Industry | Healthcare |
---|---|
Headquarters | United Kingdom |
Number of locations | 440 |
Four Seasons Health Care is a British provider of health and social care services. It also owns The Huntercombe Group, a provider of inpatient mental healthcare and brain injury rehabilitation as well as care home operator brighterkind. Four Seasons, as it is today, was created both organically and by the buying out of smaller chains of care homes and rebranding them, as evidenced by the takeovers of Tamaris (formerly Quality Care Homes) and Bettercare. At its largest it was the second-biggest care home operator in the UK.
Founded in 1988 by Robert Kilgour, it opened its very first care home, Station Court in Kirkcaldy in Fife in Scotland in May 1989 and Four Seasons Health Care remained a small operator building up to just seven care homes in Fife by 1997. The size and fortunes of the business were dramatically changed with the appointment by Chief Executive Robert Kilgour of Hamilton Anstead as Joint Chief Executive. (Kilgour left the company in early 2000, when with 101 homes it was the UK’s 5th largest care home operator. He made his final financial exit from the company in 2004.) There followed a rapid expansion programme for the business, which transformed it within seven years into the largest care home operator in the UK (it was subsequently overtaken). The business was attractive to many suitors, and as a result it was sold for £775 million in 2004. Anstead ceased to be CEO in 2005.
The company was acquired for around £1.5bn in 2006 by Three Delta LLP, the investment fund backed by the state of Qatar, and further expanded. The acquisition was funded by debt which was readily available in a market where investors saw rising property prices and continuing demand for care for the elderly, much of it paid for by the public sector. However, the company was unable to pay its debts and with a downturn in the property markets was unable to refinance, and the owners walked away, losing their investment.
Peter Calveley was appointed CEO in 2007 and his senior management team were left to resolve debts of circa £1.5 billion as a result of borrowings by its owners to buy the homes.
The Group completed a financial restructuring in December 2009, with lenders – banks and other financial institutions – agreeing to swap about £780 million of debt for equity in the business, so becoming its new shareholders. Maturity of the remaining debt was extended to September 2012. Four Seasons was then trading profitably with an EBITDA of over £100m pa. Under Calveley’s leadership, the quality of care performance changed from below the sector’s average to having 89% of its homes rated good or excellent by the Care Quality Commission.
This turnaround in quality helped to drive up occupancy to around 88%. Another factor in the Group’s performance was Calveley’s strategy of anticipating market changes in order to provide specialist care. Four Seasons has 80% nursing or high dependency beds and 20% residential, in contrast to the sector average of 55% residential. It developed services for people who are physically frail or suffering from the onset of dementia or chronic neurological conditions, respite care, intermediate care and rehabilitation, and terminal care. Because there are few readily available alternatives for high dependency care – such as care provision at home – the market for higher dependency care is more resilient than the market for residential care.
As of July 2011 [update] the Group had achieved substantial expansion without new borrowings by acquiring the operations of Care Principles with 17 hospitals and homes – nearly doubling the size of FSHC’s specialist care business – and 1,000 additional care home places (c. 6% growth) through acquisitions over the preceding year from Craegmoor and Eton Square Healthcare. As of September 2011 [update] the group was expected to acquire over 100 care homes from the collapsed provider Southern Cross, which would make it the largest provider in the UK. [1]
In 2012 the company was bought by Terra Firma Capital Partners for £825 million. It has three divisions: brighterkind, with 70 private pay-focused care homes; Four Seasons, which has around 300 homes; and The Huntercombe Group, with around 35 specialist mental health facilities and around 25,000 staff.
