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Newsletter Dezember 2017

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ACXIT Healthcare Newsletter
December 2017
Healthcare News
For Europe and Germany
Colosseum Acquires Italian OdontoSalute

Colosseum Dental Group, part of Swiss-based investment firm Jacobs AG, reached an agreement with Dr. Fabio Boscolo to acquire 70% of OdontoSalute. Italy-based OdontoSalute operates a chain of 40 clinics, generating around EUR 40m in annual sales. Colosseum, with sales in excess of EUR 250m, operates more than 150 clinics in Europe.
Nordic Capital signed an agreement to acquire Alloheim for EUR 1.1bn

In a competitive sales process Nordic Capital has outrivaled numerous competitors (i.e. DomusVi, Fosun, etc.) and agreed to acquire the German Alloheim Group from Carlyle for EUR 1.1bn. With an EBITDA multiple of about 12.5x the acquisition of the No. 2 operator is the largest transaction in the consolidating German nursing care industry to date.
European Procession into LATAM Continues

Latin America (LATAM) keeps being in focus for European nursing home operators. After Belgium-based Senior Assist made a foray into the Chilean healthcare sector, planning to triple its beds to 1,500 and further expand to Colombia, Orpea also announced two joint ventures, building more than 2,000 nursing beds in Brazil.
Vitanas and PuW Majority Stake Acquired by Oaktree

Oaktree Capital Management acquired a majority stake in Vitanas and Pflegen und Wohnen Hamburg (PuW). Vitanas and PuW are amongst the largest nursing home operators in Germany with a combined capacity of 8,300 care beds. ACXIT Capital Partners and equinet Bank have exclusively advised the sellers in this transaction.
Agfa and Luxembourg Hospitals Cooperate for VNA

Fédération des Hôpitaux Luxembourgeois has signed a contract with Agfa HealthCare for a national vendor-neutral archive (VNA). VNA is a medical imaging technology in which images and documents are archived in a standard format. The project will include all images from all departments of all hospitals in Luxembourg.
Chequers Capital Acquires Majority of MK-Kliniken

Ulrich Marseille, group founder and majority shareholder of MK-Kliniken, has agreed with Chequers Capital on the sale of part of the business to the private equity house. The assets on sale exclude the company’s real estates and ambulant care services. MK-Kliniken operates 55 care institutions and four homes for assisted living with a total capacity of 8,000 care beds.
Orpea in Acquisition Talks with Clinica Lopez Ibor

Europe’s largest nursing home operator, France-based Orpea, is planning to expand further in Spain. The company is currently in talks with the owners of Clinica Lopez Ibor, a Madrid psychiatry center. After Orpea almost closed a deal in July, talks have continued. As of now, Lopez Ibor has 67 operating beds and offers psychiatric consultation services.
Oberberg Kliniken Sold to Trilantic Capital Partners

Trilantic Europe, the European arm of Trilantic Capital Partners, acquired Oberberg Kliniken from the German PE House Odewald & Compagnie. Oberberg Kliniken operates nine clinics with approximately 560 beds specialized on psychotherapy, psychiatry and psychosomatic treatments. The transaction marketed the company at an EV of EUR 200m.
Source: Mergermarket; ACXIT Capital Research
Healthcare Topic of the Month
Single Room Rate in the Nursing Home Market

Nursing Homes Strongly Increased Single Room Rates During the Last Year

Single Room Rate per Operator

The single room rate of nursing homes in Germany is steadily rising. In 2017 approximately 19 percent of the nationwide more than 11,000 homes offer exclusively nursing homes in individual (single) rooms. In average the facilities comprise of 77.7% single rooms in the German stationary market. In comparison to the previous year this represents an enhancement of around 13 percentage points. Since several years this trend of increasing single room ratios in Germany is accelerated by customer demand and a regulatory environment on federal state level.

However, improving the single room ratio of existing homes and portfolios poses a structural and financial challenge for home operators. New homes are frequently built as single rooms only properties. The reasons for this development are, among others, statutory building regulations which are applied, for example, in Baden Wuerttemberg and North Rhine-Westphalia over the next two years. Nevertheless, there are still large differences in the single room quota between federal states, as shown in the graph.

The federal states of Bremen and North Rhine-Westphalia, followed by Thuringia and Baden-Wuerttemberg, have the highest quota of single rooms in nursing homes throughout Germany. In particular, North Rhine-Westphalia shows a strong increase in the single room rate of 13 percentage points, compared to the previous year, to 83 percent now. From August 2018 there is a legal quota of 80 percent single rooms for nursing homes. The houses in Baden-Wuerttemberg are still remote from the legal quota. Although the average proportion of single rooms rose to 82 percent, from September 2019 onwards the legal quota only allows single rooms to be offered.

A clear difference in the single and double room rates can also be seen in the type of sponsorship. The distribution shows that the average single room rate in private-sector houses is 73.4 percent, well below the nursing homes of community and non-profit operators where the single room rate is 81.2 percent.

Source: Federal Bureau of Statistics (Destatis); pflegemarkt.com; ACXIT Capital Research
Healthcare Valuation Analysis Europe
European Healthcare Companies Outperform EURO STOXX 50

Comparable Company Analysis

Healthcare Indices vs. EURO STOXX 50

Note: Indices for Nursing (EU) and Acute & Rehabilitation (EU) correspond to the companies listed in the CCA, equally weighted
Source: S&P Capital IQ
Recent Healthcare M&A Transactions in Europe
Highly Fragmented Private Sector Provides for
Further Add-on Consolidation Opportunities

Recent M&A Transactions Characterized by Financial Investors

Source: S&P Capital IQ; Mergermarket; ACXIT Capital Research
ACXIT Capital Partners
About us
  • ACXIT Capital Partners is a leading international corporate finance and investment advisory firm for mid-market clients and entrepreneurs in Europe and beyond
  • As an independent, privately owned firm, we maintain offices in Frankfurt, Berlin, Munich, Leipzig, Zurich and Hong Kong as well as strong alliances in India, China and the USA
  • Our clients are corporations, family-owned businesses, entrepreneurs, financial sponsors and family offices

Our Services
  • Since 1998, we offer our clients comprehensive corporate finance advisory services including M&A and capital markets advisory as well as restructuring, debt and strategic advisory
  • To date, we have completed 400 transactions with a total deal/financing volume of approx. EUR 20bn
  • While our home market is in the German speaking region, most clients are international and transactions cross-border

Our Industries
  • Our advisory expertise is founded on an in-depth understanding of the key industries served by the company, covering the industrial and technology sectors as well as the real estate sector
  • We have successfully advised clients in their key sectors: Internet & Media, Software & IT, Mobile & Telecom, Healthcare & Pharma, Retail & Consumer Goods, General Industries and Real Estate
For information regarding ACXIT Capital Partners, please visit acxit.com.

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Dr. Ingmar Ackermann, Managing Partner

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