Global Medical REIT Inc.

and welcome to Global Medical REIT second quarter 2024 earnings conference call. At this time, all participants are in a listen only mode. A brief question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Mr. Steve Sweat, Investor Relations. Thank you, Mr. Sweat. You may begin.

Thank you. Good morning, everyone, and welcome to Global Medical REIT's second quarter 2024 earnings conference call. On the call today are Jeff Bush, Chief Executive Officer, Alfonso Leon, Chief Investment Officer, and Bob Kiernan, Chief Financial Officer. Please note the use of forward-looking statements by the company on this conference call. Statements made on this call may include statements which are not historical facts and are considered forward-looking. The company intends these forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995 and is making this statement for the purpose of complying with those safe harbor provisions. Furthermore, actual results may differ materially from those described in the forward-looking statements and will be affected by a variety of risks and factors that are beyond the company's control including, without limitation, those contained in the company's 10-K for the year ended December 31, 2023, and its other SEC filings. The company assumes no obligation to update publicly any forward-looking statements, whether as a result of new information, future events, or otherwise. Additionally, on this call, the company may refer to certain non-GAAP financial measures, such as funds from operations, adjusted funds from operations, EBITRE, and adjusted EBITRE. You can find a tabular reconciliation of these non-GAAP financial measures to the most currently comparable GAAP numbers in the company's earnings release and its filings with the SEC. Additional information may be found on the investor relations page of the company's website at www.globalmedicalreit.com. I would now like to turn the call over to Jeff Bush, Chief Executive Officer of Global Medical REIT. Jeff?

Thank you, Steve. Good morning and thank you for joining our second quarter 2024 earnings call. Our high quality diversified portfolio continues to produce solid results. At the end of the second quarter, portfolio occupancy was 96.2% with a weighted average lease term of 5.8 years. And portfolio average rent coverage ratio of 4.6 times. For the second quarter, our net loss attributable to common shareholders was $3.1 million, or 5 cents per share, compared to net income attributable to common shareholders of $11.8 million, or 18 cents per share, in the second quarter of 2023. FFO attributable to common shareholders and non-controlling interest in the second quarter was $0.20 per share and unit, down $0.01 from the prior year quarter. And our AFFO attributable to common stockholders and non-controlling interest was $0.22 per share and unit, down $0.01 from the prior year quarter. During the quarter, we entered into a purchase agreement for a 15 property portfolio of outpatient medical real estate for an aggregate purchase price of $80.3 million at an 8% cap to be completed in two tranches. These properties are fully occupied and leased under triple net and absolute net leases. Subsequent to quarter end in July, we closed on the first tranche, acquiring five properties in the 15-property portfolio for an aggregate purchase price of $30.8 million. We expect to complete the acquisition of the 10 remaining properties during the fourth quarter of 2024. We are optimistic about the overall acquisition market in our asset class and are pleased with the improvement in market conditions. Currently, our investment pipeline consists of approximately $120 million of assets at attractive cap rates. As we think about our growth opportunities, we are focused on maintaining a strong balance sheet. An important element to our prudent approach is utilizing select dispositions. to fund a portion of our growth. Our dispositions can be part of an asset recycling program or in response to expectations regarding long-term property performance. During the quarter, we closed on the sale of a medical facility in Mishawaka, Indiana, receiving gross proceeds of $8.1 million. And in July, we closed on the sale of a medical facility in Panama City, Florida, that we generated $11 million of gross proceeds. We continue to selectively sell assets as we move forward. In terms of tenant-related items, last quarter we discussed Stewart Healthcare bankruptcy announcement and their exposure in the company's portfolio. At the time of the filing, Stuart represented 2.8% of the company's annualized base rent, primarily in one facility in Beaumont, Texas. Prior to the bankruptcy announcement, the company was actively pursuing releasing opportunities at this facility and is optimistic about our long-term prospects at this location. Bob will provide an update and more details regarding the financial assets of our steward relationship in his remarks. Overall, I'm pleased with our second quarter results, and we want to thank the entire team for their hard work and contribution to our results. With that, I turn the call over to Alfonso to discuss our investment activity and the current acquisition market conditions in more detail.

