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HEALTHCARE TRUST OF AMERICA, INC. The Largest Dedicated Owner & Operator of Medical Office Buildings in the U.S.
Q3 2020
WakeMed Medical Park of Cary, Raleigh, NCOwned and Operated by HTA
F O R W A R D L O O K I N G S T A T E M E N T SThis document contains both historical and forward‐looking statements. Forward‐looking statements are based on current expectations, plans, estimates, assumptions and beliefs, including expectations, plans, estimates, assumptions and beliefs about our company, the real estate industry, pending acquisitions, future medical office building performance and the debt and equity capital markets. All statements other than statements of historical fact are, or may be deemed to be, forward‐looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended.
Forward‐looking statements include information concerning possible or assumed future results of operations of our Company. The forward‐looking statements included in this document are subject to numerous risks and uncertainties that could cause actual results to differ materially from those expressed or implied in the forward‐looking statements. Assumptions relating to the foregoing involve judgments with respect to, among other things, future economic, competitive and market conditions and future business decisions, all of which are difficult or impossible to predict accurately and many of which are beyond our control. Although we believe that the expectations reflected in such forward‐looking statements are based on reasonable assumptions, our actual results and performance could differ materially from those set forth in the forward‐looking statements. Factors which could have a material adverse effect on our operations and future prospects include, but are not limited to: changes in economic conditions affecting the healthcare property sector, the commercial real estate market and the credit market; our ability to complete our pending acquisitions; competition for acquisition of medical office buildings and other facilities that serve the healthcare industry; economic fluctuations in certain states in which our property investments are geographically concentrated; retention of our senior management team; financial stability and solvency of our tenants; supply and demand for operating properties in the market areas in which we operate; our ability to acquire properties, and to successfully operate those properties once acquired; changes in property taxes; legislative and regulatory changes, including changes to laws governing the taxation of REITs and changes to laws governing the healthcare industry; fluctuations in reimbursements from third party payors such as Medicare and Medicaid; changes in interest rates; the availability of capital and financing; restrictive covenants in our credit facilities; changes in our credit ratings; our ability to remain qualified as a REIT; and the risk factors set forth in our 2019 Annual Report on Form 10‐K filed on February 18, 2020.
Forward‐looking statements speak only as of the date made. Except as otherwise required by the federal securities laws, we undertake no obligation to update any forward‐looking statements to reflect the events or circumstances arising after the date as of which they are made. As a result of these risks and uncertainties, readers are cautioned not to place undue reliance on the forward looking statements included in this document or that may be made elsewhere from time to time by, or on behalf of, us.
The Company has an effective registration statement (including a prospectus) with the Securities and Exchange Commission (the “SEC”). Before you invest in any offering of the Company’s securities, you should read the prospectus in that registration statement and other documents the Company has filed with the SEC for more complete information about the Company and any such offering. You may obtain copies of the Company’s most recent Annual Report on Form 10-K and the other documents it files with the SEC for free by visiting EDGAR on the SEC website at www.sec.gov. Alternatively, the Company will arrange to send such information if you request it by calling (480) 998-3478.
For definitions of terms and reconciliations for certain financial measures disclosed herein, including, but not limited to, funds from operations (FFO), normalized funds from operations (Normalized FFO), annualized base rents (ABR), net operating income (NOI), and on‐campus/aligned, please see our Company’s earnings press release and Supplemental Financial Package for the quarter ended June 30, 2020 issued on August 6, 2020 and our Company’s Supplemental Financial Package for the quarter and year ended December 31, 2019, each of which is available in the investor relations section of our Company’s website located at www.htareit.com..
2
$7.4BGROSS INVESTMENTS
25.1M SFACCROSS 467 BUILDINGS
4.5% Yield*DIVIDEND INCREASED LAST 7 YEARS
BBB / Baa2INVESTMENT GRADE BALANCE SHEET
67%
33%
HTA: THE LARGEST DEDICATED OWNER & OPERATOR OF MEDICAL OFFICE BUILDINGS IN THE U.S.
