Expansion Spree: Cleveland Clinic Is Opening New Facilities And Buying Others

Thirty years after moving beyond its Midwest base and founding a Florida outpost, Cleveland Clinic has taken a giant leap here this year with a round of acquisitions and expansions that will take it from 155 beds in Weston to 1,058 beds across five Southeast Florida hospitals and a geographic range eclipsing that of its Ohio home.
In October, Cleveland Clinic Florida inked deals to absorb the non-profit Martin Health, a system with three hospitals in Martin and St. Lucie counties, and the non-profit Indian River Medical Center in Vero Beach in Indian River County.

“Our footprint in Southeast Florida is geographically going to be much bigger than our present footprint in northeast Ohio,” says Cleveland Clinic Florida CEO Dr. Wael Barsoum. Indian River lies 128 miles to the north of its base in Weston in Broward County. In Ohio, Cleveland Clinic’s main campus, plus 11 regional hospitals and 18 fullservice family health centers, all lie in a seven-county region within a 30-mile radius of Cleveland.

The two Treasure Coast hospital deals were Cleveland Clinic’s biggest by far, but the year also has seen it expand in Palm Beach and Broward. It opened a medical office in Wellington in March. In north Broward, in July it opened a 73,000-sq.-ft. family health center. In Weston, its Florida base for 17 years, Cleveland Clinic opened a tower and an expanded emergency department that total 221,000 square feet. In Fort Lauderdale, it opened a concierge medical practice this year and imported as its lead doctor a Cleveland Clinic Ohio internist who had been the personal doctor for doctors there, including Barsoum.
Hospital and health system mergers and acquisitions last year totaled a record 115 nationally, according to Illinois consulting firm Kaufman Hill. Driven by Obama-era health law changes and by a desire for negotiating power with insurers in the face of rising costs and decreasing reimbursements, hospitals have gone after scale. Stand-alone hospitals in particular have faced a squeeze.
Barsoum says Cleveland Clinic has cut $1 billion in costs in the last five years from its $8-billion system. “To stay at the top of the hill, you have to be thinking about what’s coming and to an extent be our own disruptor,” he says.
Investment rating service Moody’s says that while Cleveland Clinic is an international brand with strong cash flow and “exceptional fundraising capabilities,” revenue growth is constrained in northeast Ohio. In part, that’s what’s driving the geographic expansion in Florida and also the opening of a 200-bed hospital in London. (Cleveland Clinic also has sites in Toronto, Abu Dhabi and Las Vegas.)
At Martin Health, Cleveland Clinic has promised to invest $500 million over five years. The two already had teamed up on heart and vascular care. A Cleveland Clinic Florida cardiothoracic surgeon joined Martin Health to perform heart and lung surgeries at Martin Medical Center. At Indian River, Cleveland Clinic promised to invest $250 million over 10 years. Indian River board Chair Dr. Wayne Hockmeyer has said Cleveland Clinic’s reputation will be a “powerful recruiting tool” for top-quality doctors.
In its report, Moody’s mentioned more “potential acquisitions” in Florida. Barsoum says the organization is open to the idea. “We recognize health-care organizations, to be successful, need some level of scale,” he says. “We are regularly approached by health systems and hospitals, and we are open to talking with them. If there is a community or hospital that wants us and they are like-minded and a clinical fit, then we look forward to exploring those options.”
Cleveland’s Expanding Reach
Indian River Medical Center and Martin Health have recently joined Cleveland Clinic Florida.


