investor presentation · 2021. 3. 1. · 2 the doc investment thesis $5.0bn healthcare real estate...
TRANSCRIPT
Investor PresentationMarch 2021
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This document may contain “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. These forward-looking statements concernand are based upon, among other things, the possible expansion of the company’s portfolio; the sale of properties; the performance of its operators/tenants andproperties; its ability to enter into agreements with new viable tenants for vacant space or for properties that the company takes back from financially troubled tenants, ifany; its occupancy rates; its ability to acquire, develop and/or manage properties; the ability to successfully manage the risks associated with international expansionand operations; its ability to make distributions to shareholders; its policies and plans regarding investments, financings and other matters; its tax status as a real estateinvestment trust; its critical accounting policies; its ability to appropriately balance the use of debt and equity; its ability to access capital markets or other sources offunds; its ability to meet its earnings guidance; and its ability to finance and complete, and the effect of, future acquisitions. When the company uses words such as“may,” “will,” “intend,” “should,” “believe,” “expect,” “anticipate,” “project,” “estimate” or similar expressions, it is making forward-looking statements. Forward-lookingstatements are not guarantees of future performance and involve risks and uncertainties. The company’s expected results may not be achieved, and actual results maydiffer materially from expectations. This may be a result of various factors, including, but not limited to: the unknown duration and economic, operational, and financialimpacts of the global outbreak of the COVID-19 pandemic and the actions taken by governmental authorities in connection with the pandemic on the Company’sbusiness; material differences between actual results and the assumptions, projections and estimates of occupancy rates, rental rates, operating expenses and requiredcapital expenditures; the status of the economy; the status of capital markets, including the availability and cost of capital; issues facing the healthcare industry, includingcompliance with, and changes to, regulations and payment policies, responding to government investigations and punitive settlements and operators’/tenants’ difficulty incost-effectively obtaining and maintaining adequate liability and other insurance; changes in financing terms; competition within the healthcare, seniors housing and lifescience industries; negative developments in the operating results or financial condition of operators/tenants, including, but not limited to, their ability to pay rent andrepay loans; the company’s ability to transition or sell facilities with profitable results; the failure to make new investments as and when anticipated; acts of God affectingthe company’s properties; the company’s ability to re-lease space at similar rates as vacancies occur; the failure of closings to occur as and when anticipated, includingthe receipt of third-party approvals and healthcare licenses without unexpected delays or conditions; the company’s ability to timely reinvest sale proceeds at similarrates to assets sold; operator/tenant or joint venture partner bankruptcies or insolvencies; the cooperation of joint venture partners; government regulations affectingMedicare and Medicaid reimbursement rates and operational requirements; regulatory approval and market acceptance of the products and technologies of life sciencetenants; liability or contract claims by or against operators/tenants; unanticipated difficulties and/or expenditures relating to future acquisitions and the integration ofmulti-property acquisitions; environmental laws affecting the company’s properties; changes in rules or practices governing the company’s financial reporting; themovement of U.S. and foreign currency exchange rates; and legal and operational matters, including real estate investment trust qualification and key managementpersonnel recruitment and retention. Finally, the company assumes no obligation to update or revise any forward-looking statements or to update the reasons why actualresults could differ from those projected in any forward-looking statements.
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The DOC Investment Thesis
$5.0bn Healthcare Real Estate Portfolio
• 94% of Cash NOI from MOBs
• 89% Health System Affiliated (GLA)
• 61% Investment Grade Tenancy(1)
• 275 Assets
• 53,000 sf Average Asset Size
• 96% Leased
Who We AreDOC is an internally managed healthcare REIT focused on theselective acquisition and management of high quality medical officefacilities leased to leading health systems
Experienced Management TeamManagement’s long-standing health system relationships provide astrategic advantage in any MOB market
Unmatched Focus on Tenant CreditDedicated credit department provides for robust monitoring of portfoliofinancial health, with systematic recurring financial statement review of124 of the Portfolio’s Top 125 tenants by ABR
A Portfolio for the Future of HealthcareDOC’s portfolio emphasizes off-campus outpatient facilities leased toleading healthcare systems, which will continue to benefit asprocedures move to more efficient sites of care
Proven Cash Flow GrowthLong-term leases with top quality tenants and careful CapExmanagement have enabled DOC to achieve historical cash flowgrowth that outpaces its peers Baylor Charles A. Sammons Cancer Center | Dallas, TX
All values as of December 31, 2020 unless otherwise noted.(1) Consolidated assets only, by GLA. Includes parent ratings where
appropriate plus tenancy attributable to Northside Hospital (non-ratedentity due to no outstanding public debt).