The HTA Difference
• Industry Leading Portfolio: Core, critical MOBs where healthcare demand is growing: on-campus, core community outpatient, and academic locations. With limited ground lease restrictions
• Key Market Focus: Investing in high growth markets where we can achieve operational scale. 10 markets of ~1MM SF and 17 markets >500k SF.
• Unique, Vertically Integrated Operating Platform: The strength of a dedicated, national platform delivering tenant satisfaction, performance and growth in our key markets
• Strong and Diverse Tenant Base: Partnered with leading healthcare providers in our markets. ~74% of tenants are Health Systems or National/Regional providers. 60% of tenants are credit rated.
• Steady and Consistent Performance: Delivering earnings growth to the bottom line, even during COVID
• Dividend Growth: Only MOB REIT to raise dividend each of the last 7 years
• Investment Grade Balance Sheet: $1.5 billion in liquidity and low leverage positions HTA for future growth and stability
Best in Class Portfolio Focused in 20-25 Key Markets
ALL VALUES AS OF SEPTEMBER 30, 2020, UNLESS OTHERWISE NOTED.*DIVIDEND YIELD AS OF NOVEMBER 13, 2020
3
HIGHLIGHTS
PORTFOLIO
PERFORMANCE
INVESTMENT
ACTIVITY
BALANCE SHEET &
LIQUIDITY
• Record Normalized FFO of $0.43 per diluted share for Q32020; reported year-to-date Normalized FFO of
$1.28 per diluted share through September 30, 2020, up almost 5% from 2019
• Reported record Normalized FAD of $82.4 million for Q32020; reported year-to-date Normalized FAD of
$237.3 million through September 30, 2020, an increase of over 9%
• Raised our quarterly dividend for the 7th consecutive year in a row
• Leased rate of 90.1% by GLA and occupancy rate of 89% by GLA for Q32020
• Executed 1.1 million SF of leases (4% of our total portfolio) for 3Q2020 with re-leasing spreads of 7.4%; year-
to-date, executed 3.3 million SF of leases (13% of our portfolio) through September 30, 2020 with re-leasing
spreads of over 5%
• Q3 2020 cash collections totaled 102% of Q3 charges. Cash collections and deferrals totaled 99% of monthly
rents for Q3 charges only. October collections continued this trend
• Same Store Cash NOI growth of 2.5% excluding the impact of free rent associated with early renewals
granted during the COVID-19 pandemic
• Development: Completed flagship ground-up development started by HTA. This 127k SF, Class A MOB in
Raleigh, North Carolina is anchored by WakeMed Health System. Our 3 remaining projects continue on-
track for delivery in 2021
• Total liquidity of $1.5 billion, inclusive of $1.0 billion available on our unsecured revolving credit facility,
$227.5 million of unsettled equity forward transactions and $277.1 million of cash and cash equivalents
• Raised $800 million of senior unsecured notes at a coupon of 2% per annum, which was used to payoff
existing debt and raise an additional $200 million we can use for investment purposes
• No current debt due and no debt maturities until 2023
RECENT BUSINESS UPDATE
4
1200 Binz | Houston, TX Owned and Operated by HTA
Measured and Intentional Response to COVID-19
OUR FACILITY TEAMS KEPT BUILDINGS OPERATIONAL
• Our local property management teams focused on maintaining building operations without disruptions in service, allowing our healthcare providers to continue seeing patients.
• We have taken steps at our buildings to ensure that they remain operational for our tenants during the COVID-19 pandemic, including enhanced janitorial services, increased signage and hand sanitization stations, as available, increased PPE for our property management and building engineering staff, and stringent protocols for visitors and vendors to seek to ensure that they are limiting the potential spread of the virus.
FLEXIBLE LEASING STRATEGY
• We were able to successfully pivot our leasing strategy to accommodate virtual tours. As a result, new leasing activity is on track with last year and renewals are at record levels, with totaling leasing of ~13% of our portfolio during COVID-19 at attractive rates
PROACTIVE, RELATIONSHIP-BASED APPROACH TO OUR HEALTHCARE PROVIDERS
• We have proactively focused on working with our healthcare partners, who are critical to our long term success.