The underlying bond debt was bought by H/2 Capital Partners which has investments in senior living or similar nursing homes in the United States. Terra Firma has offered to give the company to them. [2]
In November 2015 the company planned to sell 14 care homes as going concerns, and "a portfolio of homes currently run by third party operators" to assist its liquidity problems, hoping to raise £60 million. It has £565 million worth of debt, with annual interest and rent obligations of about £110 million. [3] It later announced plans to close seven homes in Northern Ireland: Victoria Park and Stormont in Belfast; Antrim; Garvagh; Donaghcloney near Banbridge; Oakridge in Ballynahinch, County Down; Hamilton Court in Armagh. [4]
In December 2015 it was reported that the company had sold £20 million worth of properties to Monarch Alternative Capital, a US investment fund which claims to specialise in swooping on “distressed and bankrupt” companies. [5]
In April 2016 it reported a 39% drop in profits which was blamed on the cuts in the local government social care budget and the introduction of the UK living wage, although its average weekly care fees rose by 3.4 per cent. The company has net debt of £565 million, because Terra Firma borrowed heavily to fund the purchase in 2012. The business has to find annual interest payments of about £50 million. Earnings before interest, tax, debt and amortisation fell from £64.1 million in 2014 to £38.7 million in 2015. Its property portfolio has been revalued down by £224 million to £505 million and its credit rating has plummeted. [6]
In September 2017 the Daily Telegraph reported that a legal mistake meant that bondholders had inadvertently already been given ownership of 71 private patients care homes and hence could not use them as security to raise extra money. A High court hearing led by a major bondholder – the US hedge fund H/2 Capital Partners – was scheduled for April or June 2018 but the firm was unlikely to be able to restructure before then. [7] The following month the company warned it could not meet a £26m payment due in December without restructuring and if this was delayed the bondholders could potentially seize its assets of 360 nursing homes. This would probably lead to an intervention by the Care Quality Commission (CQC). A restructuring was planned for November and Four Seasons' owners would add 24 care homes in exchange for reduced and delayed repayments of 175m of bonds maturing in 2020. [8] In December the company narrowly avoided collapse after the principle bondholder agreed to wait until February 2018 for a restructuring proposal. According to The Daily Telegraph, the cause of Four Seasons' problem is a 90% reduction in the number of EU nurses and a cut in state funding. [9]
In October 2018 H/2 Capital Partners replaced the management and put the business up for sale. [10] In April 2019 the holding companies Elli Finance (UK) and Elli Investments were put into administration. [11]
The company handed over 44 care homes to rivals Roseberry, Harbour Healthcare, Belsize Healthcare and Barchester Healthcare in December 2019. [12] Administrators from Mazars arranged the sale of 11 care homes to Barchester Healthcare in April 2020. They plan to sell more 33 care homes as going concerns. [13]
In June 2022 it appointed Christie's to oversee an auction of its core portfolio, not including the business in Northern Ireland, which consists of 111 sites across the UK. There are around 6000 residents and 10,000 staff. [14] Its 29 homes in Northern Ireland, with 1415 beds, were sold to Beaumont Care Homes in August 2022. The last 111 Four Seasons facilities in England, Scotland, and Jersey were then up for sale. [15]
Atos is a French multinational information technology (IT) service and consulting company with headquarters in Bezons, France, and offices worldwide. It specialises in hi-tech transactional services, unified communications, cloud, big data and cybersecurity services. Atos operates worldwide under the brands Atos, Atos|Syntel, Atos Consulting, Atos Healthcare, Atos Worldgrid, Groupe Bull, Canopy, Maven Wave, and Unify.
Encompass Health Corporation, based in Birmingham, Alabama, is one of the United States' largest providers of post-acute healthcare services, offering both facility-based and home-based post-acute services in 36 states and Puerto Rico through its network of inpatient rehabilitation hospitals, home health agencies, and hospice agencies. Effective January 2, 2018, the organization changed its name to Encompass Health Corporation and its New York Stock Exchange (NYSE) ticker symbol from HLS to EHC.
Cinven Limited is a global private equity firm founded in 1977, with offices in nine international locations in Guernsey, London, New York, Paris, Frankfurt, Milan, Luxembourg, Madrid, and Hong Kong that acquires Europe and United States based corporations, and emerging market firms that fit with their core businesses, and necessitate a minimum equity investment of €100 million or more. As of 2023, it has €39 billion in assets under management.
Cerberus Capital Management, L.P. is an American global alternative investment firm with assets across credit, private equity, and real estate strategies. The firm is based in New York City, and run by Steve Feinberg, who co-founded Cerberus in 1992, with William L. Richter, who serves as a senior managing director. The firm has affiliate and advisory offices in the United States, Europe and Asia.
NMC Health is a healthcare chain and distribution business in the United Arab Emirates (UAE). The company is headquartered in Abu Dhabi and has branch offices in Dubai, Ajman, Al Ain and Northern Emirates. The company operates and manages over 200 facilities in 19 countries.
