Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6...

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MEDICAL FACILITIES CORPORATION June 2015

Transcript of Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6...

Page 1: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

MEDICAL FACILITIES CORPORATION June 2015

Page 2: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

FORWARD-LOOKING STATEMENTS

This presentation may contain forward-looking statements within the meaning of certain securities laws, including the “safe harbour” provisions of the Securities Act (Ontario) and other provincial securities law in Canada. These forward-looking statements include, among others, statements with respect to our objectives, goals and strategies to achieve those objectives and goals, as well as statements with respect to our beliefs, plans, objectives, expectations, anticipations, estimates and intentions. The words “may”, “will”, “could”, “should”, “would”, “suspect”, “outlook”, “believe”, “plan”, “anticipate”, “estimate”, “expect”, “intend”, “forecast”, “objective” and “continue” (or the negative thereof), and words and expressions of similar import, are intended to identify forward-looking statements. Any such statements are subject to risks and uncertainties that could cause actual results to differ materially from those projected in these forward-looking statements. For more information on the risk factors related to these forward-looking statements, please refer to the management’s discussion and analysis, annual information form and ongoing quarterly filings of Medical Facilities Corporation available on SEDAR at www.sedar.com.

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Page 3: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

INVESTMENT HIGHLIGHTS

STABLE CASH FLOW

ATTRACTIVE MARKETS

WITH STRONG ECONOMIES

HIGH-YIELD INVESTMENT

(~6%)

HIGHLY-RATED, HIGH-QUALITY

FACILITIES

EXPERIENCED MANAGEMENT

TEAM AND BOARD

FAVORABLE INDUSTRY

GROWTH DRIVERS

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Page 4: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

COMPANY OVERVIEW

Majority ownership in five specialty surgical hospitals and one ambulatory surgery center

High dividend-yield stock (TSX: DR)

Current yield: ~6.9%

Market Cap: C$509M

Strong, stable cash flow

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Page 5: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

INDUSTRY BACKGROUND U.S. SURGICAL FACILITIES

Traditional Hospitals Specialty Surgical Hospitals (SSHs)

Ambulatory Surgical Centers (ASCs)

Full-service hospital (diagnostic & surgical)

Inpatient and outpatient

Over 60% are not-for-profit

Most specialize in orthopedics, spine, ENT

Inpatient and outpatient

~ 300 SSHs

Outpatient only

> 6,000 ASCs

Sioux falls exterior picture

Generic Hospital

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FACILITY REVENUE MODEL

PAYOR Public, Private

Insurance, Self Pay

Professional Fees

Facility Fee

PHYSICIAN Private Surgeon LLC

ANESTHESIA Private Anesthesia LLC

MFC 51% of profit

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PHYSICIAN- OWNERS

49% of profit

MFC FACILITY

Page 7: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

MFC’S STAKEHOLDERS

Patient Physician

High quality care

Hotel-like environment

Excellent customer service

Predictable scheduling

Ownership stake

Increased productivity

Improved professional income

Involvement in management

Payor Investor

Competitive rates

Efficient billing procedures

Stable, secure income

High-yielding investment 7

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SUPERIOR OPERATIONS

Traditional MFC Hospitals

Day-to-day operations run by Administration Physicians

Types of surgeries performed Emergency & elective Only elective

Admissions & scheduling Emergency & elective Predictable & certain

Average operating room turnaround time >40 min <20 min

Average patient time in post-op care 7 days Hours - 1 day

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Page 9: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

LEADING-EDGE FACILITIES

HOTEL-INSPIRED ENVIRONMENT WITH ADVANCED MEDICAL TECHNOLOGIES 9

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SPECIALTY SURGICAL HOSPITALS