• Through October 28, 2020, HTA has approved deferral plans that total approximately $11.0 million with approximately 50% of these going to health system tenants. To date, approximately $3.7 million have been repaid, with the remainder to be repaid over the next 6 to 12 months.
• We have also worked with several health systems in 2Q to extend ~500k SF of leases early on market based terms. The tenant received customary free rents, while HTA locked in key health system tenants at attractive rates that were 18% higher than our portfolio on a net effective basis.
Our focus on efficient operations and relationship building has positioned us for
long-term growth post-COVID
COVID PLAYBOOK
5
$0.250
$0.260
$0.270
$0.280
$0.290
$0.300
$0.310
$0.320
$0.330
4Q14
1Q15
2Q15
3Q15
4Q15
1Q16
2Q16
3Q16
4Q16
1Q17
2Q17
3Q17
4Q17
1Q18
2Q18
3Q18
4Q18
1Q19
2Q19
3Q19
4Q19
1Q20
2Q20
3Q20
0.0%0.5%1.0%1.5%2.0%2.5%3.0%3.5%4.0%
4Q14
1Q15
2Q15
3Q15
4Q15
1Q16
2Q16
3Q16
4Q16
1Q17
2Q17
3Q17
4Q17
1Q18
2Q18
3Q18
4Q18
1Q19
2Q19
3Q19
4Q19
1Q20
2Q20
*3Q
20*
INCREASING NORMALIZED FFO/ SHARE
SAME STORE CASH NOI GROWTH
$0.34$0.35$0.36$0.37$0.38$0.39$0.40$0.41$0.42$0.43$0.44
4Q14
1Q15
2Q15
3Q15
4Q15
1Q16
2Q16
3Q16
4Q16
1Q17
2Q17
3Q17
4Q17
1Q18
2Q18
3Q18
4Q18
1Q19
2Q19
3Q19
4Q19
1Q20
2Q20
3Q20
DIVIDENDS PER SHARE
*2.5% SAME STORE CASH NOI FOR 2Q20 AND 3Q20 EXCLUDES THE IMPACT OF FREE RENTS ASSOCIATED WITH EARLY RENEWALS EXECUTED IN 2Q20, DURING THE COVID-19 PANDEMIC
PROVEN TRACK RECORD OF PERFORMANCE TO BOTTOM LINE
Continued earnings growth during COVID-19
2.7% Average Same Store NOI Growth Since 2014
11.3% Dividend Growth Since 2014
184% Shareholder Return since Inception
CONSISTENT PERFORMANCE IN DYNAMIC MARKET CONDITIONS
6
HTA, 11.3%
PEAK*, 0.0%
HR, 0.0%
DOC, 2.2%
-1.0%
1.0%
3.0%
5.0%
7.0%
9.0%
11.0%
13.0%
15.0%
HTA PEAK* HR DOC
*INFORMATION FOR PEAK IS REFLECTIVE OF DIVIDEND GROWTH POST SPINOFF OF QUALITY CARE PROPERTIES, INC. IN Q4 2016
THE ONLY MOB REIT WITH PROVEN DIVIDEND GROWTH
7
CONTINUED LEASING STRENGTH
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Q4
2017
Q1
2018
Q2
2018
Q3
2018
Q4
2018
Q1
2019
Q2
2019
Q3
2019
Q4
2019
Q1
2020
Q2
2020
Q3
2020
-
250
500
750
1,000
1,250
1,500
Q4
2017
Q1
2018
Q2
2018
Q3
2018
Q4
2018
Q1
2019
Q2
2019
Q3
2019
Q4
2019
Q1
2020
Q2
2020
Q3
2020
Leased SF - New Leased SF - Renewal
0.0%
1.5%
3.0%
4.5%
6.0%
7.5%
9.0%
Q4
2017
Q1
2018
Q2
2018
Q3
2018
Q4
2018
Q1
2019
Q2
2019
Q3
2019
Q4
2019
Q1
2020
Q2
2020
Q3
2020
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Q4
2017
Q1
2018
Q2
2018
Q3
2018
Q4
2018
Q1
2019
Q2
2019
Q3
2019
Q4
2019
Q1
2020
Q2
2020
Q3
2020
OCCUPANCY
LEASINGRE-LEASING SPREADS
RETENTION
In Thousands
8
WHY MEDICAL OFFICE BUILDINGS?