Thank you, Jeff. The transaction market for our target assets, which align with our investment criteria, continues to show signs of promising progress. We remain actively engaged with a wide range of physician groups, brokers, and corporate sellers to identify acquisition opportunities. As Jeff mentioned, in the quarter, we entered into a purchase agreement to acquire a 15-property portfolio of outpatient medical real estate for an aggregate purchase price of $80.3 million to be completed in two tranches. These properties align with our investment criteria being fully occupied and leased under triple net or absolute triple net agreements. As Jeff discussed earlier, we completed the first tranche subsequent to quarter end acquiring five properties encompassing roughly 95,000 leaseable square feet for an aggregate purchase price of $30.8 million with aggregate annualized base rent of $2.5 million, and the second tranche is expected to close in the fourth quarter of 2024. The ability to close the deal in two tranches provides us with additional flexibility to prudently fund a transaction. As a reminder, the second tranche of this deal is currently under contract and subject to customary terms and conditions, including due diligence reviews. Accordingly, there is no assurance that the company will close this acquisition on a timely basis or at all. We see this transaction as indicative of current market trends where sellers are increasingly accepting higher cap rate deals due to the ongoing challenges in the refinance market and pressure on real estate funds to sell. Regarding the asset that we acquired in July, note the following details. We acquired the five properties in the first tranche at an average price of $325 per square foot an 8% in-going cap rate, 5.4 years of weighted average lease term, and 2.2% average rent bumps. The five properties in the portfolio include a family medicine clinic in Cerritos in Southeast LA leased to PIH Health, a regional health network with three hospitals and 26 clinics with an A rating, two ophthalmology-focused outpatient clinics in the Detroit MSA leased to Henry Ford, a $7 billion revenue health system with an A2 credit rating. A multi-specialty clinic and surgery center in Minot, North Dakota leads to Trinity Health, the region's dominant health system with three hospitals and 18 clinics with a BB minus rating. A primary care focused multi-specialty outpatient center in Spartanburg, South Carolina leads to the county with an AA1 rating. On a disposition front, during the quarter, we closed on the sale of a medical facility in Mishawaka, Indiana, receiving gross proceeds of $8.1 million, resulting in a loss on sale of $3.4 million. The lease at this property was set to expire at the end of the year, and our decision to dispose of this property was based on our lease renewal expectations and outlook for finding a suitable tenant replacement. The property was originally part of a four-property portfolio the company purchased in 2019. After quarter end in July, the company sold a medical facility in Panama City, Florida, receiving gross proceeds of $11 million. The property had a net book value of approximately $8.9 million at the time of sale. This sale was part of our general asset recycling process, whereby we identify assets that we believe can be sold at gains, and the proceeds reinvested accretively by the company. Looking ahead, we will remain persistent and disciplined in seeking opportunities that align with our investment strategy and underwriting standards. We plan to leverage our competitive advantages, including scale, access to capital, the potential use of OP unit deal structures to unlock opportunities and drive value. As Jeff mentioned, our current investment pipeline consists of approximately $120 million of healthcare assets, I now like to turn the call over to Bob to discuss our financial results. Bob?