Facility Operating Since Acquired Operating Rooms Overnight Rooms Square Feet

Sioux Falls Specialty Hospital 1985 2004 13 35 76,000

Black Hills Surgical Hospital 1997 2004 11 26 75,000

Dakota Plains Surgical Center 1998 2004 3 15 19,000

Oklahoma Spine Hospital 1999 2005 7 25 61,000

Arkansas Surgical Hospital 2005 2012 11 41* 126,000

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* 51 licensed beds

Specialty surgical hospitals have consistently demonstrated

HIGHER PATIENT SATISFACTION ratings resulting from

HIGHER QUALITY OF CARE RECEIVED

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Our physician owned hospitals benefit from direct physician involvement in

facility management resulting in SUPERIOR PROCESSES AND

EFFICIENCIES

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WELL-SITUATED IN CURRENT MARKETS

Unemployment Rate (%) U.S. South Dakota Oklahoma Arkansas

2014 5.6 3.3 3.9 5.7

2013 6.7 3.6 5.4 7.4

65 and Over (% of population)

2013 14.1 14.9 14.3 15.4

Situated in geographic regions that have proven to be resilient against challenging economic environments

MFC physicians and staff are integral part of our success, they provide patients with innovative treatments and optimal service

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INDUSTRY DRIVERS AND OTHER FACTORS

Increased demand for surgical services Overall population growth Aging population Expanded coverage under healthcare

reform

Specialty hospitals: consistent higher quality and patient satisfaction ratings

Healthcare reform may pose some challenges, uncertainties, and opportunities ~300 specialty hospitals grandfathered

provide acquisition opportunities But specialty hospitals that survive will

be stronger

1 Source: U.S. Census Bureau, 2010 based on National Population Projections 2008; 2015 & 2020 based on National Population Projections 2012 2 Source: Centers for Medicare & Medicaid Services, National Health Expenditure Projections 2011-2021

Under 45 years 45 to 64 years 65 years and over National Health Expenditure (US$ billion)

(millions) (US$ billion)

Pop

ulat

ion

National H

ealth Expenditure

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0

1,000

2,000

3,000

4,000

5,000

0

100

200

300

400

2010 2015E 2020E

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GROWTH BY BUILDING OUR BRAND…

URGENT CARE +

PRIMARY CARE SPECIALIST

IMAGING

MFC SPECIALTY HOSPITALS

Surgery

Pain Management

PATIENT

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…THROUGH URGENT & PRIMARY CARE

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SELECTIVE ACQUISITIONS

Accretive metrics

Strong operating performance

Balanced composition of physicians

Attractive markets (demographics, location)

Change pic to something less similar

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FINANCIAL REVIEW

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FACTORS DRIVING OUR RESULTS

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Revenues

Case Mix

Case Counts

Payor Mix

Ancillary Services

Level of

Revenue

Operating Margins

Salaries & Benefits

Drugs & Supplies (incl. implants)

General & Administrative

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MFC PAYOR MIX – 2014

10%

25% 33%

32% 10%

33% 25%

32%

GROSS REVENUE NET REVENUE

Medicare/ Medicaid

Blue Cross/ Blue Shield

Workers Compensation

Other Private Insurance and Self-pay

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(US$ millions, except where noted otherwise)

Q1 2015 Q1 2014 Change %

REVENUE 75.6 72.9 3.7%

INCOME FROM OPERATIONS* 17.2 13.8 24.9%

OPERATING MARGIN 22.8% 18.9% 20.6%

CASH AVAILABLE FOR DISTRIBUTION (C$ MILLIONS) 11.2 8.9 26.0%

PAYOUT RATIO 78.5% 98.9% (20.6)%

OPERATING RESULTS – Q1 2015

19 * Based on income from operations, which is income before interest expense, gains or losses on foreign currency translation and other non-operating income and expenses.