Webb Medical Plaza B |Phoenix, AZOwned and Operated by HTA
WHY HEALTHCARE?
• Healthcare is the fastest growing sector in dollars and in employment within the US.
• Aging demographics boost healthcare spending: 10,000 people turning 65 every day (4x as many physician visits as younger population).
• Healthcare is shifting to outpatient locations to focus on cost-effective care. Medical Office Buildings, or “MOBs,” are the primary beneficiary of this trend.
• Healthcare providers are consolidating and will require new and innovative capital providers who can help meet their strategic goals.
WHY MEDICAL OFFICE BUILDINGS?
• MOBs are traditional real estate where location, barriers to entry, and operations are critical.
• MOBs deliver steady and consistent growth with limited capital and volatility in all market conditions.
• MOB sector is fragmented, with less than 20% owned institutionally, which provides opportunity for HTA to capture market share.
• MOBs have limited new supply concerns.
• Dedicated MOB operators understand healthcare providers and the real estate dynamics to ensure premium performance.
Source: Revista
11%
52%13%
24%
REITs
Hospitals / Health Systems
Providers / Private Owners
Private Equity / Developers
THE MEDICAL OFFICE BUILDING THESIS
10
Ambulatory Visits Have Rebounded and Health Care Services are Recovering
-60
-50
-40
-30
-20
-10
0
10
16-Feb 16-Mar 16-Apr 16-May 16-Jun 16-Jul 16-Aug 16-Sep
SOURCE: SOURCE: ATEEV MEHROTRA ET AL., THE IMPACT OF THE COVID-19 PANDEMIC ON OUTPATIENT CARE: VISITS RETURN TO PREPANDEMIC LEVELS, BUT NOT FOR ALL PROVIDERS AND PATIENTS(COMMONWEALTH FUND, OCT. 2020). HTTPS://DOI.ORG/10.26099/41XY-9M57
Percent Change in Number of Ambulatory Visits In A Given Week Since Baseline Week (March 1 – 7)
Baseline Week
01,0002,0003,0004,0005,0006,0007,0008,0009,000
Jan Feb Mar Apr May Jun Jul Aug Sep
Total Ambulatory Services Employees –in Thousands, Monthly
SOURCE: BUREAU OF LABOR AND STATISTICS SERIES CES6562100001, REVISTA
Feb – April: -17%April – Sept: +16%
THE MEDICAL OFFICE BUILDING DURING COVID
11
THE HTA DIFFERENCE
The Pavilion MOB |Dallas, TXOwned and Operated by HTA
SINCE 2014, WE HAVE GROWN
OUR PORTFOLIO & EARNINGS
WHILE INCREASING OUR
CAPABILITIES AND
ESTABLISHING SCALE IN KEY
MARKETS WHICH WE BELIEVE
FACILITATES COMPANY
OPERATIONS & LONG-TERM
GROWTH OPPORTUNITIES
Portfolio Size ($B) $3.0B $7.4 B
Portfolio Size (GLA in millions)
14.1MM SF 25.1MM SF
Top Five MSAs PhoenixPittsburghGreenville
AlbanyIndianapolis
DallasHouston
BostonTampaAtlanta
1 MM SF Markets 3 10
500K SF Markets 10 17
In-House Property Management (GLA in MM)
90%13.4MM SF
97%24.3MM SF
% MOB’s 91.7% 94.8%
Development In Process/LTM Completion ($ in MM)
$0 $154.1MM
Earnings (NFFO/Share) $1.46 $1.72(1)
