Market Commentary: Lifelines and Safety Nets

Everything comes to pass and nothing comes to stay. This is the message, usually comforting and reassuring, delivered in sermons, therapy sessions, or along with a bear hug from grandma. Covid-19 has already been an abhorrent presence for too long, and it cannot pass quickly enough for any of us, especially for its principal victims: those with serious underlying medical conditions and those over 65. Medicare is the federal health insurance program for those of us in this age group or with certain disabilities. More than 62 million Americans, nearly 19% of our population, now fall into one of these categories. In data released on Monday, the Centers for Medicare and Medicaid Services reported that, between January 1 and May 16, there were 326,674 Medicare recipients diagnosed with Covid-19, with peak counts coming between mid-April and early May. The percentage of men and women affected was nearly equal, as was the percentage of the aged and disabled, but the agency found disproportionately higher counts in those over 85 as well as in Black enrollees, those in lower income brackets, and those from urban areas. Of all diagnosed, 109,607 or 33% required hospitalization at an average cost of $23,100 per patient. Twenty-seven percent of those admitted were successfully treated and went home, 23% were discharged to a skilled nursing or assisted living facility, 5% went to hospice care, and 28% died in the hospital.

There are 6,146 hospitals here in the United States and, at last count by the American Hospital Association (“AHA”), they have an average occupancy of 60%. Altogether they have 924,107 staffed beds or 2.8 beds available for every 1,000 people. And, every second of every hour of every day, at least one patient is being checked in. Hospital staff began preparing for chaos early this year, they opened satellites in gyms and convention centers, rationed masks and ventilators, and saw pandemic-related spikes in admissions mid-Spring. Many now face new surges and wonder, what comes next? The paradox is that hospitals are the only place where the word “positive” is a bad thing.

On an annual basis, for one reason or another, 34.2 million of us will be admitted to what is known as a community hospital. The AHA defines such facilities as non-federal hospitals serving the general public with average lengths of stay under 30 days; others define them as hospitals with fewer than 550 beds and minimal teaching programs, typically located in a smaller town and locally governed. Fifty-eight percent of us live less than five miles away from a community hospital but–even if the closest one is 25 or more miles away–we can all immediately call to mind the one nearest us where our babies were born, the place we rushed to at 3 am when an alarming symptom appeared, where we celebrated a miracle cure or lost someone we love, where we can count on facts and empathy from doctors and nurses because they are also neighbors and friends. These hospitals are among our largest local employers and serve as a central resource not only for acute care but also for counseling, housing, shelter, job training, and long-term care placement. Some are actually designated as “safety nets” when in fact they all are. In every sense, our community hospitals are not only essential service providers but the true lifelines of our communities.

At HJ Sims, we remain big believers in not-for-profit community hospitals and are investors in the bonds that they issue. Our traders and analysts take a close look at individual credits which vary widely by location, size, level of care, specialization, ownership, management quality and function. We like many critical access hospitals–those with 25 or fewer inpatient beds located more than 35 miles from another hospital. We consider inpatient and outpatient revenue, operational challenges such as nursing shortages, operational efficiencies such as sponsored or acquired health plans, competitors with major market share, government payor mixes, area demographics, charity care, and the emergence of nontraditional disruptors like Amazon. Since the pandemic hit, we have been monitoring the amount of federal assistance received, the increased use of telemedicine, the resumption of elective surgeries, the levels of hazard pay wage increases, and the likelihood of consolidations, particularly for rural hospitals under the most financial stress.

On April 10, the U.S. Department of Health and Human Services began distributing the first of $175 billion of relief funds to hospitals and health care providers. Although federal aid has offset some of the increased expenses and revenue losses attributed to the pandemic, many hospitals have nevertheless had to delay capital projects, furlough staff, and make pay cuts. Some entered the crisis with strong cash positions and are in locations that have been less severely impacted. Others have been slammed and, lacking further aid, may soon breach their bond covenants. Although it is unlikely that debt service payments will be missed, each situation varies depending on the depth and extent of the pandemic, its spread in the community, and the timing of successful treatments and vaccines. Financial challenges posed by dwindling patient volumes, increased competition, rising costs, and reduced reimbursements have already led to the closure or bankruptcy of at least 42 hospitals so far this year.

