Japan Hospital Revitalization Fund (tentative name, plan)— overview
By
PreMed Inc. (KAIZEN Group headquarters)
Updated
2026.10.03
Stage
Plan (no fund has been formed)
This is a plan to keep struggling hospitals in their communities. The first form: when a hospital that a regional bank is already lending to needs to be turned around, PreMed goes in on site together with the bank and supports the turnaround plan and its execution. Beyond that, we plan to share roles with real-estate investors and a fund to support hospital turnaround and succession. This is still a plan: no fund has been formed. Hospitals continue to be managed by their medical corporations and physicians.
fig.1 why hospitalsWhere hospital finances stand (from published surveys)
74.6% of hospitals ran an operating loss in FY2024, and 13.6% of private hospitals had negative net worth. Yet more than 97% of failed healthcare providers end in liquidation; rehabilitation through civil proceedings happens only about twice a year. We believe hospitals need someone to build and carry out a turnaround plan before they reach the courts.
fig.2 entering with the bankStarting from hospitals a regional bank already lends to (plan)
The first form is to go in together with a regional bank when a hospital it already lends to needs to be turned around. When early signs appear — continuing losses, cash-flow strain, physicians leaving, no successor — the bank consults us, and PreMed goes on site to check the numbers, operations and the medical side. We then build an improvement plan together with the bank, combined with rescheduling and public medical lending (such as the Welfare and Medical Service Agency). In execution we take on roles on site — administrative director, planning, finance and systems — and report progress to the bank every month in numbers. The exit is either recovery or succession to physicians.
For the bank, it adds one more option: supporting a client hospital together from an early stage, and keeping healthcare in the community. PreMed does not put in capital, and management decisions remain with the medical corporation and its physicians. Some public medical loans require an improvement plan backed by a financial institution; building and executing that plan is our role. For the cost of planning, we are considering the national program that supports improvement planning.
fig.3 three layersThree layers, and how money and roles flow. Dashed = plan
Medical corporations have no equity stakes and, under Japan's Medical Care Act, may not distribute surplus as dividends. A fund therefore cannot invest in the medical corporation — the hospital itself. The plan splits money and roles into three layers. (1) The medical corporation borrows from banks and public medical lenders, and is managed by the medical corporation and its physicians. (2) Buildings and large equipment are sold to real-estate investors and leased back. (3) For the surrounding stock companies (headquarters support, software and the like), the fund and PreMed form a joint holding company. The fund comes in at layers 2 and 3.
fig.4 what it means for each partnerWhat it means for lenders and investors (plan)
For the main bank, it means a partner that supports a client hospital's improvement — from building the plan to carrying it out on site. Some public medical loans require an improvement plan backed by a financial institution, and we support building it. Real-estate investors own hospital buildings and large equipment and lease them to the hospital; the fund holds the surrounding stock companies through a joint holding company with PreMed. None of these is equity in the medical corporation.
fig.5 successionSuccession uses the same three layers. Dashed = plan
Succession is built on the same three layers. On the medical corporation's side, members and directors change and physicians take over its management; the surrounding stock companies and the buildings are taken on by the joint holding company and real-estate investors respectively (plan). The fund never takes over the medical corporation itself.
fig.6 monthly numbersChecking progress in monthly numbers. Dashed = plan
At our group's clinics, our own software turns daily reports, bookings, billing and medical records into a daily management dashboard and a monthly report. Patients per day, revenue per patient, the insurance/self-pay mix, booking fill rate and more are lined up every month, along with the change from the previous month and why. We plan to bring the same system into hospitals so that lenders and the fund can check the turnaround plan's progress in monthly numbers.
track record — clinics
successions since 2025.01
2
succession → systems running
~3 mo
visits at naminami, since opening
×2.6
changes to our software
6,500+
All of these are results at our group's clinics. Two successions of medical corporations since January 2025. At Hatanodai, booking, online intake and the claims system were fully running about three months after succession. At Naminami in Meguro, monthly visits (three-month averages) grew about 2.6x from just after opening. Our software has taken in 6,500+ changes since March 20, 2026. A hospital track record is what the pilot will build.
fig.7 roadmapPhased plan. Dashed = plan
We start by approaching financial institutions and funds, build a track record, run a pilot at one hospital, and then move to forming a joint holding company and the fund. Timeframes are indicative.
who we'd like to talk to
We would like to start by explaining the plan and exchanging views with regional banks that lend to hospitals, investors interested in hospital real estate and medical equipment, and funds focused on healthcare.
This page introduces a plan and does not constitute a solicitation to acquire securities or to invest. Plans reflect our expectations at the time of writing and may change.