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Religare Health Trust 2013 , June. STRICTLY PRIVATE AND CONFIDENTIAL. About Religare Health Trust Our Ability to Provide Stable & Growing Distributions Financial Highlights. Religare Health Trust. Listed on 19 October 2012. Notes :

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Religare Health Trust 2013 , June



About Religare Health Trust

  • Our Ability to Provide Stable & Growing Distributions
  • Financial Highlights
religare health trust
Religare Health Trust

Listed on 19 October 2012


(1) Projected yields excludes distributions to Sponsor, which has committed to waiving rights to distribution until Mar 31, 2014 in favor of holders of Common Units. Based on unit price as at 28 May 2013


fortis and religare partnership
Fortis and Religare Partnership
  • Part of Religare Enterprises, a diversified financial services firm listed on the BSE and NSE
  • Global multi-boutique asset management platform with over US$13.0 billion in Assets Under Management

Unique Healthcare Offering

  • One of the largest healthcare chains in India and Asia Pacific’s fastest growing multi vertical healthcare delivery system
    • 73 healthcare delivery facilities
    • ~ 12,000 beds
    • Presence in 10 countries
    • Listed on the BSE and NSE

RGAM Affiliates

Investment mandate to acquire healthcare assets across Asia, Australasia and global emerging markets

Leveraging the Complementary Strengths and Expertise of Fortis and Religare

overview of religare health trust
Overview of Religare Health Trust

RHT Structure

Fortis Healthcare (“Sponsor”)

Institutional & Public Investors



Acts on behalf of unitholders and provides management services


TM Fees





Fortis Operating Companies

Current Portfolio

  • S$773m total valuation (1)
  • 11 Clinical Establishments
  • 4 Greenfield Clinical Establishments
  • 2 hospitals managed and operated by RHT

Service Fee

Clinical Establishment Services

  • Notes:
  • Independently valued by DTZ in INR as at March 31, 2013based on S$1 = INR 43.75. Valuation of operating assets based on DCF and Hospital and Medical Services Agreements (“HMSAs”) as relevant; valuation of greenfield assets based on Market Value.
17 quality assets geographically diversified across india
17 Quality Assets Geographically Diversified Across India

New Delhi, Shalimar Bagh

  • Initial portfolio valued at S$773m (1)(2)
  • 11RHT Clinical Establishments (S$737m)
  • 4 Greenfield Clinical Establishments ($31m)
  • 2 hospitals managed and operated by RHT ($5m)


130 Operational Beds

350 Installed Bed Capacity

153 Operational Beds

166 Installed Bed Capacity


191 Operational Beds

200 Installed Bed Capacity


75 Potential Bed CapacityOperational: 2QFY2015

Greater Noida


350 Potential Bed Capacity

Operational: 4QFY2016

450 Installed Bed Capacity

1,000 Potential Bed Capacity


210 Operational Beds

210 Installed Bed Capacity


  • Approximately 4.1 million sqft of built-up area across 10 states
  • Sizeable Population Catchment
  • Located Close to Major Transportation Nodes

207 Operational Beds

320 Installed Bed Capacity

Mumbai, Kalyan

44 Operational Beds

52 Installed Capacity


126 Operational Beds

373 Installed Bed Capacity

Mumbai, Mulund

236 Operational Beds

567 Installed Bed Capacity


400 Potential Bed CapacityOperational: 4QFY2016

Bengaluru, Rajajinagar

31 Operational Beds

31 Installed Bed Capacity

Chennai, Malar

170 Operational Beds

178 Installed Bed Capacity

: RHT Clinical Establishments: Greenfield Clinical Establishments

: Operating Hospitals

Bengaluru, Nagarbhavi


45Operational Beds

45 Installed Bed Capacity

45 Potential Bed Capacity

Operational: 1QFY2015

  • Notes:
  • No. of beds and installed capacities as of March 31, 2013. Potential bed capacity assumes all planned phases of development and construction are completed in respect of the Gurgaon Clinical Establishment and the Greenfield Clinical Establishments
  • Independently valued by DTZ in INR as at March 31, 2013 based on S$1 = INR 43.75. Valuation of operating assets based on DCF and Hospital and Medical Services Agreements (“HMSAs”) as relevant; valuation of greenfield assets based on Market Value.