Cleveland Clinic Florida, Weston
Beds: 205
Employees: 3,067
Revenue: $500 million
Staff size: 259 physicians; 2,808 others
Campus: Main campus in Weston with locations in Coral Springs, Fort Lauderdale, Parkland and Palm Beach County


Indian River Medical Center, Vero Beach
Beds: 332
Employees: More than 2,000
Revenue: $290 million
Patients: 15,300 admissions
Physicians: 320
Campus: IRMC includes the Welsh Heart Center and Scully Endoscopy Center within the facility; separate buildings on the campus: Scully-Welsh Cancer Center, Health and Wellness Center, Wound Care Center


Martin Health
Beds: 521
Employees: 4,500
Revenue: $559.6 million
Patients: 34,418 admissions, 117,112 emergency department visits
Staff size: 504 physicians on medical staff, 150 employed physicians
Campus: Three hospitals (two in Stuart, one in Port St. Lucie)


Source: Florida Trend

Welltower Agrees To Purchase 55 Medical Buildings From CNL Healthcare Properties

Welltower Inc. (NYSE: WELL) and CNL Healthcare Properties announced today that they have entered into a definitive agreement under which Welltower will acquire a Class A medical office and outpatient facilities portfolio comprised of 55 buildings from CNL Healthcare Properties for $1.25 billion. The sale is expected to close during the first half of 2019, subject to customary closing conditions, governmental and other third-party consents.

Welltower will be acquiring 55 assets out of the 63 properties (medical office buildings, post-acute care facilities and specialty hospitals) initially marketed by CNL Healthcare Properties through its strategic financial advisors. The 55 properties have a current occupancy of 94 percent and average annual rent increases of 2.4 percent. The properties are strategically located and 92 percent are affiliated with some of the nation’s premier health systems including Novant, Memorial Hermann and Cleveland Clinic. With 3.3 million rentable square feet in major metropolitan markets across 16 states, the acquisition portfolio will have significant overlap and synergies with Welltower’s existing outpatient medical footprint. Welltower’s proprietary data science and analytics platform has identified this Class A portfolio to have above average market potential defined by opportunity metrics such as market prioritization rank, predictive annual gross rent, insurance/payor mix and physician net need score. At the same time, the portfolio is affiliated with strong hospitals and health systems, none of which are “at risk” hospitals based on Welltower’s proprietary hospital risk analysis.

“Through the strategic acquisition of 55 high-quality medical office buildings from CNL Healthcare Properties, we continue to accretively expand our outpatient medical and health system portfolio,” said Shankh Mitra, Welltower’s chief investment officer. “Welltower was able to act quickly and definitively when the opportunity presented itself, leveraging our proprietary data science platform and deep local presence through our real estate services platform to come to an agreement with CNL as a high quality and reputable sponsor. With market potential metrics and low risk factors, along with a healthy initial cash yield, good escalators and low capital expenditure requirements, this investment will provide an excellent total return for our shareholders.”

CNL Healthcare Properties, a public, non-listed real estate investment trust (REIT) focused on seniors housing and healthcare facilities with a highly respected and seasoned management team, is monetizing this medical office portfolio as part of its ongoing process to pursue strategic alternatives to provide liquidity for its shareholders. The company plans to use the proceeds from the sale to repay debt, pay closing costs and other related expenses. The company, with approval from its board of directors, may use proceeds to rebalance corporate borrowings to further bolster its balance sheet as it pursues additional liquidity alternatives. Post-closing, the company expects to make a special distribution to shareholders, also subject to approval of its board of directors.

CNL Healthcare Properties will continue to own and actively manage a sizeable private-pay, seniors housing centric portfolio of 87 communities located in 31 states.

“Since CNL Healthcare Properties made our first investment in early 2012, we have worked swiftly and thoughtfully to construct and nurture a leading national portfolio of seniors housing and healthcare assets,” said Stephen H. Mauldin, president and CEO of CNL Healthcare Properties. “The sale of our Class A medical office assets to Welltower underscores both the high quality of these properties and our focused work to drive investment performance and value for our investors. Welltower’s deep knowledge of the sector, the CNL platform’s positive experience in past dealings with Welltower, along with its reputation of certainty in delivering on commitments will realize significant value for our shareholders in today’s volatile capital market environment. While we are in the early phases of our strategic liquidity process for the fund, we are confident that this transaction is a strong first step to begin returning capital to our shareholders.”

In June 2018, CNL Healthcare Properties engaged the real estate investment banking groups of HFF Securities L.P. and KeyBanc Capital Markets Inc. to act as strategic financial advisors in exploring and executing potential liquidity alternatives.