Our day to day inventory of hospital bonds varies but we have access to a wide array in different rating, geographic and functional categories. At this writing, we own and offer, for example, New Jersey bonds issued for AA- rated RWJ Barnabas Health, the largest academic healthcare system in the state by virtue of its affiliation with Rutgers University and one of the state’s largest private employers with 11 acute care hospitals, 4 children’s hospitals, and the state’s largest behavioral health network. At the time of its last financial report on March 31, the system had 274 days cash on hand and covered its debt service by 3.9 times. These bonds will likely be sold by the time of this publication, but we welcome inquiries for this or similar credits. The primary calendar has recently been heavy with health care deals as institutions look to refinance or bolster liquidity. In the market last week for example, Spartanburg Regional Medical Center in South Carolina, a tertiary care hospital with the first regional heart center and in-patient hospice unit in the two Carolinas, sold $125 million of insured A3/A rated revenue bonds that included a 20 year tax-exempt term maturity priced at 3.00% to yield 3.02% and taxable muni bonds due in 2050 at par to yield 3.553%. The Seattle Cancer Care Alliance, the top cancer treatment and research center in Washington state, issued $232.9 million of A2 rated revenue bonds; the maximum yield bonds in 2055 came with a coupon of 5.00% to yield 2.66%.

This week’s calendar includes tax-exempt and taxable bond issues totaling $350 million for Aa1 rated Intermountain Healthcare, a system of 24 hospitals based in Salt Lake City. On the forward calendar is a $32.1 million deal for BBB- rated White River Medical Center and Stone County Medical Center which together serve 10 counties in North Central Arkansas. The California Health Facilities Financing Authority also plans to bring a $145 million issue for AA rated Stanford Health Care in Palo Alto, the principal teaching affiliate of Stanford University School of Medicine.

The AAA general obligation bond benchmark yields are significantly below where they began the year and where they stood one year ago. The 2-year at 0.27% is 77 basis points below the yield on January 2, the 10-year at 0.88% is 56 basis points lower, and the 30-year at 1.66% has dropped by 43 basis points. One year ago, these benchmark yields were at 1.27%, 1.63% and 2.32%, respectively. So far this year, hospital bonds as measured by the ICE Bank of America Merrill Lynch Hospital Index, have returned 1.42%. The ICE BoAML main gauge of municipal bond performance is up 1.78% and its taxable municipal bond index is up 7.31%.

Merrill Gardens VI Series II and III

HJ Sims raises additional capital for investment in development fund for Merrill Gardens. HJ Sims secured the capital for the Series III securities in a turbulent market amidst concerns of COVID-19 to fulfill its investment and meet the timing needs of the Fund.

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HJ Sims 2020 Late Winter Conference Recap

Thank you!

On behalf of the entire HJ Sims Investment Banking team, we want to thank you for attending the 17th Annual HJ Sims Late Winter Conference at the InterContinenal San Diego in San Diego, California. We at HJ Sims are proud of our commitment to furthering conversation about financing methods & operating strategies in the Senior Living Industry. Bringing together a dynamic group of speakers from Non-Profit and Proprietary Senior Living Providers, as well as outside experts with thought-provoking views, it is our goal to have provided profound insight and an invaluable forum for exchanging ideas and information.

We also recognize that our conference was one of the last in-person events that was fortunate to take place. We appreciate those who attended, and we look forward to when we can get together in-person again.

Post-Conference Follow-Up

Our Conference Recap provides comprehensive coverage of the many sessions and event highlights from the 2020 HJ Sims Late Winter Conference.

Highlights include:

  • Keynote speakers from outside the senior living industry who shared valuable ideas from fields like Canyon Ranch® – the leader in luxury health and wellness introduced a potential new concept for senior living communities; Dr. Matthew Lieberman, a dedicated researcher on cognitive social neuroscience where we explored research indicating that we need to be connected socially to be physically and psychologically healthy; and Dr. Robert Genetski, an economist who led a discussion of the current financial markets where we explored principles vital to economic and political freedom.
  • Informal and memorable activities to bolster connection and conversation, included a glorious morning on the waters of San Diego Harbor for sailors and fishing enthusiasts; golfing at the world-renowned Torrey Pines; tasting a sample of San Diego’s best brewery and distillery products; and sharing an incredible evening with friends and a few new animal pals at the famed San Diego Zoo.
  • Educational sessions that covered topics such as: acute and post-acute care, medical and recreational cannabis, serving middle-income seniors, strategies to avoid moving from a stressed to distressed financial or operational situation, and a new approach to incorporating wellness in senior living.