Thank you, Alfonso. At the end of the second quarter of 2024, our portfolio consisted of gross investments in real estate of $1.4 billion and included $4.7 million of total leaseable square feet, 96.2% occupancy, 5.8 years of weighted average lease term, 4.6 times rent coverage, with 2.2% weighted average contractual rent escalations. In the second quarter of 2024, our total revenues decreased by approximately 6% compared to the prior year quarter to $34.2 million, due primarily to the impact dispositions that were completed in 2023. Additionally, the recognition of reserves for $800,000 of rent and the write-off of $100,000 of deferred rent primarily related to our tenant-steward healthcare, our BOMA facility, contributed to the decline. Total expenses for the second quarter of 2024 were $32.8 million, compared to $35 million in the prior year quarter. The decrease was primarily due to disposition transactions that were completed during 2023 and lower interest expense. Our interest expense in the second quarter was $7 million compared to $8.5 million in the comparable quarter of last year, reflecting lower borrowing rates due to lower leverage, the impact of our interest rate swaps, and lower average borrowings compared to the prior year period. Our operating expenses were $7.2 million for both the second quarter of 2024 and the prior year quarter. Regarding the second quarter 2024 expenses, $4.9 million related to net leases, where the company recognized a comparable amount of expense recovery revenue, and $900,000 related to gross leases. G&A expenses for the second quarter of 2024 were $4.6 million compared to $4.5 million in the second quarter of 2023. The increase primarily resulted from an increase in non-cash LTIP compensation expense, which was $1.3 million for the second quarter of 2024, compared to $1.1 million for the same period in 2023, partially offset by a decline in general corporate expenses. Looking ahead, we expect our G&A expenses in the second half of 2024 to be in the range of $4.4 million and $4.6 million on a quarterly basis. That loss attributable to common stockholders for the second quarter of 2024 was $3.1 million, 5 cents per share, compared to net income attributable to common stockholders of $11.8 million or 18 cents per share in the second quarter of 2023. The loss in the second quarter of 2024 was primarily due to a $3.4 million loss recognized on the sale of the medical facility in Mishawaka, Indiana. The results for the second quarter of 23 reflected a gain on sale of investment properties of $12.8 million. FFO attributable to common stockholders and non-controlling interest in the second quarter of 2024 was $13.9 million, or 20 cents per share and unit, compared to $14.7 million, or 21 cents per share and unit, in the second quarter of 2023. AFFO attributable to common stockholders and non-controlling interest in the second quarter of 2024 was $15.7 million, or 22 cents per share and unit, compared to $15.9 million, or 23 cents for sharing unit in the second quarter of 2023. Moving on to the balance sheet. As of June 30, 2024, our gross investment in real estate was $1.4 billion. At June 30, 2024, we had $620 million of total gross debt with a weighted average remaining term of 2.5 years. At quarter end, 83% of our total debt was fixed rate debt. Our leverage ratio was 43.8%. And our weighted average interest rate was 3.89%. Lastly, as of today, the current unutilized borrowing capacity under the credit facility is $261 million. We did not issue any shares of common stock under our ATM program during the second quarter or to date in the third quarter. As we consider funding options for the acquisitions that we have closed or are expected to close later this year, we will continue to be disciplined as we seek to maintain leverage in our target range of 40% to 45%. With respect to our investment portfolio and our 2024 lease expiration, we are pleased with our progress on renewals and based on activity to date, we are currently trending towards a retention rate of between 75% and 80% on this year's expiring leasable square feet. Regarding capital expenditures on the portfolio, during the second quarter, our cash spend was approximately $3.2 million. Year to date, through June 30th, our cash outflows for capital expenditures were approximately $5.2 million, with slightly more than half of that related to tenant improvements. Currently, for the full year of 2024, we're projecting total capital expenditures of $11 to $13 million. As Jeff mentioned, during the quarter, Stewart Healthcare announced that it would file for Chapter 11 bankruptcy. At the time of the bankruptcy filing, Stewart represented 2.8% or $3.1 million of the company's annualized base rent, of which 86% related to our facility located in Beaumont, Texas. Post-bankruptcy, the company has received base rent payments on its Stewart leases for the months of June, July, and August. The company has been proactively exploring releasing options at the Beaumont facility since before the bankruptcy announcement, and we remain optimistic about our long-term prospects at this location. In conclusion, as we look to the second half of the year, we believe that our strong portfolio and ample liquidity provide a solid foundation for our future growth. We are encouraged by our acquisition opportunities and look forward to sharing our progress with you. This concludes our prepared remarks. Operator, please open the call for questions.

Thank you. We will now be conducting a question and answer session. If you would like to ask a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star 2 if you would like to remove your questions from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment please while we poll for questions. The first question comes from the line of Austin Pro Schmidt with KeyBank Capital Markets, Inc. Please go ahead.