Bengaluru, BG Road

239 Operational Beds

255 Installed Bed Capacity


diversified healthcare portfolio positioned for growth
Diversified Healthcare Portfolio Positioned for Growth

Organic Growth Potential(Number of Beds as of 31 March 2013)

Focus on Provision of High End Healthcare Services(% of Initial Portfolio Valuation)

+1,420 beds


+1,415 beds

Tertiary (2)




Substantial Portion of Initial Portfolio Comprise Long Term Lease / Freehold Land

(% of Initial Portfolio Valuation)

High Proportion of Income Generating Clinical Establishments(% of Initial Portfolio Valuation (3))

Weighted Avg Lease Life of Leasehold Assets of ~58 Years (3)

Freehold 60.3%

GreenfieldClinical Establishments3.9%

RHT Clinical Establishments 95.4%

Operating Hospitals0.7%

>50 Years Remaining Lease Life26.1%

<50 Years Remaining Lease Life13.7%

  • Notes:
  • Installed capacity refers to the maximum number of beds that can be operated at each hospital without further expansion. Potential capacity refers to the maximum number of beds that can operate at each hospital when all stages of development are completed.
  • Includes Secondary/Tertiary Services.
  • Weighted by asset valuation.


stable growing distributions
Stable & Growing Distributions

Our distributions are stable and growing stemming from the following:

Service Fees structure

Policy of fully hedged distributions for next 12 months

Potential for organic & inorganic growth (including ROFR)

Working with a premium healthcare operator

stabilized distributions with in built organic growth
Stabilized Distributions, With In-Built Organic Growth

Long term Hospital & Medical Services Agreement


100% Distribution Payout

Fully Hedged Distributable Income

Low Gearing

Downside Protection, With In-Built Organic Growth





Service Fee (1)


HMSAs with Fortis for 15 years, with further 15 year extension by mutual consent


Variable Service Fee

  • 7.5%of Fortis Operating Companies’ Operating Income
  • Base Fee with fixed escalation of 3% p.a. (accounts for c.79.4% of total Service Fee for FY2013)
  • Variable Fee of 7.5% of Fortis Operating Companies’ Operating Income

Base Service Fee (2)

  • 3.0%p.a. fixed escalation
  • Upward revision for any capex/ expansion

8.9% Low in comparison to peers

  • 100% distribution payout over Forecast Year and Projection Year
  • Sponsor distribution waiver over Forecast Year and Projection Year


Distributable income has been hedged for the next payouts –30 September 2013 & 31 March 2014

  • Notes:
  • Excludes income from ancillary services; Financials converted at S$1 = INR 44.04 for FY2013, S$1 = INR46.70 for FY 2014, and exchange rate at the listing date of S$1= INR43.55
  • Base Service fee excludes accounting straight lining and includes Technological Renewal Fee and are on a full year basis. Base Service Fee from the Gurgaon Clinical Establishment will increase by more than 3.0% per annum until March 31, 2014 when the asset is expected to stabilize.



Capacity Expansion- Update

RHT has four running projects for capacity expansion, below is the status as of 31st March 2013


In-Built Development Pipeline; Sponsor’s Interests Aligned

25% interest free commitment deposit from Sponsor via HMSA to finance development cost

  • Note
  • Converted to S$ from INR at S$1 = INR 43.55.
  • Source: Fortis presentation, RHT preliminary prospectus dated 15 October 2012


growth strategy supported by sponsor
Growth Strategy Supported by Sponsor

Access to Regional “On-the-Ground” Intelligence

Key ROFR Assets (1,120 beds)(1)

India (289 beds)

Escorts Okhla


289Licensed Beds

Singapore (31 beds)

Hong Kong




Fortis ColorectalHospitalSingapore

31 Licensed Beds

Sri Lanka

Vietnam (800 beds)