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New Medical Office starts, most frequently developed on a“built-to-suit” basis for health systems, are overwhelmingly
being constructed away from the hospital campus
Favorable Market Trends
MOB Construction Starts / On vs Off Campus
National Hospital Beds vs Outpatient Centers
26.9
40.62.8
2.5
Outpatient Centers (in Thousands)
Hospital Beds (Per Thousand Persons)
43%
72%
57%
28%
Off Campus On Campus
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The delivery of healthcare continues to shift to moreefficient, more convenient outpatient facilities – leading to
the net closure of 161 hospitals between 2014 and 2018
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Technological advances and reduced regulations haveincreased the number and acuity of procedures that
can be performed on an outpatient basis
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“We no longer believe there is a need for the (inpatientonly) list in order to identify services that requireinpatient care. Instead, the physician should use hisor her clinical knowledge and judgment, together withconsideration of the beneficiary’s specific needs, todetermine whether a procedure can be performedappropriately in a hospital outpatient setting”
-- CMS OPPS Proposed Rule, August 2020
Sources: Revista, CBRE, US Census County Business Patterns,AHA 2020 Trendwatch Chartbook
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Pandemic Impacts
DOC Consumer Survey / May 2020
Revista Provider Survey / October 2020
Q: Which location characteristics do you find more orless favorable now than prior to the pandemic?
Provider Preference MoreFavorable
NoChange
LessFavorable
Off-Campus 35% 58% 7%
On-Campus 12% 40% 48%
Suburban Locations 58% 42% 0%
Off-Campus PreferenceThe ongoing pandemic has accelerated the move to off-campus care,with both providers and patients viewing the off-campus venue morefavorably as a result of COVID
Asset Utilization & Patient VolumesWhile PPE shortages drove dramatic (but temporary) declines inhealthcare utilization during March and April 2020, non-emergencyprocedure volumes have now largely returned to pre-pandemic levels
TelehealthTelehealth enhances provider efficiency by moving low-revenue follow-up visits to the virtual setting, increasing the number of procedure visitsthat can be delivered by practitioners – ultimately growing theprofitability of provider real estate
Space NeedsSector fundamentals remain in tact, with 78% of providers estimatingthat their long-term space needs have either increased or remainthe same as a result of the COVID Pandemic
Q: If you had to visit a physician office or clinic today,what type of facility would you prefer?
Consumer Preference % Respondents
Located in or Connected to a Hospital 23%
Not Located in or Connected to a Hospital 77%
Sources: Revista, Epic Health Research Network, DOC Commissioned Survey
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A Portfolio for the Future of Healthcare
78%
91% 93%100%
% Health-System Affiliated (Asset GLA) Acquisition Cap Rate
29%
62%73%
87%
% Investment Grade Tenancy (GLA)
90% Avg.
61% Avg.
Leading Tenants Stronger Credit Day-One Accretion
`
% Investment Grade Tenancy
61% 45% 46%
% Portfolio Located Off-Campus
47% 33% 12%
The DOC Portfolio has been builtwith an unmatched emphasis on
investment grade tenants occupyingassets best positioned to capitalize onhealthcare’s continuing transition away
from the hospital campus
Acquisition Activity Focus(1)
(1) Statistics by year acquired for the Company’s consolidatedproperties, as of December 31, 2020.
7.7%
6.6%
5.5% 5.6%6.3% Avg.