In case you missed it, below are the details from our 17th Annual HJ Sims Late Winter Conference.

Agenda
Schedule and activities
Roster of conference speakers and their biographies

We invite you to watch the highlights of our conference in a recap video that features all the best parts of our conference. We also invite you to view the many beautiful photos from our conference.

Peruse the photo gallery and video montage below, and visit the HJ Sims FacebookInstagramLinkedIn or Twitter pages.

Taco Tuesday Dinner and Reception – LWC2020

San Diego Zoo Reception

Network Breaks

Corporate Social Responsibility: Gift of Life

The Gift of Life (GOL) team was thrilled to provide an update about the strong partnership between HJ Sims and GOL during the last two years, which has helped to promote the registry and subsequently add new donors, as well as supported numerous efforts to advance the GOL mission.

For more information on HJ Sims’ CSR program and Gift of Life, please visit: www.hjsims.com/servingourcommunitites.

Save the Date

Please save the date for next year, the 18th Annual Sims Late Winter Conference at the Sarasota Hyatt Regency, Sarasota, Florida. While we are still grappling with how we will hold our annual conference, rest assured, we will hold one… more to follow. Stay tuned, and stay healthy.

Thanks again!

Voralto Living

Voralto Living, along with its affiliates (“Voralto”), is a 42-year-old best in class senior living owner, operator, and developer whose leadership team has a combined 120+ years of experience in the senior living industry.

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Arizona LeadingAge Annual Conference & Expo

Attendance: Jimmy Rester, Aaron Rulnick

Education Session: Best Practices in Board Governance (Breakout Session 08), Recorded session
This session will provide information on best practices related to board governance and how it impacts your organization.

Learning Objectives:

  • Focus on key governing issues
  • Review the correlation between strong governance and organizational strength
  • Describing “Financial Foot Faults” and contrasts in governance
  • Target: CEO/Administrator, CFO/Finance, Trustees

Speakers: Aaron Rulnick, Managing Principal, HJ Sims; James Rester, Senior Vice President, HJ Sims

MRC Manalpan

HJ Sims secures financing for start-up assisted living and memory care community in unique for-profit/not-for-profit collaboration. MRC Manalpan is a newly formed for-profit senior living developer, consisting of two principals, including LV Development.

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Market Commentary: Summer Palace

The Beverly Hills Hotel, subject of the 1977 Eagles classic rock and roll platinum album, is among the California hotels where you are welcome to check in anytime you like. The 108 year-old Pink Palace with its five-star luxury suites and bungalows, long associated with honeymoons and Hollywood, are open although spa services have not resumed yet. Denver’s Brown Palace, which just re-opened after a 64-night shutdown, the first in its 128-year history, is back to offering manicures and massages as well as its iconic afternoon tea. Nationwide, hotel occupancy rates have been slowly rising since April, when they reached a low of 21%. There have been one or two point gains almost weekly in May and June, so reservations have crept up to 36.4% in the most recent week tracked by data firm STR.

All classes of lodging are reporting rates over 20 percent now with the economy bracket showing the best improvement. Many hotels were deemed essential businesses at the state and local level, and have remained open to house medical workers and non-critical patients. But as stay-at-home orders ease, Americans are arranging for some getaways. Among the hotel markets with the fastest improving figures are Virginia Beach, Phoenix, and Philadelphia. In central business districts such as the one in Chicago, however, occupancy is still stuck in the 16% range and it may take two or more years before corporate travel returns to pre-pandemic levels. New York’s hotel industry has perhaps been hardest hit; as many as 25,000 rooms or 20 percent of the city’s total, may never reopen in their current form or under current ownership.

