Realization takes time from all players

Care Vision Care & Real Estate Congress 2024

At the Zorgvisie Zorg & Vastgoed Congres on October 3, 2024 at Van der Valk Utrecht, a broad spectrum of speakers took the stage as part of the journey to realization. Healthcare organizations all have to build at some point, whether it is for sustainability or because of depreciation of buildings. "Make sure you can always answer questions in the language of financiers."

From architect to user, each stakeholder invests on average years in the realization of healthcare real estate. Often it is meticulously customized, sometimes involving amounts of hundreds of millions. The presentation by Ellen van der Wal of Vakwerk Architecten once again made clear how carefully and to the square meter care buildings are designed in the Netherlands. The locations are tight and/or hard to find; the demands are high. What eventually stands in Krimpen a/d IJssel, Meppel or Groningen is never the bottom of the real estate market - whether it is a monument converted into a residential group, the sustainable incorporation of a new hospital or the filling of open space on the densely built-up plot of the UMCG.

CO2 reduction tool

The energy transition in 2024 is an important reason for healthcare organizations to (re)build. As a foundation it is of course necessary to map out what needs to be done. Consultant Sustainable Care Esther de Groot of Stimular Foundation presented the CO2 reduction tool of the Expertise Center for Sustainable Care. The tool consists of an Excel file with a breakdown of CO2 performance per portfolio component and is suitable for providing information to banks and governments, such as the energy audit obligation (EED). According to the room, there is still work to be done because the CO2 reduction tool is not yet accepted in all cases.

Vivium Care Group

A detailed account of Vivium Zorggroep's investment plans was offered by Director of Finance & ICT Erwin Melger. His organization is doing much to look as far into the future as possible, with the sustainability of the real estate portfolio and to find the right resources to realize upgrades and new construction plans. "We are moving toward capital-intensive investing," Melger said. Vivium Care Group is not only involving consulting firms and insurers in the initial process, but also healthcare groups in the area to reassess strategic policies. "Optimize what you have and then make your portfolio strategy," Melger said.

Financial discipline

Vivium Care Group drew up timelines for each location to achieve the desired sustainability goals, as the starting point of the real estate plan. This resulted in an investment requirement of 144 million until 2030. The organization then created business cases and technical analyses for individual properties, as evidence towards investors. As part of a European grant, the women's quota also had to be included. "A long process, but this kind of process disciplines your organization. Make sure that you can always answer questions in the language of financiers, the granting of funding can be a matter of luck of the right moment."

Pension investors

Investment money is plentiful. Like from Bouwinvest, which builds to rent with money coming mainly from pension fund bpfBouw. 11% of the 65 billion euros of pension money is invested in real estate, says Martin Otten. "Most of it in housing." Bouwinvest does this in "safe and livable environments, Paris-proof" and including transformations such as that of a tax office in Apeldoorn, a municipal monument from 1962 whose monolithic plinth and ten-story high-rise will be preserved. The tower will contain independent apartments; in the plinth and basement, 's Heeren Loo and Estea Zorg will rent spaces for disability care and places for dementia and recovery. Three care functions in one building, purchased by Bouwinvest Healthcare Fund from developers Explorius Vastgoedontwikkeling and Nijhuis Bouw.

Management relationship

A more obvious alternative is cooperation with the local housing corporation, as Sjaloom Zorg is doing on Goeree-Overflakkee with OostWestWonen. They realized 26 NoM apartments (Zero-in-the-Meter), where people with disabilities can live independently. The care organization specified as a tenant, although the housing corporation is the owner. Head of Finance & Operations Peter Kleppe of Sjaloom learned that in addition to a development relationship, you also get a management relationship - "and that's quite complicated." For example, both parties found out during operation that solar control glass was not sufficient and an additional solution had to be found. Nothing unusual, says developer Michel van Golberdinge of OostWestWonen. "We do this for every tenant." The apartments are suitable to be used for another target group if the lease is not renewed.

Cycling through Zwolle

At the end of the afternoon we went to Zwolle with Sander Oosterhuis of Steenbok Huisvesters, who, as program manager for housing and care for the municipality, brings parties together. A bit of deregulation municipal direction, it could be said. "Zwolle is a forerunner in care housing. We have been doing courtyard living for 700 years and the first Knarrenhof is here." Oosterhuis engages in networking. For example, he cycles through the city with officials, care workers and local builders, aiming to make better use of the existing housing stock.

Local networks

The company already took a photo with ministers Hugo de Jonge and Conny Helder. There is still a lot of work to do, because locations are scarce. "Most land positions in Zwolle are in the hands of private parties," Oosterhuis said. Sometimes municipal interests conflict, when a building plan for home care is rejected because of a tree to be cut down. A positive initiative without a breakthrough? The enthusiasm that comes from investing in local networks will certainly pay off."