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Data-Driven Investments Platform
Tenant CreditQuality
TenantAffiliation
Tenant MarketShare
LeaseCharacteristics
MarketHealth
BuildingEcosystem
Physical Plant
DOCscore // 2020 Revisions
55% 25% 20%Tenant Specific
CriteriaDemographics /
EcosystemPhysical
Plant
Proprietary ScorecardThe Company’s proprietary DOCscore is derived throughportfolio experience and observed market data to identify andprioritize the most attractive investment opportunities
Emphasis on Tenant StrengthTenant Credit holds the largest weight in the DOCscore inrecognition of the outsized impact that a lease default has onshareholder returns and asset economics
Constantly EvolvingThe DOCscore is reviewed and recalibrated on a regular basisto optimize predictive value
The DOCscore: An ObjectiveMeasure of Asset Quality
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($480,000)
($360,000)
($240,000)
($120,000)
$0
$120,000
$240,000
$360,000
$480,000
$600,000
$720,000
DOC matches acquisition pace to equity value tomaximize shareholder benefit
-40%
-30%
-20%
-10%
0%
10%
20%
30%
40%
50%
60%
Demonstrated Acquisition Discipline
Premium to Consensus NAV vs Net Acquisition Volume
MN Portfolio- - - - - - - - - - -
$297mmFollow-OnOffering
January 2015
CHI Portfolio- - - - - - - - - - -
$443mmFollow-OnOffering
April 2016
ROFR Portfolio- - - - - - - - - - -
$421mmFollow-OnOffering
June 2017
CAB C
B
A
D
PandemicDiscipline
- - - - - - - - - - -reduced volumes
during COVIDuncertainty
D
Return toGrowth
- - - - - - - - - - -$208mm of Fourth
Quarter 2020Investments
E
E
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2020 Investment Highlights
Date Name AssetValue(1)
CapRate(2) Source
02/2020 Westerville II MOB $ 10,683 6.1% Off-Market
03/2020 TOPA Fort Worth MOB 49,145 4.1%(3) Off-Market /Loan Conversion
09/2020 Ascension Cancer Center 21,085 5.8% Off-Market
11/2020 Health Center at Easton 15,775 5.3% Off-Market
12/2020 Hartford HC Cancer Center 16,855 5.5% Marketed
12/2020 Sacred Heart MOB & ASC 32,409 6.3% Off-Market /Loan Conversion
12/2020 Westerville II MOB 5,350 6.1% Off-Market
12/2020 Landmark Loan Portfolio 54,250 7.9% Off-Market
12/2020 Davis Joint Venture 55,262 6.2% Off-Market
(1) Inclusive of loan conversion value and post-acquisition earnouts, where applicable(2) Represents first year cash yield, adjusted for completion of short-term abatements and
inclusive of Joint Venture management fees where applicable(3) Newly constructed asset purchased at 82% occupancy. Underwritten 5.5% yield at stabilization
2021 Guidance
• Real Estate Investments: $400 – $600mm• Cash Cap Rates: 5.0% - 6.0%
2020Investments $275.5mm // 6.4% First Year Yield
Acquisition Highlights
Ascension Sacred Heart Summit MOB and ASC | Pensacola, FLAcquired thru DOC Loan-to-Own Development Program
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$0.65 $0.85 $0.88 $0.93 $0.94 $0.93 $0.99
138%
93%
2014 2015 2016 2017 2018 2019 2020
FAD / Sh Payout Ratio
DOC’s steadfast focus on cash flowhas resulted in total shareholderreturns that lead the peer group
since our IPO
Focus on the Bottom Line
DOC Payout Ratio History
+ 30%
+ 4%+ 6%
+ 1% (1%) + 6%
Total Shareholder Return Since DOC IPO
+126% 75% 54%
Total Shareholder Return from July 24, 2013 to February 25, 2021
100% Payout
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DOC has demonstrated higher and more consistent per-sharecash flow growth relative to its closest peers
$0.18
$0.25
$0.35$0.36
$0.31
$0.28
Superior Earnings Growth
FAD / Share History
Source: Company filings. 2Q20 HTA and HR FAD adjusted to include $4.7mm and$0.9mm, respectively, in recurring tenant bad debt expense.
Annualized FAD / Share Growth – 2015 to 2020
+3.1% +0.7% +0.3%
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Industry Leading Tenant Base
0%
5%
10%
15%
20%
DOC HTA HR
Near-Term Lease Expiration Schedule(% Portfolio Leased GLA as of December 31, 2020)
DOC HTA HR
% Leased 96% 90% 87%
% Investment Grade Tenancy(1) 61% 45% 46%
Wtd. Lease Term Remaining 6.8 Years 5.6 Years 3.8 Years
Recurring CapEx(1) / Cash NOI(Prior Four Quarters) 6.2% 12.1% 19.5%
Source: Company filings. 2021 expirations include MTM leases.
