If you are jumping into the healthcare facility operator or investor pool, this spreadsheet will be of great use. This model will let the user enter bottom-up assumptions about the prospective care home / assisted living facility and generate forecasted financial statements. This financial model has it all. The spreadsheet has clear input/output summaries, three statement model monthly and annual views, visualizations, and so much more.
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Note, this would work for a nursing home or regular hospital as well.
An assisted living facility sort of fits in the middle of a general real estate model and a standard startup model. You have rooms that are rented out to residents just like a real estate model runs off rent rolls, but you also have much more in-depth operational costs / staffing assumptions.
So, in this model I have used a few features from multiple past templates and come up with a great way to forecast the financial performance, initial investment requirements, and general feasibility of starting an assisted living facility (development or acquiring) and then running for up to 10 years with the option for terminal value.
Features Include:
Revenue and Expense Assumptions
- Rent revenue driven from up to 5 room types, each with up to 6 tiers of care.
- Each combination of room type/tier of care has its own:
- Base room rate
- Tier of care add-on charge
- Room count
- Starting occupancy, monthly occupancy improvement, and stabilized occupancy
- Fully loaded staffing assumptions for in-house salaried positions, outsourced therapy teams, and outsourced professionals.
- Each with an input for payroll taxes / benefits, start month, headcount, and a global annual increase in expenses is defined separately for in-house vs. outsourced staff.
- Slot for other ancillary income per month.
- Separate operating expense schedule for things like utilities/insurance/other overheads.
Acquisition / Development and Financing
- Up to 6 cost schedules where you can put acquisition costs and/or development costs on a monthly timeline. There are six separate cost sections for this, each with 22 slots. Each slot can define if it will be financed or not (yes/no selector) and if so the percentage financed.
- Debt financing uses the option for an interest-only initial loan, option to accrue or pay interest monthly, option for interest-only period, percentage of development/acquisition financed, and months to pull negative cash flows until equity only funding.
- The interest-only loan rolls into a traditional p+i loan with its own terms.
- Final ReFi loan can also be configured with its own terms and LTV based on an annualized EBITDA.
Output Summaries
- Monthly and Annual Income Statement, Balance Sheet, and Cash Flow Statement.
- Monthly and Annual Cash Flow Detail (shows all assumptions and how they flow down to each main sub-total financial line item).
- Annual Executive Summary.
- DCF Analysis (based on monthly periods) - includes IRR/ROI/Equity Multiple for project as well as Investor vs. Owner if applicable.
- Visualizations.
- Optional Waterfall Distribution structured like a joint venture with IRR hurdles for the LP (runs on a monthly basis).
What This Financial Model Can Be Used to Do
- Test Room Pricing (rent charged for various room types and tiers of care)
- Understand general economics of an assisted living facility / nursing home
- General financial feasibility study
- Cost analysis (staffing / SG&A)
- Determine minimum investment required
- Value the entire operation from start to dissolution / terminal value
- Perform scenario analysis based on various occupancy rates over time
- Plan out staffing costs and counts / general strategy for staff planning
- Retail Building Construction
- Lot Development
- Strip Mall Acquisition Model
- Apartment Building
- Single Tenant Industrial
- Mobile Home Parks
- Mixed-Use Real Estate
- Self Storage: Up to 6 Deals
- Rental Property Scaling
- Condo Development
- STRs (Short-term Rentals)
- Unit-Based Real Estate Acquisition
- Short-term Rental Arbitrage
- Hotel Development / Acquisition
- IRR Sensitivity Analysis (occupancy)
- Multi-family Real Estate Acquisition (annual only)
- Real Estate Flipping Calculator
- Property Management Business
- Real Estate Brokerage
- Real Estate Development
- Real Estate Checklist
- Rental Property ROI Calculator
- Seller Financing
- General Cash Flow Waterfall: 3 IRR Hurdles
- General Cash Flow Waterfall: 3 IRR Hurdles and GP Catch-up Provision
- Preferred Equity
- Preferred Return
- Zero Down Seller Financing
- Cost Segregation Study