Great. Good morning, everybody. I was hoping to get some additional details regarding the $120 million investment pipeline. Maybe just starting with, you know, whether this amount includes the second tranche or the 15 property portfolio, or is the $120 million on top of that kind of remaining $50 million or so?

The pipeline does not include the second tranche. I mean, this is stuff that is in our pipeline that we've been pursuing in various ways and in discussions with various parties. The market has improved pretty significantly since the last earnings call. And, you know, there's more willing sellers that are willing to sell their assets at attractive pricing.

And what's the composition of these assets, Alfonso? And maybe can you share some details around the economics and then just timing that you'd expect to close on the deals?

Sure. So these are medical office buildings. I mean, our focus has been on medical office buildings in our pipeline. And geographically, it's It's in markets that are like the types of market that we've been pursuing historically. And these are quality buildings with quality tenants.

And as far as the cap rates on the $120 million, where would you expect kind of that to shake out on average?

Sure. So, I mean, we're targeting cap rates that are north of eight caps. and are finding opportunities that are in the high eights and even in the nine caps.

This is Jeff. I just want to add to that. It's a very exciting time, which I haven't said in a long time for us. You know, if interest rates start to fall as projected and there's opportunities out there in our niche, at very attractive properties, good quality, like we bought the $80 million portfolio, extraordinarily good quality and an ACAP. And there is higher ACAPs and hires out there for us in our niche that, you know, we'll be able to absorb and we could have a very good year of that.

That's helpful. And then just lastly, on the funding side, Jeff, you spoke about the asset recycling program. you know, with that pipeline, kind of the acquisition pipeline building, you know, are you marketing additional assets today? And what's your latest thoughts on, you know, cap rates on the disposition side? That's all for me. Thank you.

Yeah. Yeah, no, I agree with you. On disposition, we always look, there's properties out there that we could sell, or if we could do a point or two above some type of sell. But we're really monitoring also the equity side of the business. The reason is, you know, if the Fed, you know, which people think now after multiple times, you know, brings the rates down, which my belief it's finally going to happen, but we'll see. Our stock historically, the three times the market thought it was coming down had a really nice jump. and we could be very accretive for the properties we're going to buy. So it'd be a combination of selling properties at lower cap rates and making the spread and also possibly raising money to acquire these new properties. It's really nice. You know, like this is the first time out there that market has sort of capitulated on the, the market of selling real estate is sort of capitulated. that the pricing is going to be substantially higher so it matches to being accretive for us.

Appreciate the thoughts.

Thank you. Next question comes from the line of Juan Sanabria with BMO Capital Markets. Please go ahead.

Hi. Good morning, and thanks for the time. Just a question following up on the dispositions. Could you comment or provide the cap rates for what you sold in the second quarter and in July to date, recognizing there was some vacancy risk with the upcoming expiration?

Sure. So on the Panama City, we sold that for a 7.1 cap. And on the Mishawaka asset, I mean, again, just to point out, I mean, this is one that we felt like the releasing prospect was going to be very difficult and it made sense to sell. And we had found a buyer that was a user, owner-user of the property. And keep in mind, too, that this was part of a portfolio that we acquired back in 2019, a $94 million portfolio. And we allocated roughly $16 million of that value to this property. And since then, we've collected more than $9 million of rent from this property from an A-rated system. And we're able to sell it for just over $8 million. And the other three properties have outperformed. We got a 10-year renewal on the Las Vegas property. On the Oklahoma property, we got an expansion and a 14-year renewal. And the surprise Arizona property had a long-term lease to begin with. And these are all properties that have very strong rent coverage. And so from our perspective, you know, when we bought the portfolio, we underwrote it as a package. And as a whole, this portfolio has performed very well.

But what was the rent accrued in the second quarter with regard to the Wisconsin assets? The Wisconsin asset? Yeah, just get back into the cap rate.

Oh, sure. I mean, it was north of a, you know, low double-digit cap rate.