Expirations Thru 2025(% Portfolio)
DOC 28%
HTA 51%
HR 73%
(1) DOC & HR by Leased GLA, HTA by ABR. Includes parent ratings whereappropriate plus tenancy attributable to Northside Hospital (a non-rated entity).
(2) Recurring CapEx includes 2nd Generation TI and Leasing Commissions paid
DOC’s portfolio provides industry-leadingstability, exceeding closest peers in credit
quality, occupancy, and remaining lease term
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Diversified Portfolio
Top Ten MSAs(1) MSA Rank % GLA % ABRInternal
ManagementPresence
1 Atlanta / Sandy Springs / Roswell, GA 9 7.6% 8.1%
2 Dallas / Fort Worth / Arlington, TX 4 6.9% 8.2%
3 Louisville / Jefferson County, KY / IN 46 5.3% 4.5%
4 Phoenix / Mesa / Scottsdale, AZ 10 5.2% 5.3%
5 Minneapolis / St. Paul / Bloomington, MN / WI 16 5.1% 5.3%
6 Indianapolis / Carmel / Anderson, IN 33 4.8% 4.3%
7 Omaha / Council Bluffs, NE / IA 57 4.3% 4.0%
8 Columbus, OH 32 4.0% 3.5%
9 Seattle / Tacoma / Bellevue, WA 15 2.7% 2.4%
10 Houston / The Woodlands / Sugar Land, TX 5 2.4% 2.5%
Top Ten Tenants(1) PrimaryState
Credit Rating(2)
(Moody’s / S&P / Fitch) % ABR 4th QuarterCollections
1 CommonSpirit - CHI – Nebraska NE Baa1 / BBB+ / BBB+ 5.6% 100.0%
2 Northside Hospital GA Not Rated(3) 4.9% 100.0%
3 University of Louisville Health KY Baa1 / A+ / NR 4.0% 100.0%
4 US Oncology, Inc. TX Baa2 / BBB+ / BBB+ 3.2% 100.0%
5 Baylor Scott and White TX Aa3 / AA- / NR 2.6% 100.0%
6 Ascension - St. Vincent’s IN Aa2 / AA+ / AA+ 2.5% 100.0%
7 CommonSpirit - CHI - St. Alexius ND Baa1 / BBB+ / BBB+ 2.2% 100.0%
8 HonorHealth AZ A2 / NR / A+ 2.0% 100.0%
9 Great Falls Clinic MT Caa1 / B- / NR 1.8% 100.0%
10 CommonSpirit - CHI - Franciscan WA Baa1 / BBB+ / BBB+ 1.7% 100.0%
(1) Figures as of December 31, 2020, excluding unconsolidated JV assets(2) Parent rating used where appropriate(3) Northside Hospital carries no public debt, but carries a shadow rating of ‘A-’ per DOC’s
Credit Model
DOC’s consolidated portfolio is diversified across31 states, with no MSA representing over 8% of
leasable square footage or tenant responsible formore than 6% of annual base rent
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Strong Liquidity with Access to Capital
Debt Maturity Schedule(As of December 31, 2020)
‘BBB’ / ‘BBB-’ / ‘Baa3’ $684mm 5.06x 5.25xFitch / S&P / Moody’s
Investment Grade RatingsAvailability Under
Revolving Credit Facility4Q20 Enterprise Net Debtto Adjusted EBITDAre(1)
2021 Target Net Debt toAdjusted EBITDAre
(1) Adjusted EBITDAre is a non-GAAP measure. Refer to slide 16 for a reconciliation ofNet Income to Adjusted EBITDAre
$6
$187
$265
$25 $25
$70
$425$401
$- $-
$45
$- $-
$50
$100
$150
$200
$250
$300
$350
$400
$450
Mill
ions
Senior Notes
Credit Facility Term Loan
Revolving Credit Facility
Mortgages
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Engage Tenants / HostGreen Events
Environmental Strategy
Project Highlight: 2,500 Panel Solar GridStrictly Pediatrics Specialty Center | Dallas, TX
Quantifiable Environmental Objectives
10%Improvements in Key
Metrics by 2021(three year performance period)
Energy Use per Square Foot
Greenhouse Gas Emissions
Water Consumption per Square Foot
Percentage of Waste Diverted
RepeatableProperty
SustainabilityProgram
3
Collect PerformanceData
1
Implement Low & NoCost Measures
2
Incorporate GreenLease Clauses
4
Perform EnergyAudits
5
Design & ExecuteGreen CapEx Projects
6
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ESG Achievements to Date
View our full ESG Report online at docreit.com/ESG
2020 Gold Green Lease Leader IREM CSP Certifications Numerous “Best Place to Work” Awards
