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LNA Santé – the Home Care Pioneer in France

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LNA Santé – the Home Care Pioneer in France A Work Project presented as part of the requirements for the Award of a Master Degree in Finance from NOVA – School of Business and Economics LNA Santé – The Home Care pioneer in France Maria Inês Costa e Sousa de Sena Esteves | 25855 A Project carried out on the Master in Finance Program, under the supervision of: Professor Luís Mota Duarte Professor Fábio Soares Santos 03/01/2020 1 LNA Santé – The Home Care pioneer in France Abstract: Begun operating in 1992 and today is ready to be bought and to grow massively in the upcoming years. LNA Santé, the fifth French player in the long-term care market, will be acquired in 2019 in a Private Equity deal and will improve its operations in Europe. This deal is expected to return 3.1x the money invested by the fund and an internal rate of return of almost 26% with an exit in five years (2023). This successful exit is possible due to an ageing population that is set to increase demand for dependent care which is reflected in the number of nursing home beds forecasted to double. By the time of exit, the firm will amount €828 M of revenues and €94 M of EBITDA streaming from consolidation of operations in the current operating countries – France and Belgium – and an internationalization bet in the Netherlands. It is presumed that this paper will inform how a deal in Private Equity in the long-term care market in Europe is conducted. Key words: Long-Term Care Market, Nursing Home, European Market, LNA Santé This work used infrastructure and resources funded by Fundação para a Ciência e a Tecnologia (UID/ECO/00124/2013, UID/ECO/00124/2019 and Social Sciences DataLab, Project 22209), POR Lisboa (LISBOA-01-0145-FEDER-007722 and Social Sciences DataLab, Project 22209) and POR Norte (Social Sciences DataLab, Project 22209). 2 Forecasted Financials 3 FORECASTED FINANCIALS|Revenue Levers LNA will grow 16% its revenues from 2019 to 2023. Inorganic growth is crucial for LNA to diversify its operations and keep growing its revenues. In the first three years, both acquisitions and greenfields will be the main drivers (millions €) 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 Revenue Growth Revenues 538,8 716,5 766,1 862,5 822,0 828,2 848,6 871,7 898,6 930,5 • Revenue Growth will be 54% from 2018 to 2023 and it will % growth 33% 7% 13% -5% 1% 2% 3% 3% 4% correspond to a 5 and 7-year CAGR of 9% and 7%. In 2022 there is a decrease in revenue growth due to the end of revenue stream Revenue Levers* from real-estate. Operational +10,0 +18,3 +18,6 +16,9 +13,0 +13,3 +13,5 +13,7 +13,8 • Operational efficiencies are mainly due a better allocation of beds Greenfields - +16,8 +29,2 +5,8 - - - - - (Annex 10). The number of beds per facility ratio increased 7%, 8% and 5% in ALF France, ACR France and Belgium until 2023. Overall Acquisitions +227,3 +0,2 +0,2 +0,2 +0,2 +0,2 +0,2 +0,2 +0,2 revenue increase due to pricing are reflected in the operational lever. The price increased 1,5% a year. Internationalization +20,4 +2,1 +2,8 +3,8 +5,1 +7,0 +9,5 +13,0 +17,8 Non-core -80,0 12,2 45,5 -67,2 -12,3 - - - - • Greenfields will impact revenues in 2020, 2021 and 2022 with the construction of 6 new facilities in France. Each construction only Organic Growth 2% 5% 6% 3% 2% 2% 2% 2% 2% impacts revenues in the year of its launch because in the following years there won’t be additional facilities. Inorganic Growth 31% 2% 6% -7% -1% 1% 1% 2% 2% • Acquisitions will have a higher impact in 2019 with the acquisition Segments of 2 HC firms in France and an ALF/ACR firm in Belgium. ALF 261,1 450,8 467,4 482,9 499,9 508,3 516,8 525,5 534,4 543,5 Acquisitions have a residual impact in revenues of €0,2 M due the % Total Revenues 60% 64% 63% 62% 61% 61% 61% 60% 59% 58% expansion of patients visited in Home Care in France. ACR 137,4 158,8 175,8 206,5 210,6 214,9 219,2 223,6 228,2 232,8 • Internationalization to the Netherlands will drive revenues in the % Total Revenues 28% 22% 23% 24% 25% 26% 26% 26% 26% 27% first year with 1 