Great. Thanks. And then, Bob, you spoke to expected retention on upcoming expirations for the balance of the year. So, I guess, what is then the implied occupancy that we should think about by year end and does that have any impact to FFO for share with presumably some expected move outs or timing before you release? That's crazy.

Sure. I mean, as we look ahead to the, you know, the expirations that are coming up in the second half of the year, William Johnson, We're still projecting as we've said on previous calls pretty steady occupancy and right around this kind of William Johnson, 96% plus, you know, plus or minus and with the trending, you know, toward a little bit plus that 96 so in that 96% and above tech range and from an from an earnings perspective. Again, sometimes there are renewals that have free rent periods from a timing perspective. You're subject to that from a long-term perspective or in the short term. But overall, we're projecting solid occupancy as we look ahead, and it shouldn't provide that much volatility from an earnings perspective.

And just one last one for me, if you don't mind. On the steward space, I guess in particular the Beaumont lease, how does that compare to kind of current market levels? And I guess if there is, if you have to release it, presumably that is the case, then how much market to market could we expect either positive or negative in your MIS initial assessment?

So, we're still in the process, but I mean, yeah, it's going to be very comparable to what we had. Thank you.

Yeah, I just want to comment on the Stewart property. It's an excellent property that is in pretty decent demand. So, you know, that's why we're optimistic about the releasing and the market on that.

Thank you. Next question comes from the line of Rob Stevenson with Jenny Montgomery. Scott, please go ahead.

Good morning, guys. Bob, what is you indicated that you had gotten paid through June, July, and August on Stewart. What is, is it just the 800,000 reserves and the 100,000 of deferred rent write-off? Is that the hit, the only hit thus far from Stewart? Or is there other, you know, may or something that you didn't get paid for as well that you think that you might down the road?

Right. Yeah, Rob, think of it as though, yeah, March, April, May from an exposure perspective, as well as expenses.

Okay. And what's the cumulative of that March, April, May?

So that's about that 800 to a million dollar type reserve, because we're now incurring, you know, facing the operating expenses on that property, particularly as we think about keeping it in solid shape for renewal opportunity or releasing opportunities. And again, that's just a delta compared to having it be just a very straightforward triple net lease where the tenant was funding all the expenses.

Okay, and then I guess at this point, I mean, how fast is this moving? Are they likely to pay you for September and October or is August basically the extent to which you guys think that you're going to get paid and then it's up to a releasing process after that in order to get back to having this be cash flow positive for you guys?

So with the bankruptcy process, it's not totally clear to us in terms of how they're managing their timeframe. So from our perspective, they have not yet rejected the lease and pursuant to the bankruptcy, they would owe us base rent and expenses during the period subsequent to bankruptcy up through to the point where they would reject the lease. And so at this point, we're just collecting that rent post-bankruptcy, but it's not clear to us when that, you know, when their process is going to kind of move on and provide that kind of more clarity for us even in terms of that final step. But with that said, we have it staged and are kind of working off to the side, you know, very, you know, as quickly as we can to have it staged for as quick a transition Phil Kramer, As as we could possibly have recognizing that there's probably there would probably be again a modest transition period for free rent element, things of that nature that could could impact us between again the current situation. And when we would onboard a prospective tenant. Okay.

And then Trinity Health was replaced as your number 510 by Team Health here in the second quarter. It sounded like from Alfonso's comments, if I heard it right, that at least one of the five portfolio acquisitions completed thus far in the third quarter is leased to Trinity. Is any of these other acquisitions out of the five or the 10 acquisitions expected to come in the fourth quarter or the likely closings of the $120 million that you're circling with existing top tenants or other tenants that will be pushed into the top five by these deals?

Yes. There's not going to be a meaningful move to the top ten.

Okay. All right, and then last 1 for me, can you talk about the size and scope of the tenant watch list today versus the last couple of quarters? You know, 1 of your direct competitors is having issues with the geriatric and patient behavioral hospital tenant. get Steward Genesis and some others, you know, operators are cracking here and what's still a relatively robust economy. If the economy starts to weaken here, you know, how much more are you thinking that the tenant watch list expands over the next sort of four quarters or so?