Payout Ratio 91% 86%
Leverage (Net Debt / Adjusted EBITDAre)
5.7x 5.7x
2014 2020
Eskenazi Administration Building |Indianapolis, INOwned and Operated by HTA
2020 DATA AS OF 9/30/2020(1) ANNUALIZED NFFO/SHARE AS OF 9/30/2020
PLEASE REFERENCE THE COMPANY’S FILED AND FURNISHED FINANCIAL REPORTS FOR THE RESPECTIVE PERIODS FOR FINANCIAL RECONCILIATIONSPAYOUT RATIO DEFINED AS DIVIDENDS PAID PER SHARE OUT OF FUNDS AVAILABLE FOR DISTRIBUTION (FAD) ON A PER SHARE BASIS
CREATING THE SUPERIOR PLATFORM
13
SOURCE: COMPANY FILINGS & SNL FINANCIAL; DATA AS OF 9/30/2020
HTA – LARGEST MEDICAL OFFICE REIT
14
HTA DOC HR PEAK VTR WELLMOB GLA 23.8 14.3 14.7 21.1 19.7 22.2
MOBs On-Campus / Aligned (%) 93% 89% 95% 97% 69% NA
Top Five MSAs
Dallas Houston Boston Tampa Atlanta
AtlantaDallas
LouisvillePhoenix
Minneapolis
DallasSeattle
Los AngelesCharlotteNashville
DallasHoustonSeattleDenver
Philadelphia
Los AngelesChicagoPhoenixSt. Louis
San Francisco
HoustonLos Angeles
New YorkDallas
Philadelphia
Portfolio Managed In-House (%) 97% N/A 77% N/A N/A 82%
NFFO/Sh Growth (since 2014) 16.2% 18.2% 7.9% -49.4% -34.8% -18.4%
Avg SS Growth (since 2014) 2.7% 2.4% 3.4% 2.6% 1.7% 2.2%
Acquisitions (Avg $ Invested Since 2014) $471M $335M $114M $308M $419M $616M
Moody / S&P Ratings Baa2 / BBB Baa3 / BBB- Baa2 / BBB Baa1 / BBB+ Baa1 / BBB+ Baa1 / BBB+
THE LEADING MOB OPERATOR
Lincoln Medical Center |Parker, COOwned and Operated by HTA
Critical Mass in Established Gateway Markets
PORTFOLIO SNAPSHOT
Key Markets Investment(in thousands)
% of Investment
Dallas, TX $ 861,274 11.6%
Houston, TX 455,459 6.1
Boston, MA 397,693 5.4
Tampa, FL 347,764 4.7
Hartford/New Haven, CT 344,604 4.6
Atlanta, GA 338,886 4.6
Orange County/Los Angeles, CA 323,424 4.4
Indianapolis, IN 281,769 3.8
Raleigh, NC 278,113 3.7
Phoenix, AZ 267,781 3.6
Denver, CO 265,807 3.6
New York, NY 256,144 3.5
Chicago, IL 231,178 3.1
Miami, FL 224,023 3.0
Charlotte, NC 214,887 2.9
Albany, NY 170,071 2.3
Austin, TX 164,425 2.2
Orlando, FL 156,300 2.1
Pittsburgh, PA 148,612 2.0
Milwaukee, WI 116,081 1.6
Top 20 MSAs $ 5,844,296 78.8%
Additional Top MSAs 1,145,058 15.5
Total Key Markets/Top 75 MSAs $ 6,989,354 94.3%
HTA MARKET CRITERIAHIGH GROWTH MARKETS WITH DENSE PATIENT BASELocation, Location, Location. 94% of our GLA located is in the top 75 MSAs, most with strong academic university concentration. We strategically invest in some of the fastest growing markets where we can build scale to efficiently service our properties and provide value to our tenants.
SCALABILITYWe believe each key market should hit a critical mass of 1-2 million SF to create operating synergies and enhanced relationships with local providers that drive growth. We have reached economies of scale in 10 markets of ~1MM SF and 17 markets >500k SF.