Over the last 15 years, CNL Financial Group has been especially active in the seniors housing and healthcare sectors. As of Dec. 31, 2018, CNL-sponsored companies have invested in seniors housing and healthcare real estate investments valued at more than $10 billion, collectively.

This Hospital Is The Highest Ranked In Florida, According To U.S. News & World Report

Baptist Hospital of Miami ranked No. 1 in South Florida and No.6 in the state in the ranks of best hospitals in a new report from U.S. News & World Report.
The nonprofit hospital was one of 12 South Florida hospitals to get a “best” designation, according to the publication’s 2017-18 rankings published Tuesday morning. It was one of four Baptist Health South Florida hospitals in the rankings.

“We are very proud that Baptist Hospital earned the top spot in our area for its commitment to excellence. We share this first-rate recognition with our physicians, nurses and employees, who carry out our mission of providing high-quality, compassionate healthcare to our patients,” said Brian E. Keeley, president and CEO of Baptist Health. “To be honored among the best hospitals locally and in the nation validates that we are meeting and surpassing the high standards we set for our organization and that results in great patient care.”

Nationally, the Mayo Clinic claimed the No. 1 spot for the second year in a row, followed by Cleveland Clinic at No. 2 and Johns Hopkins Hospital at No. 3. The highest ranked hospital in Florida was once again Mayo Clinic Jacksonville in the No. 1 position.
U.S. News releases the rankings to help patients make more informed health care decisions, the publication said in a news release.
Other South Florida hospitals in the 2017-18 U.S. News report and their rankings in Florida are:
– Cleveland Clinic Florida, No. 2 in South Florida and No. 8 in the state.
– Holy Cross Hospital, No. 3 in South Florida and No. 10 in the state.
– University of Miami Hospital, No. 4 in South Florida and No. 12 in the state.
– Memorial Regional Hospital, No. 5 in South Florida and tied for No. 14 in the state.
– Boca Raton Regional Hospital, South Miami Hospital, West Kendall Baptist Hospital tied for No. 6 in South Florida and tied for No. 16 in the state.
– Bethesda Hospital East, Homestead Hospital and Mount Sinai Medical Center tied for No. 9 in South Florida and tied for No. 23 in the state.
– Memorial Hospital West, No. 12 in South Florida and tied for No. 33 in the state.
For the 14th consecutive year, U.S. News & World Report ranked the Bascom Palmer Eye Institute of the University of Miami Health System as the No.1 hospital in the nation for ophthalmology.

“Our patients inspire Bascom Palmer’s superb team of 1,200 doctors, scientists, nurses, ophthalmic technicians and support staff to excel in patient care, vision research, education and surgical innovation,” said Dr. Eduardo C. Alfonso, chairman of Bascom Palmer Eye Institute. “Ensuring personalized, exceptional care for each of our patients is our priority. The fact that ophthalmologists from around the country recognize us as the best in the nation again and again is a great honor.”

Source: SFBJ

Rendina Breaks Ground On Cleveland Clinic Facility

cleveland clinic

Rendina Healthcare Real Estate obtained a $26.6 million construction loan to break ground on the Cleveland Clinic outpatient facility in Coral Springs.
New Jersey-based Siemens Financial Services awarded the mortgage to Coral CC Investors, an affiliate of Jupiter-based Rendina Healthcare Real Estate. The developer recently acquired the 5.2-acre site at 5701 N. University Drive — near the Sawgrass Expressway — from Cleveland Clinic Florida for $3.2 million. The new building will be leased to Cleveland Clinic.
The nonprofit health care organization held the ground breaking ceremony for the 72,000-square-foot facility on April 3. It will include family health services, ambulatory surgery with six operating rooms, imaging equipment such as CT/MRI, mammography and X-ray, 24 prep/recovery bays and 40 exam rooms.
This will be Cleveland Clinic’s eighth facility in South Florida. The hospital is also expanding its main campus in Weston.
Source: SFBJ

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