So right now, we've talked in the past few quarters about, you know, prospect health and Q4. steward in Q1. And those have been our primary tenant related items that we've had to deal with from an accounting and reporting perspective. And at this point, again, we continue to monitor our acute care. We have one acute care hospital. But again, it is something that, again, we're very actively involved with. But at this point, we don't have anything that's beyond that group that we're actively focused on. We also don't have any loans to tenants that we would highlight or note either in how we're managing the portfolio.

I just want to add, I mean, the vast, vast majority of our business has been MOB work. And MOBs are strong out there. And in a downturn, they'd be strong. When we did purchase into some of the one acute hospital and some other type of, you know, like surgical, like Beaumont and others, those were doing well. But, you know, after the pandemic and others and the billing system, the reimbursement system change, they've struggled more. that you see that, but that's a very limited part of our portfolio. The vast, vast majority of our portfolio is, you know, absolute and triple net MOBs that are doing very well.

I guess one question that that poses then, Jeff and Alfonso, given that comments and given that Alfonso indicated that the vast majority or almost all of the 120 million in your pipeline today are medical office buildings, to do behavioral health or hospitals, are you still interested in doing them at all? Is it just requiring a much wider return that you need another 100, 150 basis points to make the risk worthwhile? Or is the focus here and for the immediate future just going to be medical office no matter what for you guys?

The market has turned so substantially for us to buy medical office buildings. The private equity does not get the bank lines that they had before. and the rates and a lot of the sellers are capitulating and saying, okay, the rates are higher now. So we're finding like we did early when we started and then the private equity during the pandemic saw that, you know, 99% of our tenants paid whether they had patients or not and moved into the MOB field. Right now we find it open again. I can't see, I can't say never, But I can't see us being in the medical, I mean, being in, definitely not in the acute hospital area. Rehabs, we got in early and we liked those. But I can't see us going into that field and possibly reducing our exposure to them would probably be more of a future. I love the MOB program. field, especially the absolute and triple net area.

Okay. Thanks, guys. Appreciate your time this morning.

Thank you. Our next question comes from the line of Brian Marr with B Riley Securities. Please go ahead.

Thanks, and good morning, everyone. Most of my questions have been asked already, but can I get a point of clarity on Stewart A little confused. So they paid for June, July, and August, but they haven't paid for March, April, and May. Is that correct? That's the 800 you're going after? That's correct. And are they physically out of the building with no intention of coming back to that building?

Yeah, the first part for sure, they're out. The second part, I mean, it's most likely. Okay.

It just seems curious that somebody would keep paying you June, July, and August if they have zero intention instead of making you fight to get the money.

It's hard that they haven't rejected the fees. We feel very optimistic we could rent this out given that this is popular in the market. So therefore... You know, we're at the point now where, you know, we'd almost like them to reject the lease and get on with renting it and getting a new tenant in because this is a very good facility. It's in the best part of town of the facility. It's a good medical market, actually. And that's why we use the word and we've been using optimistic out there is that But, Stuart, I think we're just such a small part of it, and they're confused in their bankruptcy that they just haven't rejected it. But when they do reject it, we hope to be moving very quickly and get this solidified.

Okay. To be clear, the property is not being operated currently, and you cannot release it until they reject it or the bankruptcy court says so.

That is correct.

Okay. My other question maybe for Bob, with how quickly interest rates have come down here and given the fairly short two and a half years weighted average debt maturities, is there any opportunity for you to kind of move quickly to lock in some of these lower rates? Or I guess, Jeff, with your commentary, you seem to think rates might be going a little lower. Is that the view of the firm to wait and hope for even lower from here?

I think going lower. You know, I think once they start, you know, people talking about, you know, a point, point and a half or so. So, you know, I think we have time and we could, you know, get a good rate in the future. If a recession happens, it will even go lower out there.

Okay, thank you. That's all for me. Thank you.

This concludes our Q&A session and today's teleconference. You may disconnect your lines at this time. Thank you for your participation.