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CASH AVAILABLE FOR DISTRIBUTION PER COMMON SHARE BEFORE FOREX

0.263

0.308 0.297

0.399

0.286 0.289 0.281

0.333 0.331

0.288 0.269

0.371

0.295 0.296 0.288

0.418

0.275 0.299

0.324

0.360

0.320

1Q10 2Q10 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 3Q12 4Q12 1Q13 2Q13 3Q13 4Q13 1Q14 2Q14 3Q14 4Q14 1Q15

(US$)

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$290.8

$201.3

$51.4

$111.1

$45.8 $35.0 $40.6

STRONG FINANCIAL POSITION – Q1 2015

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Current Assets

Total Liabilities

Total Equity

Non-Current Assets

Cash & Cash Equivalents, Short-Term Investments

Long-term Debt (including current portion)

Convertible Debentures

Other Current Assets

Other Liabilities

* 7.5% Convertible Debentures with approximately C$38.5 million principal amount outstanding as of March 28, 2013 expired on April 30, 2013.

Consolidated Balance Sheet (US$ millions)

2.5x Current Ratio

49.5% Net Debt/Equity

2.6x Subsidiary Debt Coverage (LTM)

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31.2 31.2 31.5 34.4 35.3

37.8 33.8

37.8 40.8 41.4

37.1 33.3

35.7

40.8 43.3

2010 2011 2012 2013 2014

85.2 2014

PAYOUT RATIO*

%

83.3% 92.3% 82.5%

(C$ millions)

Distributions Cash Available for Distribution (including realized gains/losses on FX forward contracts)

84.3% Payout Ratio*

*Including realized gains/losses of FX forward contracts

STRONG CASH FLOW

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Cash Available for Distribution (Excluding realized gains/losses on FX forward contracts)

85.2%

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OUR STRENGTHS

Long-Term Reliable Dividend

Luxurious Hotel-Inspired Amenities

Exceptional Patient Care Experience

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Page 24: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

MEDICAL FACILITIES CORPORATION June 2015

www.medicalfacilitiescorp.ca

Page 25: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

IMPACTS OF PPACA

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Pressure on reimbursement rates

Increase in Medicare/Medicaid patients

MFC hospitals grandfathered

Physical plant expansion limited (ORs and number of beds)

Aggregate percentage of physician ownership is capped

Restrictions on Physician Ownership

Number of physician owners can increase

Page 26: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

CORPORATE INFORMATION

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Page 27: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

MANAGEMENT TEAM

Michael Salter Chief Financial Officer

Michael Salter, CPA, CA, has been CFO of Medical Facilities since February 2004. Mr. Salter has held numerous financial management positions in a variety of Canadian and U.S. based companies involved in the oil and gas, manufacturing, and hospitality industries and was a Trustee of HealthLease Properties REIT until November 2014 when it was purchased by Health Care REIT, Inc. (NYSE: HCN).

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Dr. Donald Schellpfeffer Chief Executive Officer

Dr. Schellpfeffer is an original founder of Sioux Falls Specialty Hospital and a member of its Management Committee. In addition, from 1985 to 2015, Dr. Schellpfeffer was its Chief Executive Officer. He has over 30 years of experience in ambulatory surgical environments and in general, cardiovascular, and trauma practices and has also authored numerous medical publications.

Page 28: Medical Facilities Corporation TSX: DR · $290.8 . $201.3 . $51.4 . $111.1 . $45.8 . $35.0 . $40.6 . STRONG FINANCIAL POSITION – Q1 2015 . 21 Current Assets Total Liabilities .

BOARD OF DIRECTORS

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Seymour Temkin, CPA, CA, FMCA Chair of the Board

Dr. Gil Faclier Consultant Anaesthesiologist at Sunnybrook Health Sciences Centre (“Sunnybrook HSC”) and Pain Medicine Consultant at Sunnybrook HSC and Women’s College Hospital, University of Toronto

Irving Gerstein, C.M., O.Ont Member, Senate of Canada

Dr. Donald Schellpfeffer Chief Executive Officer, Medical Facilities Corporation

Marilynne Day-Linton, CPA, CA Corporate Director

David Bellaire Senior Advisor, Bain & Company

Dale Lawr, CPA, CA (Ontario) & CPA (Illinois) Corporate Director

John Perri Partner, Dorchester Capital, LLC