• One of 15 Landlords to be named a“Gold” level Green Lease Leader bythe Department of Energy’s “BetterBuilding Alliance”
• Nearly all new leases since 2019include Green Lease provisions
• Green Leasing provisions allowDOC to access and share energyuse data, participate in OpExsavings from Green CapEx spend
• Established by the Institute of RealEstate Management as a programfor property types not covered byother sustainability organizations
• 18 DOC assets have received theCSP designation based on energy,water, and recycling criteria
• DOC is on pace to exceed ourestablished goal of earning 25certifications by 2023.
• DOC’s in-place Diversity, Equity, andInclusion Council establishes andoversees organizational goals andeducation on inclusivity
• Stock grants are awarded to allemployees upon achievement ofone year of service time
• Culture of philanthropy includesfinancial gifts, quarterly DOC-organized volunteer projects, andvolunteer-time-off to all employees
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Reconciliation of Non-GAAP Measures
Calculation of Enterprise Net Debt December 31, 2020
Enterprise Debt $ 1,584,820
Less: Cash and Cash Equivalents (2,515)
Enterprise Net Debt $ 1,582,305
Calculation of Enterprise Net Debtto Enterprise Adjusted EBITDAre
Quarter EndedDecember 31, 2020
Net Income $ 18,609
Depreciation and Amortization Expense 37,846
Interest Expense 13,658
Gain on the Sale of Investment Properties (5,842)
Impairment Loss 4,872
Proportionate Share of Unconsolidated JV Adjustments 2,759
EBITDAre $ 71,902
Non-Cash Share Compensation Expense 3,325
Pursuit Costs 79
Non-Cash Intangible Amortization 1,162
Pro Forma Adjustments for Investment Activity 1,721
Enterprise Adjusted EBITDAre $ 78,189
Annualized $ 312,756
Enterprise Net Debt / Enterprise Annualized Adjusted EBITDAre 5.06x
This presentation includes disclosure of AdjustedEBITDAre, which is a non-GAAP financial measure. Wedefine Adjusted EBITDAre as EBITDAre, computed inaccordance with standards established by the NationalAssociation of Real Estate Investment Trusts (“Nareit”),plus non-cash compensation, pursuit costs, non-cashintangible amortization, the pro forma impact of investmentactivity, and other non-recurring items. We considerAdjusted EBITDAre an important measure because itprovides additional information to allow management,investors, and our current and potential creditors toevaluate and compare our core operating results and ourability to service debt.
For purposes of the Securities and Exchange Commission’s(“SEC”) Regulation G, a non-GAAP financial measure is anumerical measure of a company’s historical or futurefinancial performance, financial position or cash flows thatexcludes amounts, or is subject to adjustments that havethe effect of excluding amounts, that are included in themost directly comparable financial measure calculated andpresented in accordance with GAAP in the statements ofoperations, balance sheets or statements of cash flows (orequivalent statements) of the company, or includesamounts, or is subject to adjustments that have the effect ofincluding amounts, that are excluded from the most directlycomparable financial measure so calculated and presented.
As used in this presentation, GAAP refers to generallyaccepted accounting principles in the United States ofAmerica. Our use of the non-GAAP financial measure termsherein may not be comparable to that of other real estateinvestment trusts. Pursuant to the requirements ofRegulation G, we have provided reconciliations of the non-GAAP financial measures to the most directly comparableGAAP financial measures.