Hoan My Da Lat


200 Licensed Beds

Hoan My SaigonPhan Xich Long Vietnam

200 Licensed Beds

Hoan My Da NangVietnam

200 Licensed Beds

Hoan My Minh Hai


50 Licensed Beds

Hoan My Can Tho


150 Licensed Beds


(1) Provided that the Relevant Sponsor Entity is a subsidiary that is jointly owned with 3rd parties, ROFR will be subject to the consent of such 3rd parties. Sponsor shall use its best endeavors to obtain such consent; Data on ROFR assets as of Dec 31, 2011.



Leverage Sponsor’s Expertise and Development Track Record

Fortis’ Historical Indian Hospital Business Performance

(INR m)

Annual Basis

Quarterly Basis

28% y-o-y growth

Average c.6% q-o-q growth

Proven Track Record of Maturing Greenfield Assets (1)

Performance Of A Greenfield Facility: Jaipur

Extracting Value From M&A: Escorts Amritsar

Ramp Up At An Acquired Facility: Fortis Malar, Chennai




36% Revenue CAGR

52% Revenue CAGR

4x revenue growth on annual basis since inception

Acquired Fortis Malar in February 2008

Source: Company filings, corporate presentations.(1) Financial year ending 31 March; Financials converted to S$ at S$1 = INR 44.34.


key drivers of growth in the indian healthcare market
Key Drivers of Growth in the Indian Healthcare Market

Growing & Aging Population

High Healthcare Demand / Supply Gap

Growing Affluence




India’s Population (Million)

Hospital Beds per 1,000 Population in 2011

GDP Per Capita (US$)


7.8% CAGR





Implied gap of 3.7m beds

Changing Disease Profile

Increasing Health Insurance Coverage

Growing Medical Tourism




US$2.1bn Industry by 2015E

% of Hospitalisation Cases

% of Healthcare Spend at Corp. Hospitals in Tier 1 Cities Covered by Insurance

Indian Medical Tourism Industry(‘000 Medical Tourists)

40% of expenditures covered by insurance

14.0% CAGR

25-30% of expenditures covered by insurance



Source: F&S Market Research Report.


market and sector update
Market and Sector Update
  • Delhi Development Authority hiked FAR of hospitals by 25-50%. This would have an impact on the Shalimar Bagh hospital, potentially allowing for an increase in number of beds
  • The government has clarified its stance on Put and Call Options, stating that regulation drafted by SEBI on allowing these options will be approved. This was one of the risk factors in RHT’s prospectus
  • RBI has over the last few monetary policy meetings lowered interest by .75 bps stating that Inflation being lower than 5% also gives it to reduce rates further at the next monetary policy meeting on June 17th
  • The Indian Hospital sector continues to attract foreign investments. Since 1st of January 2013, Temasek invested S$32 million in a Bangalore based cancer hospital group, IFC and Sabre invested S$51 million in Global Hospitals, Sequoia invested S$11.5 million in ASG Eye Hospitals
gurgaon ce launch
Gurgaon CE Launch
  • Inaugurated On May 1st2013 by Actor – philanthropist Mr Salman Khan
  • Guests of Honor were Dr Pratap Reddy, Chairman Apollo Hopsitals, Dr Naresh Trehan, CEO Medanta and Salman Khurshid Cabinet Minister for External Affairs
  • The facility would have core specialiaites in Oncology, Mother and Child and Trauma alongside speciailities in Cardiac, Transplants (Bone Marrow has started) and Neurosciences
  • The current capacity is 450 beds (Phase I) that will be taken up to 1000 beds over time. All relevant staff to manage the 450 beds, including doctors and nurses, have been hired.
  • Collaboration announced with Being Human – an NGO sponsored by Mr Salman Khan to treat 500 children with heart ailments free of cost. RHT would also be giving space to the charity to set up a store at the hospital free of cost as part of its CSR initiatives.

