SOLUTIONS PREPARED FOR: MBRE HEALTHCARE SEPTEMBER 9, 2013
OUTPATIENT
TRACY GUO – CLIENT EXECUTIVE COMMERCIAL MARKETS KENT FRANCIS – NATIONAL DIRECTOR, PLANNING SOLUTIONS
County models built from historical claims data: 100% CMS Medicare facility, all-payer commercial, Medicaid, and physician claims across the US. Includes all delivery settings, and partial data from all counties, all payers and all delivery settings to reflect local utilization patterns PLANNING
Utilization varies in each local market. Making the right investment decisions for growth, physician recruitment, site placement require accurate local market knowledge
A R EA
DEVELOPMENT PIPELINE
BENEFITS OF
ON-CAMPUS LOCATION
Forecasts reflect population growth, insurance change forecasts by ZIP, Colonoscopy Rate / 1,000 Pop and historical utilization, practice patterns, reimbursement, and disease prevalence derived from actual data
Cataract Surgery Rate / 1,000 Pop Outpatient Code Profiles
OUTPATIENTAvg.CODE PROFILES:
Avg.
41.2 Per BY CPT-4/HCPCS CODE & 12.6 Per OF SERVICE ESTIMATE VOLUMES SITE 1,000 Pop
1,000 Pop
2
Estimate volumes by CPT4/HCPCS code for Truven Health Analytics procedure groups, or create custom user defined groups of individual procedure codes. View by county or ZIP code and Site of Service
AGE, QUALITY , & LOCATION
COMPETING BUILDING PRODUCT
Sources: Truven Health Analytics Outpatient Procedure Estimates, Nielsen Claritas Demographics 3
Some of the resources utilized include Truven Healthcare Analytics, Neilsen Demographic Analysis and our own market analysis.
4
4
TYPICAL DEVELOPMENT PLAN • I ntegrated project delivery method bringing the team together early and working together throughout the process to deliver the best product at the lowest cost • Initial and Final Rent = Tenant’s Project Costs X Rent Constant • T enant’s Project Costs = each Tenant’s pro-rata share of Base Building costs and 100% of each Tenant’s individual tenant improvement package (this method removes the burden from the initial tenants from covering the entire base building cost) • S avings and Unused Contingency = 100% of the savings and unused contingency are passed on to client and other tenants (keeps costs at a minimum and avoids any development “gamesmanship”)
DUE DILIGENCE • C onduct site due diligence (environmental, civil, geotechnical, etc.) • Evaluate availability of utilities • Verify zoning requirements/restrictions • Establish the building and site program • Establish preliminary project budget & schedule
• 100% Open Book
SCHEMATIC DESIGN/ DESIGN DEVELOPMENT CONCEPTUAL DESIGN • Initial programming and site confirmation • Concept design • P repare conceptual site & building configurations incorporating the building and site program with planning & zoning requirements • Present conceptual ideas
• 100% Transparent with Hard and Soft Costs
• Select the preferred conceptual design
• C onstruct initially leased space simultaneously with core/ shell in order to save time and reduce costs to the tenants for their fit-out
• S chematic design and design development refinement • D esign building to include plans, elevations, materials, etc. • Conduct test-fit of tenant interiors layouts • Perform preliminary civil engineering of the site • E stablish detailed written outline specifications (Finishes, Mechanical, Electrical, Plumbing & Fire Protection, Floor loading, Roofing strategy, Building envelope, etc.)
• U pdate conceptual design budget and schedule
• Set guaranteed maximum price (GMP)
• O btain approval to move forward with initial plans and rental rate
• Zoning & entitlement submittals
• Update project budget & project schedule • O btain approval to move forward with updated plans and rental rate
CONSTRUCTION DOCUMENTS CONSTRUCTION SITEWORK, CORE & SHELL / INITIAL TENANT IMPROVEMENTS SET-UP / MOVE-IN • Coordinate with client to set-up their furniture, fixtures & equipment (FF&E) • Coordinate seamless transition from the development team to MBRE Property Management team
TENANT IMPROVEMENTS • C ommence with tenant improvement (there will be overlap of TI and core & shell construction in an effort to compress the overall schedule) • C ontinue OAC meetings, tracking of construction, proposed change orders, draws, etc.
• Close-out the construction contracts and obtain all lien waivers
• C oordinate with contractor, architect and tenant preparation and closure of TI punchlist (complete sitework and core & shell punchlist)
• True-up final costs
• Package close-out documentation
• Project completed and operational
• O btain temporary certificate of occupancy and final certificate of occupancy • Conclude the construction phase
• C oordinate planning, zoning, site plan and architectural approvals
• Deploy & commence with construction
• Prepare Construction Documents (CD’s)
• C onduct weekly owner, architect and contractor (“OAC”) meetings – produce site inspection reports
• Conduct value engineering
• C ontinuously monitor construction activities, track critical path tasks and milestones to ensure delivery schedules are met
• U pdate project budget and project schedule
• M onitor construction costs: spent, pending, and balance to completion • Monitor contingencies & allowances • Evaluate all proposed change orders • R eview and process monthly draw requests and lien release documentation • Assist with mediation to solve construction conflicts that may occur • C oordinate with contractor and architect preparation and closure of core & shell
• Subcontractor bidding
• O btain required building permits/ approvals • Notice to proceed with construction • Update GMP & Notice to Proceed • O btain client’s approval to move forward with final plans and rental rate
WHY
MBRE
PHYSI C I A N PA R TI C I PA TI ON
EQUITY PROGRAM
3 0 YEA R S OF HEA LTHC A R E
EXPERIENCE
INSTITUTIONAL RES O U RC ES ENTREPRENURIAL APPROACH
+ EXPER TI S E
FINANCIAL
STRENGTH
F U L L S ERVIC E
CAPABILITIES A C QUIS ITION S ,PROJE C T FI N A N C I N G ,
DE VELOPME N T, LEA SI N G + M A N A G EM EN T
NATIONA L
HEALTHCARE FO C U S
MBRE PRINCIPALS - CONTACTS
ANDREW DAVIDSON
PRINCIPAL, MBRE HEALTHCARE GROUP P: 312.558.3888 | F: 312.558.3883 | C: 773.972.9082 adavidson@mbres.com
CHICAGO: 312.726.1700 | NEW YORK: 212.350.2300 | ATLANTA: 404.367.3620 www.mbrehealthcare.com
PETER WESTMEYER
PRINCIPAL, MBRE HEALTHCARE GROUP P: 312.558.3878 | F: 312.558.3883 | C: 303.906.7924 pwestmeyer@mbres.com