Saga is a British company focused on serving the needs of those aged 50 and over. It has 2.7 million customers. The company operates sites on the Kent and Sussex coast: Enbrook Park and Priory Square. It is listed on the London Stock Exchange.
Apollo Global Management, Inc. is an American asset management firm that primarily invests in alternative assets. As of 2022, the company had $548 billion of assets under management, including $392 billion invested in credit, including mezzanine capital, hedge funds, non-performing loans, and collateralized loan obligations, $99 billion invested in private equity, and $46.2 billion invested in real assets, which includes real estate and infrastructure. The company invests money on behalf of pension funds, financial endowments, and sovereign wealth funds, as well as other institutional and individual investors.
Graphite Capital is a private equity firm focused on mid-market leveraged buyout investments, primarily in the UK. The group manages around £1.2 billion for institutional investors, with the most recent fund raising over £500 million in 2018. Since 1991, the firm has backed almost 100 management teams through various investments.
The British United Provident Association Limited, trading as Bupa, is a British multinational health insurance and healthcare company with over 43 million customers worldwide.
MatlinPatterson is a distressed securities fund that participates in distressed and credit opportunities on a global basis. The firm was established in 2002 as a spinout from Credit Suisse First Boston. It is headquartered in New York City and has offices in London and Hong Kong. MatlinPatterson was founded by David Matlin and Mark Patterson. MatlinPatterson, through MatlinPatterson Global Advisers, manages private equity vehicles with a distressed-for-control mandate as well as an open-ended strategy seeking non-control credit investment opportunities.
Mike Parsons is a British businessman, best known for founding Barchester Healthcare, the UK's third largest provider of care homes. He retired as CEO in 2013.
Barchester Healthcare Ltd is an independent care provider in the United Kingdom, running over 250 care homes and seven registered hospitals across the country. The organisation employs over 17,000 staff in care homes which offer residential and nursing care. The organisation's head office is located in Finsbury Square, London. It also has offices in Berkhamsted, Oxfordshire, Milton Keynes, Wiltshire and Inverness.
Spire Healthcare Group plc is the second-largest provider of private healthcare in the United Kingdom. It is listed on the London Stock Exchange and is a constituent of the FTSE 250 Index.
BMI Healthcare was an independent provider of private healthcare, offering treatment to private patients, medically insured patients, and NHS patients. As of 2019, it had 54 private hospitals and healthcare facilities across the UK, with headquarters in London. In December 2019, it was acquired by a parent company of Circle Health and was replaced by Circle Health Group in 2022.
Steward Health Care is a large private for-profit health system headquartered in Dallas, Texas. It utilizes an integrated care model to deliver healthcare across its hospitals and primary care locations, as well as through its managed care and health insurance services. As of the start of 2024, Steward operated 33 hospitals and employed 33,000 people in the United States. Steward's international ventures include Steward Colombia, which operates four hospitals, and Steward Middle East, which operates in Saudi Arabia and the United Arab Emirates. The company is currently engaged in bankruptcy proceedings.
HC-One is Britain's largest care home operator, with more than 275 care homes across England, Scotland and Wales specialising in dementia, nursing and residential care for older people.
Ali Parsadoust is a British-Iranian healthcare entrepreneur and former investment banker. He is the founder and CEO of the bankrupt digital healthcare company Babylon Health and the co-founder and former CEO of hospital operator Circle Health.
Greylock Capital Management, LLC is a U.S. Securities and Exchange Commission registered alternative investment adviser that invests globally in high yield, undervalued, and distressed assets worldwide, particularly in emerging and frontier markets. The firm was founded in 2004 by Hans Humes from a portfolio of emerging market assets managed by Humes while at Van Eck Global. AJ Mediratta joined the firm in 2008 from Bear Stearns and serves as its president.
Babylon Health was a digital-first health service provider that combined an artificial intelligence-powered platform with virtual clinical operations for patients. Patients are connected with health care professionals through their web and mobile application.
Medical Properties Trust, Inc., based in Birmingham, Alabama, is a real estate investment trust that invests in healthcare facilities subject to NNN leases. The company owns 438 properties in the United States, Australia, Colombia, Germany, Italy, Portugal, Spain, Switzerland, Finland, and the United Kingdom.