acquisition in ALF segment and with the further progressive expansion of Home Care segment. Home Care 38,7 96,5 98,9 101,5 104,1 105,5 107,0 108,5 110,0 111,5 • Non-core revenues** reflect the sale of 1 previous greenfield and % Total Revenues 8% 13% 13% 13% 14% 13% 14% 14% 14% 15% the six new constructions made between 2019 and 2021. • Inorganic Growth is the main driver of revenue growth in 2019 as a reflection of the acquisitions made (31%). The following years, growth is mainly based in organic growth. • Home Care will account 13% of total revenues in 2023 as a response to the LNA’s bet in this segment. + The Levers represent the incremental value that each Investment Thesis brings to the Revenue growth. 4 ** The sale of greenfields was based on the current asset-light strategy of LNA Santé. LNA SANTÉ | INVESTMENT COMMITTEE PAPER FORECASTED FINANCIALS|EBITDA Levers LNA will increase its EBITDA margin from 9,3% to 11% in 2023. This increase is mainly due to operational efficiencies allied with robust revenue growth (millions €) 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 EBITDA Margin Growth Revenues 538,8 716,5 766,1 862,5 822,0 828,2 848,6 871,7 898,6 930,5 • Personnel Costs are a driver of EBITDA growth due to the operational improvements in the number of employees per bed. Impact in EBITDA This ratio improved and decreased 4 pp of revenues until 2023. Revenue Change 9,5 11,7 14,8 2,0 1,7 2,5 3,2 4,7 6,5 • Rents make a big part of LNA’s cost structure and have a Personnel Costs 5,7 0,3 -0,3 2,2 0,2 0,3 0,3 0,1 0,1 negative impact on the EBITDA margin. With the expansion of the business, the level of rents as a percentage of revenues will % Total Revenues 55% 52% 49% 51% 51% 50% 50% 49% 48% increase 6 pp until 2023. Rents in France and Belgium are Rents -1,5 -0,1 0,1 -0,2 -0,1 -0,1 -0,1 -0,1 -0,1 already known values. In Netherlands the value of rents was assumed to be the average value spent by square meter in the % Total Revenues 29% 31% 30% 34% 35% 36% 37% 37% 38% long-term care industry. Others -2,4 0,0 0,0 0,0 0,0 0,0 0,0 0,0 0,0 • Other costs include external expenses and variation in finished % Total Revenues 16% 17% 21% 15% 14% 14% 14% 14% 14% goods assumed to remain constant as a percentage of revenues. Change EBITDA 11,4 11,8 14,5 4,0 1,8 2,7 3,5 4,7 6,5 • In the ALF segment the margin will improve 0,3 modest pp until 2023 given that it its a well-established service and the 50,2 61,6 73,4 88,0 92,0 93,8 96,5 99,9 104,6 111,1 EBITDA improvements come with new synergies. % EBITDA Margin 9% 9% 10% 10% 11% 11% 11% 11% 12% 12% • In the ACR segment margins will grow 5 pp until 2023 given that ALF Margin 8,9% 9,2% 9,3% 9,4% 9,2% 8,9% 8,6% 8,2% 7,9% it is a service with a track record of higher EBITDA margins. It is ACR Margin 9,7% 11,6% 14,4% 14,6% 14,7% 14,8% 14,8% 14,8% 14,6% also the segment that LNA has invested more in operational efficiencies (e.g. more beds per facility). Home Care Margin 8,0% 9,9% 11,9% 13,8% 14,9% 16,2% 17,8% 19,7% 22,1% • The Home Care segment will also see an increase of 6,9 pp in this margin mainly due to the entrance in Netherlands with a brand new and efficient model of home service. 5 LNA SANTÉ | INVESTMENT COMMITTEE PAPER FORECASTED FINANCIALS|CAPEX Expenditure The majority of CAPEX investment was made in the first three years in a total amount of €107 M spent in 6 greenfield constructions and 4 acquisitions (millions €) 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 CAPEX Expenditures CAPEX 12,2 76,3 69,3 33,9 26,6 27,2 27,8 28,6 29,5 30,5 • CAPEX: The majority of the investment will be made in 2019 and 2020 with respective expansion CAPEX of €53,5 M and €45,3 M. Current Business 12,2 22,8 24,0 25,7 26,6 27,2 27,8 28,6 29,5 30,5 • Maintenance CAPEX is approximately 3% of revenues in every year and includes costs of extending the size of the properties, Greenfields 0,7 45,3 8,2 - - - - - - the refurbishment of beds and repairs of other assets. Acquisitions 44,7 - - - - - - - - • Greenfields expenditures are all in France and start in 2019 with Internacionalization 8,1 - - - - - - - - 1 ALF and 1 ACR construction.
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