16
Key Considerations:
Strategically located, multi-tenanted MOBs within high-income, faster growth submarkets that are increasingly targeted by healthcare providers
Advances in technology have allowed an increasing number of procedures to be performed off-campus; including knee and hip replacements.
Provider preferences shifting to “off-campus” (source: Revista Survey)
No restrictions – multiple providers and health system networks compete for space
Our Portfolio of Both On-Campus and Off-Campus Facilities are Essential to the Delivery of Healthcare. Our diligent underwriting and investment expertise has created a portfolio where both our on-campus and off-campus MOBs are
focused on attractive submarkets, with similar mix of primary care and specialists, and health system tenancy that drives strong levels of tenant retention, occupancy stability, and rent growth over time.
ON-CAMPUS AND OFF-CAMPUS STRATEGY
Key Considerations:
Long-term demand supported by hospital infrastructure and ancillary services
Limited developable land around hospital campuses
Designated healthcare cluster drives referral patterns
Hospital / University name recognition and reputation
Clinical, lab, research, and academic space shapes future delivery of healthcare
On-Campus /Adjacent: Many on-campus MOB’s are subject to ground leases that allow health systems to restrict leasing and other activities. As such, HTA’s portfolio of On-Campus MOBs is specifically targeted to fee-simple ownership which allows for greater leasing flexibility and superior returns.
On
-Cam
pu
s -6
7%C
ore
Com
mu
nit
y O
utp
atie
nt
-33%
71%
16%
5%8%
Specialty Primary CareAmbulatory Surgery Center Other
Tenant Specialty – On Campus(% of GLA)
64%
21%
6%9%
Specialty Primary CareAmbulatory Surgery Center Other
Tenant Specialty – Off Campus(% of GLA)
17
59%15%
26%
HealthSystems/Universities
National/LargeRegional Providers
Local HealthcareProviders/Other
Tenant Diversification and Viability Position our Portfolio for Long-Term Performance
Credit Rated Tenancy(% of Annualized Base Rent)
Tenant Classification(% of Annualized Base Rent)
Our Partners are the Top Health Systems in our Key Markets in both On-Campus and Off-Campus Facilities
STRONG STABLE TENANT RELATIONSHIPS
45%
15%
40%
Investment Grade
Other Credit Rated
Not Rated/Other
MOB Tenant Diversification(% of MOB GLA)
74% of our tenant base is comprised of health systems, universities, and large/regional providers
and 60% of our tenant base is credit rated
18
74%
26%
Multi-Tenant
Single-Tenant
Net DEBT / ADJUSTED EBITDAre LADDERED DEBT CAPITALIZATION WITH LIMITED NEAR-TERM MATURITIES
($ in thousands)
BBB/Baa2Standard & Poor’s/Moody’s
Credit Rating
5.1xNet Debt / Adj. EBITDAre (2)
$1.5B Liquidity (1)
SOURCE: COMPANY FILINGS & SNL FINANCIAL; DATA AS OF 9/30/2020(1) INCLUDES UNDRAWN CAPACITY ON REVOLVING CREDIT FACILITY, CASH & CASH EQUIVALENTS AND UNSETTLED EQUITY FORWARD AGREEMENTS(2) INCLUDES UNSETTLED EQUITY FORWARD AGREEMENTS
5.9x
6.0x
5.5x 5.5x
5.7x 5.7x
6.3x
6.2x
5.9x 5.9x
5.8x
5.3x
5.4x
5.6x
5.7x 5.7x 5.7x
5.6x
5.7x 5.7x
4.8x
5.0x
5.2x
5.4x
5.6x
5.8x
6.0x
6.2x
6.4x
4Q 15
1Q 16
2Q 16
3Q 16
4Q 16
1Q 17
2Q 17
3Q 17
4Q 17
1Q 18
2Q 18
3Q 18
4Q 18
1Q 19
2Q 19
3Q 19
4Q 19
1Q 20
2Q 20
3Q 20
BALANCE SHEET POSITIONED FOR STABILITY & GROWTH
19
THANK YOU
Mission Tower, Orange County / Los Angeles, CAOwned and Operated by HTA
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