Since March, when travel came to a virtual standstill, an estimated 83% of hotel debt borrowers have asked their lenders for forbearance or payment deferral on loans according to the American Hotel and Lodging Association. The Bureau of Labor Statistics reports unemployment in the leisure and hospitality industry at 35.9% in May; the number of workers has fallen from 16.8 million in February to 9.8 million. Hyatt just announced that it is cutting 22% of its global workforce and extending pay cuts, reduced hours and furloughs for another three months.

So, what is the future of our hotels, valets, concierges, chefs, and housekeepers in the post CV-19 world? When will we leave the palaces we call home and again feel comfortable staying at, eating in, and enjoying the facilities, features and attractions they offer in major cities, quaint towns, and bucket-list destinations such as the palaces of Versailles and Buckingham?

The answers seem to hinge on more widespread antibody testing as well as our acceptance of data, social distancing regimens, vaccines and treatments. The future of this industry is also closely tied to the airlines, how safe we perceive planes to be, how businesses view the necessity and liability of travel. Some analysts expect that drive-to and limited service hotels will come back first and indeed leisure travelers are starting to take short road trips. But various state restrictions with respect to quarantining and rentals still apply and the Centers for Disease Control and Prevention still post alarming warnings of the associated risks of getting and spreading Covid-19. In the meantime, hotels are struggling to address key concerns via contact-free check-ins and rigorous cleaning and safety protocols. Marriott has overhauled its housekeeping practices, Hilton has partnered with Lysol, and Westin is introducing UV light-zapping robots.

The overall growth in the economy is generally expected to lead to a rebound in the hotel industry when we take to the roadways and skies again. The IMF estimates the global economy will expand by 5.8%, and the U.S. economy by 4.7%, in 2021. The Federal Reserve estimates that our economy will shrink by 6.5% this year, then grow by 5% in 2021. In testimony before Congress this week, Fed Chair Powell described three phases related to the pandemic and our recovery. The initial phase of course was the shutdown. Now he believes we are entering the second stage, a bounce-back, evidenced by the drop in the unemployment rate and record 117.7% spike in May retail sales. While continuing to pledge the use of all available tools to help bring about robust growth, he noted that there is still great uncertainty due to rising case counts, consumer fears, and the substantial damage done to many industries. A full recovery is unlikely, he noted, until the public is confident that the disease is contained.

Fallout from the coronavirus has left no sector of our economy untouched, but it is hard to tell by looking at the stock market. Since the end of February, the Dow has gained 3.5%, the S&P 500 5.8% and the Nasdaq 16%. Equity investors are casting many virus-related worries aside, feeling confident in government and central bank stimulus and better than expected economic numbers. Since the pandemic was declared on March 11, Hilton Hotels (NYSE: HLT) stock prices are up 40 percent from their low on April 3, Marriott (Nasdaq: MAR) is up 59 percent from its low on the same date, and Hyatt (NYSE: H) has gained 55% from where it sank on March 18. The prices of 30-year BB rated Hilton corporate bonds have increased by 35% from their pandemic lows in March to $104.329 at this writing. At $98.345, Baa3 rated Marriott Corporation bonds with a similar maturity are also up 35%, and Baa3 rated Hyatt bonds at $103.50 have gained 30%.

Despite the massive increase in U.S. Treasury bond issuance to finance the stimulus, demand has remained steady for the world’s haven asset and yields low. The 2-year Treasury yield has fallen 34 basis points to 0.19% since the pandemic was declared. At this writing, the 10-year yield at 0.75% is down 5 basis points, and the 30-year yield at 1.54% is only 27 basis points off its low. Similarly, municipal bonds have demonstrated remarkable resilience. Two-year tax-exempt AAA rated general obligation bond yields at 0.25% are 30 basis points below where they stood in mid-March. The 10-year benchmark at 0.87% is 4 basis points lower while the 30-year yield at 1.64% s only 9 basis points higher. The municipal new issue calendar has been very well received, municipal bond mutual fund flows have been net positive for six consecutive weeks, and daily customer “buy” trades have exceeded “sell” volume since March 17. Last week we saw a Ba2 rated Texas charter school with a 30-year maturity price with a coupon of 5.00% to yield 4.80% and two non-rated limited offerings: a Florida charter school financing due in 2055 priced at par to yield 6.00%, and a California charter school deal priced at par to yield 6.25%.

