6.4%-Yielding Healthcare Realty Is A Strong 2023 Buy

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2022 was a brainsick twelvemonth for investors. We saw the highest ostentation successful 42 years, soaring involvement rates, and a meltdown successful the UK.

The twelvemonth ended with the S&P down 18%, bonds down 14%, and UK stocks flat.

It was the lone twelvemonth successful U.S. marketplace past erstwhile some stocks and bonds fell double-digits, and 2023 is apt to beryllium conscionable arsenic breathtaking a year.

That's due to the fact that the astir anticipated and perchance the mildest recession successful past could origin stocks to autumn 5% to 24% successful the coming weeks.

That's apt to beryllium followed by a marque caller bull marketplace that could make face-ripping rallies and life-changing returns successful coming years.

What's a astute high-yield income capitalist to bash erstwhile we look specified a bipolar year? How tin you enactment safe, sane, and rolling successful dividends successful the look of specified uncertainty?

By focusing connected industry-leading ultra-yield blue-chips similar Healthcare Realty Trust Incorporated (NYSE:HR), which I conscionable recommended for Dividend King's members.

Let maine amusement you the galore reasons wherefore HR is 1 of the champion options for SWAN (sleep good astatine night) investors looking to fastener successful astonishing output contiguous and perchance Buffett-like returns for the adjacent fewer years.

The Mack Daddy of Hospital REITs

2023 is apt to beryllium a twelvemonth with a mild recession, and stocks aren't apt to commencement the twelvemonth disconnected strong.

S&P Bear Market Bottom Forecast Range

Earnings Decline In 2023

2023 S&P Earnings

X 25-Year Average PE Of 16.7

Decline From Current Level













13% (Historically average/median EPS decline)












(Source: DK S&P 500 Valuation Tool)

The bully quality is that the recession is presently expected to beryllium the mildest recession successful U.S. history, with a 0.1% GDP diminution successful Q1 and Q2.

The atrocious news? Economists historically underestimate recessions, and that means the downturn is apt to beryllium worse than expected, though inactive apt mild. That means a 5% to 10% S&P diminution successful the archetypal fewer months of 2023 is the bullish lawsuit for stocks, and a 20% diminution could hap since net estimates are apt inactive excessively high.

But this is wherever a profoundly undervalued blue-chip aesculapian bureau gathering oregon MOB (medical bureau building) REIT (real property concern trust) is simply a perchance large concern for the year's archetypal half.

Especially 1 that yields a comparatively harmless 6.4% output that volition wage you to hold retired what could beryllium a precise achy commencement to the year.

Why bash I similar Healthcare Realty Trust arsenic an ultra-yield antiaircraft enactment for 2023?

Why I Like Healthcare Realty And You Might Too

Healthcare Realty was founded successful 1992 successful Nashville, Tennessee.

Healthcare Realty owns a highly diversified portfolio of 728 hospitals successful 35 states and manages hundreds much for organization clients.

In 2022 its shareholders approved a merger with HTA that created the largest MOB REIT successful America.

About 70% of its hospitals are located connected assemblage campuses, connected to assemblage wellness systems.

Its biggest investments are located successful immoderate of the biggest, richest, and astir thriving U.S. cities, specified arsenic Dallas, Seattle, Houston, LA, Atlanta, Boston, Charlotte, Denver, Miami, and Phoenix.

82% of its properties are multi-tenant, providing currency travel diversification.

And if you privation a recession-resistant concern model? Well, hospitals are astir arsenic indispensable a concern arsenic you tin find, nary substance what the system is doing.

92% of its properties are aesculapian offices oregon outpatient facilities, an manufacture that the work-from-home question oregon Pandemic has minimally affected.

Its hospitals are leased to 57 of America's 100 largest wellness systems, specified arsenic Yale, Baylor, and the University of California.

40% of nett operating income comes from its 87-largest tenants, with conscionable 2.5% coming from a tenant without an investment-grade recognition rating.

Most of its rent comes from A-rated oregon AA-rated wellness systems similar the University of Washington oregon Baylor University.

HR is the astir concentrated aesculapian bureau gathering REIT successful America, with 95% exposure, and the highest attraction of MOBs located connected field with universities.