Dr. YogendraNathMathur

Lead Independent Director

33 years of relevant experience

Chey Chor Wai

Chairman of Audit and Risk Management Committee and Independent Director

Michael Hwang S.C

Independent Director

Peter Joseph Seymour Rowe

Independent Director

Experienced Board and Management Team

Majority independent directors with proven track record in healthcare and funds management

Religare Health Trust

Executive Directors / Management

Ravi Mehrotra

Executive Chairman

Dr Virender Sobti

Chief Operating Officer


Gurpreet Singh Dhillon

Executive Director &CEO

Tan Suan Hui

Head of Compliance / IR

Pawanpreet Singh

Executive Director & CFO

Naveen Bhatia

Head, Finance & Accounts




Hedging - Foreign currency exposure

100% Hedging done for the forthcoming 3 Distributions

Forward contracts already entered into

The average contracted rate for FY 14 is 47.28.

yield and p b comparison
Yield and P/B Comparison

Sources : Standard Chartered Research Report dated 23 May 2013, OCBC Investment Research Weekly SREITs dated 13 May 2013

RHT gearing figure based on actuals

financial highlights
Financial Highlights

Revenue (1)


Distributable Income (1)


DPU Yield (1)

Average NOI margin: 59%






Sponsor Waiver

Gearing: 8.9%

  • Notes:
  • Financials converted at S$1 = INR44.04 for FY2013, S$1 = INR46.70 for FY 2014, and exchange rate at the listing date of S$1= INR43.55;.
  • Includes straight lining of Base Service Fee.
  • DPU calculated based on unit price traded on 28 May 2013



Fee Structure

Performance based management fees designed to align Management’s interests with Unitholders

Acquisition / divestment fee

Base fee

Performance fee

  • 0.4% p.a. of the value of the Trust Property
  • 50% to be paid in Units (1)
  • 4.5% p.a. of Distributable Income (2)
  • 50% to be paid in Units (1)
  • 0.5% - 1.0% of acquisition price
  • 0.5% of the sale price (Divestment to 3rd party)
  • No divestment fee (Divestment to Sponsor)

Development fee

Asset management fee

  • 2.0% of total development project costs
  • Payable in the form of cash and/ or units
  • 1.0% of gross revenue
  • Paid quarterly in arrears
  • No asset management fee paid for assets operated by Sponsor
  • Note
  • For the Forecast Year 2013 and Projection Year 2014
  • Distributable Income means the distributable amount determined by the Trustee-Manager in accordance with the terms of the Trust Deed to be distributable for the relevant distribution period (pro-rated if applicable based on the number of months the relevant financial quarter bears to such distribution period)
efficient trust structure
Efficient Trust Structure





New Unitholders




Acts on behalf of

Unitholders and provides

management services



TM Fees



Fortis Health International Limited (Mauritius)





Clinical Establishment Services

Investments in Compulsory

Convertible Debentures (“CCDs”) and equity shares


Fortis Operating Companies (“FOCs”)

Hospital Services Companies (“HSCs”)

Fortis Global Healthcare Infrastructure

Service Fees

CCD Interest payments

and dividends

Hospital operating capabilities

Ownership of medical and

healthcare infrastructure facilities

Hospital and Medical Services Agreements(“HMSAs”)

  • Note:
  • Promoters comprise Malvinder Mohan Singh, Shivinder Mohan Singh and their associates.


income secured through long term working agreements

Prior to listing, the Hospital Services Companies (“HSCos”) will enter into Hospital and Medical Services Agreements (“HMSAs”) with the Fortis Operating Companies (“FOCs” ) to operate the healthcare infrastructure assets (1).

Income Secured Through Long Term Working Agreements

Mechanics of the HMSA

Key Terms of the HMSA

Hospital Services Company





Ancillary Services



Services Fees





Clinical Establishment

Commitment Deposits



Operated by

Fortis OperatingCompany



Source: TM


(1) Fortis has signed commitment agreements to enter into similar HMSAs for the greenfield healthcare infrastructure assets.

(2) Technology Renewal Fee will be paid into a Technology Renewal Fund to be maintained by Fortis.