On 24 September 2026, a Perth private hospital changed operators without its landlord losing a tenant. HealthCo Healthcare & Wellness REIT (ASX:HCW) said Bethesda Health Care had taken over The Mount Private from Healthscope under a new long-term Lease guaranteed by the Western Australian Government.

That handover shows why healthcare property can be steadier than other real estate, and where the risk sits. RAM Essential Services Property Fund (ASX:REP) is moving towards the same Asset Class from the other direction, selling supermarket-anchored shopping centres to become mainly a healthcare landlord. Both sit outside the S&P/ASX 200.

How each trust earns its rent

HealthCo is a Real Estate Investment Trust (REIT) managed by a Subsidiary of HMC Capital. Its 2026 Annual Report, lodged on 25 September 2026, shows 13 directly owned properties plus a 49.6 per cent stake in an unlisted fund owning 11 private hospitals. Hospitals supplied 64 per cent of income, with aged care, primary care and life sciences making up much of the rest.

RAM Essential Services Property Fund is a stapled fund, meaning two linked securities trade as one, with RAM Property Funds Management as responsible entity. At 30 June 2026 it held 26 properties worth A$662.6 million, split almost evenly between healthcare ($319.6 million) and retail ($343.0 million), according to its FY26 results presentation.

Neither has a large index weighting. HealthCo was [added to the S&P/ASX Emerging Companies Index], a benchmark for smaller companies outside the S&P/ASX 300,( in March 2026, according to MarketScreener, while Market Index does not list RAM among S&P/ASX 200 constituents.

A retail sale reshapes RAM

RAM's FY26 results announcement, released on 26 August 2026, detailed the $218.6 million sale of five retail assets, including Coomera Square and Springfield Fair, to a fund in which RAM keeps a 10 per cent interest. Settlement is expected in the second quarter of FY27.

Management called the deal a major milestone in repositioning RAM as a healthcare-focused fund, citing an ageing population, government-backed spending and private Health Insurance as long-term Demand drivers. Pro forma, healthcare rises to about 70 per cent of the portfolio and the weighted average lease expiry (WALE, the average time left on leases) lengthens from 6.8 years to 8.1 years.

The Balance Sheet changes more. Gearing, or Debt as a share of total assets, was 43.5 per cent at 30 June and falls to 16.8 per cent pro forma if all net proceeds repay debt. Its cost of debt would drop from 5.19 per cent to 4.57 per cent on the same basis.

Operationally, RAM reported occupancy of 97.3 per cent by income and positive leasing spreads of 4 per cent across 21 deals, meaning new rents exceeded previous rents. Like-for-like recurring property income rose 4.4 per cent to $37.9 million.

HealthCo's Healthscope question

HealthCo's jointly owned hospitals are leased to Healthscope, two of whose entities entered receivership and administration in May 2025. Healthscope represented about 34.1 per cent of HealthCo's external Revenue in FY26, but the Annual Report says it remained compliant and paid rent throughout the year.

A Healthscope update on 14 September said the receiver had obtained lender approval to transfer the remaining 10 hospitals to alternative operators, subject to customary approvals, and that rent had been paid up to and including September 2026. The Mount Private transition was confirmed in a separate announcement.

The uncertainty has cost unitholders. HealthCo paid no FY26 distribution, Withholding it to preserve liquidity, and booked a $49.0 million Fair Value loss on investment property as its Capitalisation rate (the income Yield used to value property) widened 38 basis points to 6.06 per cent.

The underlying portfolio held up better. Occupancy was 99 per cent, like-for-like net Operating Income grew 4.1 per cent on contractual rent increases, and six properties were sold for $76.8 million to cut debt. Its debt Maturity has since been extended to December 2027.

Comparing earnings, payouts and asset backing

HealthCo reported FY26 funds from operations (FFO, a recurring-earnings measure excluding valuation changes) of 4.0 cents per unit, or 7.7 cents on an underlying basis including its share of the unlisted fund. RAM's FFO fell to 2.93 cents per unit from 4.89 cents. Net tangible Assets (NTA, assets less liabilities per unit) were $1.35 for HealthCo and $0.71 for RAM.

Metric (FY26 / 30 June 2026)

REP

HCW

FY26 distribution

4.55 cents

Nil

FY27 distribution guidance

3.6–3.8 cents

6.0 cents

NTA per unit

$0.71

$1.35

Gearing

43.5% (16.8% pro forma)

29%

WALE

6.8 years

10.6 years

By our calculation, RAM's FY27 guidance equals 5.1 to 5.4 per cent of its NTA, compared with about 4.4 per cent for HealthCo (6.0 ÷ 135). RAM's quoted 8.5 to 9.0 per cent yield used a $0.42 closing price, which by our calculation is about 41 per cent below NTA.

HealthCo's 6.0 cent guidance is nearly all of its guided FY27 underlying FFO of 6.1 cents, as reported by Investing.com, and management made it conditional on resolving the remaining hospitals. The step down from 7.7 cents was attributed mainly to a low-cost Interest Rate swap expiring in the unlisted fund, and The Motley Fool also reported the 6.1 cent figure.

What the comparison cannot capture

The two trusts are at different points. RAM's FY26 numbers still include retail income it is selling, so pro forma metrics depend on settlement. HealthCo's reported and underlying FFO treat its unlisted fund stake differently, which is why the two figures diverge. Both reported statutory losses: $49.7 million for HealthCo and $30.1 million for RAM.

Structurally, RAM is diversified across 234 tenants, while HealthCo carries concentrated operator risk through its hospitals. Both depend on rent escalations: 84 per cent of RAM's leases have fixed or CPI-linked reviews, and 81 per cent of HealthCo's income is CPI-linked.

Indicators ahead

RAM declared a September quarter distribution of 0.95 cents, at the upper end of guidance, payable on 30 October 2026. Settlement of the retail sale and any resulting debt repayment are the next markers to track.

For HealthCo, completion of the 10 hospital transfers, the valuations that follow, and its 6.0 per cent cost of debt against a gearing of 29 per cent will shape whether distributions resume as guided.