It's not conscionable the largest MOB REIT successful America, it has the highest vulnerability to the largest cities.

  • 85% of properties successful the apical 50 cities

  • 97% successful the apical 100 cities.

Its mean infirmary is located wrong 10 miles of 814,000 people, the highest colonisation density successful the manufacture and astir 2X the colonisation density of DOC, the different large MOB REIT.

How large an accidental are MOBs and hospitals?

Here are the facts:

  • $460 cardinal size (of which REITs ain conscionable $60 cardinal oregon 13%)

  • $11 cardinal successful yearly spot income (what HR buys)

  • $9 to $12 cardinal successful caller spot developers per year, astir 3.6 cardinal quadrate feet

  • 35% of that improvement is undertaken by HR itself

  • HR's caller developments each twelvemonth are astir 4X larger than its adjacent largest rival.

In different words, HR is the manufacture person successful hospitals and MOBs, with the astir standard and each the benefits that travel with it.

Demographics are a large tailwind for HR's maturation due to the fact that of the rapidly aging colonisation of the U.S.

  • The mean American nether 45 generates $4,300 successful healthcare walk and visits the doc doubly a year

  • the mean American implicit the property of 65 visits the doc six times per twelvemonth and generates $19,100 successful yearly spending.

Older radical sojourn the doc 3X arsenic often and make astir 5X much healthcare spending arsenic young people.

And dissimilar SNFs (skilled nursing facilities), which nary 1 wants to spell to, outpatient visits person been soaring steadily for the past 30 years and are going to support rising.

  • people volition combat bony and nail to not extremity up "in a home"

  • but volition happily spell to the doctor's bureau arsenic galore times arsenic they request to.

Almost 50% of each doctors present enactment successful hospitals oregon outpatient clinics, similar the ones that HR owns.

  • up from 28% successful 1994.

HR has a $2.1 cardinal maturation backlog, including implicit $500 cardinal successful projects expected to beryllium completed by 2024.

It has a BBB unchangeable recognition standing from S&P, including implicit $1 cardinal successful liquidity, 2X what it needs to implicit its existent maturation projects.

100% of its indebtedness is unsecured, and nary matures earlier 2024, truthful determination are nary recession indebtedness maturities.

Its leverage ratio of 6.3X nett debt/EBITDA is in-line with the 6.5X information line for an manufacture with semipermanent contracts, and that's incredibly recession-resistant.

  • management's argumentation is to support leverage astatine 6X to 6.5X, a harmless scope according to S&P and Moody's.

Its mean involvement outgo is 3.2%, compared to currency travel yields of 6.5% to 11% depending connected the project.

Its balance sheet is obscurity adjacent to violating immoderate of its indebtedness covenants. For example:

  • Interest sum ratio 4.2X vs. 1.5X covenant (and standing bureau information guideline)

  • debt/equity of 39% vs. 60% oregon little covenant (and standing bureau information guideline).

In different words, HR has a beardown equilibrium expanse and plentifulness of entree to low-cost maturation superior to execute its goals. Which isn't constricted to conscionable gathering oregon improving caller oregon existing properties.

In the archetypal 9 months of 2022, HR bought $428 cardinal worthy of caller properties, a full of 30, astatine an mean currency travel output of 5.3%. Cash travel yields person been rising steadily arsenic involvement rates emergence and are expected to summation a spot much successful 2023 connected acquired properties.

In Q3 alone, it bought 8 properties for $91 million, with 98% of those properties already leased nether semipermanent contracts.

The mean lease is for 55 months oregon astir 4.5 years. But tenants astir ever renew leases due to the fact that patients hatred uncovering caller doctor's offices.

  • location, location, determination is the astir important portion of existent estate

  • doubly truthful for healthcare.

That's wherefore HR's retention rates are 80%.

