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BDO Stresstest Flags Financing Risks for Dutch Hospitals as Flevoziekenhuis and St Jansdal Slide Near the Bottom

Escalating labor costs alongside aging facilities are eroding operating results, complicating access to bank financing.

Overview

  • BDO’s 2024 analysis reports a mixed but concerning picture, with many hospitals under pressure from rising personnel expenses and investment backlogs that threaten continuity of care.
  • Flevoziekenhuis scored 3 and ranked 56th of 59, while St Jansdal scored 4 and ranked 55th after a sharp drop from last year’s 7; Antonius remained steady at a 6 and rank 32.
  • Operational outcomes highlight financing hurdles: sector average was 7.5%, versus 5.7% at Flevoziekenhuis and 4.8% at St Jansdal, below lenders’ commonly cited ~6.5% threshold; St Jansdal’s result margin was −0.7% and Flevoziekenhuis posted +0.8%.
  • Outdated real estate heightens risk—Flevoziekenhuis’ asset age was 42.5%—and BDO notes banks are wary when hospitals miss norms and defer investment, with 39 of 59 facilities flagged for aging buildings and lagging IT and AI upgrades.
  • Performance diverges across the sector: Isala improved from a 4 to a 7 and rose to 12th, Albert Schweitzer and Erasmus MC scored 9s, two UMCs in Nijmegen and Amsterdam received insufficient marks, and St Jansdal reported a €2 million loss for 2024 but expects a positive 2025; an ICU professor says patients see no immediate effect yet urges boards to act.