At HJ Sims, we believe in the outcome of income. Our bankers, traders and advisors are hard at work every day delivering revenue-maximizing and income-generating ideas for our clients. We have a nice pipeline of senior living financings to benefit non-profit and for-profit partners who have been waiting for conditions like these. We read that assets in money market funds have ballooned to $4.6 trillion, the highest level on record, up $1 trillion so far this year, and reach out to our clients all day long with specific proposals for putting their cash to work in smart ways that are in line with their respective risk tolerances.

With many public companies eliminating dividends to protect liquidity, we find that the steady interest, monthly or semi-annual, produced by higher yielding corporate and municipal bonds to be the right solution for many investors. Whether on Elm Street or Rodeo Drive, as you prepare to celebrate the official start to Summer, pay tribute to the fantastic fathers in your life, and mark the midway point in the year, we invite you to make an appointment with your HJ Sims advisor to discuss your income needs, your views on the economic recovery, and your interest in the opportunities being identified by our traders in sectors including hotels, airlines, schools, and senior living.

HJ Sims Expands Investment Banking Team to West Coast and Midwest; Grows Private Client Team in Florida and Puerto Rico

FAIRFIELD, CT– HJ Sims (Sims), a privately held investment bank and wealth management firm founded in 1935, is pleased to announce the addition of two senior bankers as the firm expands with the opening of new offices in the Midwest and on the west coast.

Lynn Daly joins Sims as Executive Vice President in its new Chicago location with 30+ years of experience working with non-profit organizations in financing. Daly was acting head of Senior Living Investment Banking at BB&T Capital Markets, where she managed BB&T’s senior living relationships in the Midwest, facilitating financings of $1.3+ billion. Prior to BB&T Capital Markets, Daly spearheaded the Catholic Initiative within senior living investment banking for Ziegler, and served as Head of Allied Irish Bank’s Midwest region. Daly earned a BS in economics from Kalamazoo College, and an MBA from Northwestern University’s Kellogg Graduate School of Management.

“We are so thrilled to welcome Lynn Daly to the HJ Sims family. Lynn is a well-respected and nationally recognized thought leader in the senior living sector and the perfect leader to grow our presence in the Midwest and to work with our team as we continue to expand throughout the US. Lynn’s extensive experience as both a senior commercial and investment banker, along with her integrity, deep knowledge, and client-centered approach, are vital characteristics and values that will guide our clients and business partners through these challenging times,” said Aaron Rulnick, Managing Principal, Sims.

Brady Johnson joins Sims as Senior Vice President in its new west coast office, in Orange County, CA. Previously with Hunt Real Estate Capital, Johnson was responsible for real estate debt originations for seniors housing and healthcare properties. He helped establish the firm’s seniors housing real estate lending platform, including a proprietary bridge loan program and expansion of the firm’s agency and HUD financing capabilities. Johnson closed the firm’s first Fannie Mae seniors housing loan, followed by its first seniors housing Freddie Mac loan. Prior to joining Hunt, Johnson served as Director of Seniors Housing & Healthcare at RED Capital Group, and served with GE Capital in various commercial finance roles. Johnson earned an MBA from Thunderbird School of Global Management and Bachelor’s degrees (Economics and Spanish) from the University of Utah.

“We are excited to welcome Brady Johnson to the Sims family. Brady will help establish our west coast presence serving for-profit and non-profit senior living clients. Brady’s broad experience in FHA, Fannie Mae, Freddie Mac, mezzanine and senior housing finance, and his focus on achieving the best solutions for his clients make him a great asset,” said Jeffrey Sands, Managing Principal, Sims.

In late 2019, Sims expanded its Private Client team, adding an office in Jupiter, FL, housing a three-person advisory team, as well as a senior partner of Sims Energy. HJ Sims’ Puerto Rico private client office moved its Guaynabo headquarters to a larger space in Metro Office Park. The spacious quarters enable the team to better host clients, while the expansion reinforces Sims’ established presence and growth on the island.