Reasons To Potentially Buy Healthcare Trust Of America


Healthcare Trust Of America


79% 10/13 Blue-Chip Quality MOB REIT

Risk Rating

Medium Risk

DK Master List Quality Ranking (Out Of 500 Companies)


DK Master List Quality Percentile


Dividend Growth Streak (Years)


Dividend Yield


Dividend Safety Score


Average Recession Dividend Cut Risk


Severe Recession Dividend Cut Risk


S&P Credit Rating

BBB Stable Outlook

30-Year Bankruptcy Risk


LT S&P Risk-Management Global Percentile

33% Below-Average, Medium Risk

Fair Value


Current Price


Discount To Fair Value


DK Rating

Potential Strong Buy



Historical P/FFO

17.5 to 18

LT Growth Consensus/Management Guidance


PEG Ratio


5-year statement full instrumentality potential

13% to 15% CAGR

Base Case 5-year statement instrumentality potential

14% CAGR (About 2X The S&P 500)

Consensus 12-month full instrumentality forecast


Fundamentally Justified 12-Month Return Potential


LT Consensus Total Return Potential


Inflation-Adjusted Consensus LT Return Potential


(Source: Dividend Kings Zen Research Terminal.)

HR isn't a fast-growing REIT, but it's presently truthful undervalued that it could present precise bully returns implicit the adjacent 5 years portion paying a harmless 6.4% from time one.

  • 36% historically undervalued

  • 11.5X FFO (funds from operations).

Healthcare Realty 2025 Consensus Return Potential

FAST Graphs, FactSet

FAST Graphs, FactSet

If HR grows arsenic expected and returns to humanities just worth by 2025, it could astir double, delivering Buffett-like 22% yearly returns.

  • about 2.5X much than the S&P consensus.

Healthcare Realty 2028 Consensus Return Potential

FAST Graphs, FactSet

FAST Graphs, FactSet

If HR grows arsenic expected and returns to humanities just worth by 2028, it could present astir 120% full returns, oregon 14% annually.

  • about 2X much than the S&P 500 consensus.

That is not atrocious from a slow-growing antiaircraft REIT.

Healthcare Realty Investment Decision Score

Dividend Kings Automated Investment Decision Tool

Dividend Kings Automated Investment Decision Tool

HR is simply a perchance bully high-yield accidental for anyone comfy with its hazard profile. Look astatine however it compares to the S&P 500 Index (SP500).

  • 36% discount to just worth vs. 4% premium S&P = 40% amended valuation

  • 6.4% harmless output vs. 1.8% (3X higher and safer)

  • approximately 9.0% semipermanent yearly instrumentality imaginable vs. 10.2% CAGR S&P

  • about 50% higher risk-adjusted expected returns

  • 3X higher income imaginable implicit 5 years.

Slow But Steady Growth Prospects For Decades To Come

HR fell 36% successful 2022, not for immoderate cardinal reasons but apt due to the fact that of the ample summation successful involvement rates. This creates a beardown 2023 buying accidental due to the fact that its maturation outlook remains strong.

HR Medium-Term Growth Consensus


2022 Growth Consensus

2023 Growth Consensus

2024 Growth Consensus

2025 Growth Consensus


























EBIT (operating income)





(Source: FAST Graphs, FactSet.)

In a twelvemonth erstwhile the S&P's net mightiness autumn a overmuch arsenic 20%, HR's recession-resistant concern exemplary is expected to make level results, followed by a beardown maturation twelvemonth successful 2024 arsenic caller maturation projects travel online.

Long-Term Growth Outlook

The semipermanent expert statement for HR isn't precise exciting, with conscionable 2.6% semipermanent currency travel per stock growth.

Why is HR expected to turn truthful slowly? Because, similar astir REITs, it funds astir 40% of its maturation by selling caller stock. Thus, portion the income maturation is awesome (due to the HTA merger), the currency travel per stock maturation is modest.

Within a tenable borderline of error, HR's precise unchangeable concern exemplary doesn't miss expectations.

Its humanities expert margins of mistake are 10% to the downside and 5% to the upside.

  • 2% to 3% margin-of-error-adjusted maturation statement range.

HR's humanities maturation complaint is astir 2% to 4%, truthful I see 2.6% a tenable semipermanent maturation estimate.

Long-Term Consensus Return Potential

Investment Strategy


LT Consensus Growth

LT Consensus Total Return Potential

Long-Term Risk-Adjusted Expected Return

Healthcare Realty










Schwab US Dividend Equity ETF





Vanguard Dividend Appreciation ETF





Dividend Aristocrats





S&P 500










(Source: DK Research Terminal, FactSet, Morningstar, Ycharts.)

HR is simply a perchance large operation of ultra-yield contiguous and coagulated 9% antiaircraft returns implicit the agelong term.

HR's humanities 12-month rolling instrumentality implicit the past decennary was 9.0%, somewhat amended than the REIT sector's 8.7%.

Investors tin expect a tenable semipermanent instrumentality from this slow-growing but highly antiaircraft 6.4% yielding REIT.

A Wonderful REIT At A Wonderful Price

Millions of income investors person paid betwixt 17.5X and 18X FFO for HR extracurricular of carnivore markets and bubbles for 10 years.

  • 90% statistical probability that this approximates intrinsic value


Historical Fair Value Multiples (all Years)





12-Month Forward Fair Value

5-Year Average Yield






13-year median yield


















Current Price


Discount To Fair Value






Upside To Fair Value (including dividend)






2023 FFO

2024 FFO

2022 Weighted FFO

2023 Weighted FFO

12-Month Forward FFO

Historical Average Fair Value Forward P/FFO

Current Forward P/FFO








Historically HR trades astatine 18X currency flow, and today, it's trading astatine 11.5X, a 36% humanities discount offering 63% upside imaginable to just value.


Margin Of Safety For Medium-Risk 10/13 Blue-Chip Quality Companies

2023 Fair Value Price

2024 Fair Value Price

12-Month Forward Fair Value

Potentially Reasonable Buy





Potentially Good Buy





Potentially Strong Buy





Potentially Very Strong Buy





Potentially Ultra-Value Buy










Upside To Fair Value (Including Dividends)




HR is simply a perchance beardown bargain for anyone comfy with its hazard profile.

Risk Profile: Why Healthcare Realty Isn't For Everyone

There are nary risk-free companies, and nary institution is close for everyone. You person to beryllium comfy with the cardinal hazard profile.

HR's Risk Profile Includes (15 Pages successful the 10K)

  • stock terms risk: if the stock terms falls excessively debased for excessively long, the highest outgo of superior could slow

  • inflation hazard (3% leases are tied to CPI)

  • regulatory hazard (state, federal, and local): rising healthcare costs could spur important changes to however doctors and hospitals are reimbursed successful the future

  • project execution risk: completing projects connected clip and connected budget

  • ground leases (on astir 20% of its properties) bounds its quality to merchantability those properties

  • Black Swan recognition information risk: If the fiscal markets slam unopen (like successful 2008), past HR's entree to low-cost liquidity could slam unopen arsenic well

  • weather risk: things similar hurricanes oregon storms tin harm their properties (though they are insured)

  • tenant risk: immoderate of its tenants (less than 10%) are junk enslaved rated, and successful bankruptcies, rent payments could beryllium postponed oregon not travel successful astatine all

  • releasing risk: HR owns specialized properties that instrumentality clip to find caller tenants erstwhile 1 of them fails

How bash we quantify, monitor, and way specified a analyzable hazard profile? By doing what large institutions do.

Long-Term Risk Management Analysis: How Large Institutions Measure Total Risk Management

DK uses S&P Global's semipermanent risk-management ratings for our hazard rating.

  • S&P has spent implicit 20 years perfecting their hazard model

  • which is based connected implicit 30 large hazard categories, implicit 130 subcategories, and 1,000 idiosyncratic metrics

  • 50% of metrics are manufacture specific

  • this hazard standing has been included successful each recognition standing for decades.

The DK hazard standing is based connected the planetary percentile of however a company's hazard absorption compares to 8,000 S&P-rated companies covering 90% of the world's marketplace cap.

HR scores 33rd Percentile On Global Long-Term Risk Management

S&P's hazard absorption scores origin successful things like:

  • supply concatenation management

  • crisis management

  • cyber-security

  • privacy protection

  • efficiency

  • R&D efficiency

  • innovation management

  • labor relations

  • talent retention

  • worker training/skills improvement

  • occupational wellness & safety

  • customer narration management

  • business ethics

  • climate strategy adaptation

  • sustainable cultivation practices

  • corporate governance

  • brand management.

HR's Long-Term Risk Management Is The 401st Best In The Master List 20th Percentile In The Master List)


S&P LT Risk-Management Global Percentile

Risk-Management Interpretation

Risk-Management Rating



Exceptional (Top 80 companies successful the world)

Very Low Risk

Strong ESG Stocks


Very Good

Very Low Risk

Foreign Dividend Stocks


Good, Bordering On Very Good

Low Risk

Ultra SWANs



Low Risk

Dividend Aristocrats


Above-Average (Bordering On Good)

Low Risk

Low Volatility Stocks



Low Risk

Master List average



Low Risk

Dividend Kings



Low Risk

Hyper-Growth stocks


Average, Bordering On Above-Average

Medium Risk

Dividend Champions



Medium Risk

Monthly Dividend Stocks



Medium Risk

Healthcare Realty



Medium Risk

(Source: DK Research Terminal.)

HR's risk-management statement is successful the bottommost 20% of the world's champion bluish chips and is akin to:

  • Cincinnati Financial (CINF) blue-chip prime dividend aristocrat

  • Camden Property Trust (CPT): Ultra-SWAN prime flat REIT

  • Apple (AAPL): Ultra SWAN

  • Main Street Capital (MAIN): SWAN prime BDC (business improvement company)

  • Broadcom (AVGO): Super SWAN quality.

The bottommost enactment is that each companies person risks, and HR is below-average, astatine managing theirs, according to S&P.

How We Monitor HR's Risk Profile

  • 12 analysts

  • two recognition standing agencies

  • 14 experts who collectively cognize this concern amended than anyone different than management

“When the facts change, I alteration my mind. What bash you do, sir?"

- John Maynard Keynes.

There are nary ineffable cows astatine iREIT oregon Dividend Kings. Wherever the fundamentals lead, we ever follow. That's the essence of disciplined fiscal science, the mathematics down retiring affluent and staying affluent successful retirement.

Bottom Line: Buy Healthcare Realty To Take Advantage Of The Bear Market

Let maine beryllium clear: I'm NOT calling the bottommost successful HR (I'm not a market-timer).

Blue-Chip prime does NOT mean "can't autumn hard and accelerated successful a carnivore market."

Fundamentals are each that find information and quality, and my recommendations.

  • over 30+ years, 97% of banal returns are a relation of axenic fundamentals, not luck

  • in the abbreviated term; luck is 25X arsenic almighty arsenic fundamentals

  • in the agelong term, fundamentals are 33X arsenic almighty arsenic luck.

While I can't foretell the marketplace successful the abbreviated term, here's what I tin archer you astir HR.

  • the manufacture person successful aesculapian bureau businesses and hospitals

  • safe 6.4% output (3X the S&P output increasing astir 2% per year)

  • 9.0% semipermanent instrumentality imaginable (good for a antiaircraft ultra-yield blue-chip)

  • 36% historically undervalued

  • 11.5X FFO compared to 17.5 to 28X historically

  • 120% statement instrumentality imaginable implicit the adjacent 5 years, 14% annually, 2X much than the S&P 500

  • 50% much income imaginable than the S&P implicit the adjacent 5 years

  • 3X higher income imaginable than the S&P implicit the adjacent 5 years.

Healthcare Realty is simply a fantastic prime for anyone looking to instrumentality vantage of the carnivore marketplace we've already had portion protecting themselves from the recession we're facing now.

It's the biggest infirmary and MOB REIT successful America, with a large equilibrium sheet, beardown entree to capital, and maturation opportunities spanning decades.

If you privation a recession-resistant REIT, they don't travel overmuch amended than HR's 728 mission-critical properties.

If you privation a antiaircraft mode to gain 6.4% contiguous portion earning coagulated 9% semipermanent returns implicit decades, HR is simply a perchance fantastic choice.

And if you privation to perchance gain Buffett-like 22% yearly returns implicit the 3 years? Then it's clip to see this blue-chip bargain hiding successful plain sight.

Source Seekingalpha