(Adds Ameos statement)
By Arno Schuetze
FRANKFURT, Jan 27 (Reuters) - Swiss-headquartered clinic chain Ameos is being prepared for a sale or refinancing as its private equity owner Carlyle seeks to cash out after almost a decade of ownership, people close to the matter said.
Ameos runs 96 acute general care and psychiatric hospitals and has annual earnings of about 110 million euros before interest, tax, depreciation and amortization, the sources said.
Several peers trade at about 12 times their core earnings. If sold at a similar multiple, Ameos could be valued at up to 1.3 billion euros, including debt, in a deal.
Carlyle and its co-investors are working with JP Morgan JPM.N and Macquarie MQG.AX and could start a sales process in the coming months, said the sources, who sought anonymity because they were not authorised to speak to media.
They could also opt for a dividend payment and refinancing of Ameos' debt if price indications do not meet expectations, the sources added.
An Ameos spokeswoman confirmed that the group is considering a debt refinancing following the pandemic and that it has already started preparations for that.
She added that a structured sales process would not be possible to execute while the pandemic is still ongoing.
Ameos' owners and the banks declined to comment.
Like most clinics, Ameos has suffered from a fall in the volume of medical surgeries in 2020 as healthcare service firms kept beds free for potential COVID-19 treatment and patients opted to delay non-critical treatment.
Carlyle invested in Ameos in 2011, with peer investor Quadriga Capital and founder and CEO Axel Paeger retaining stakes.
German healthcare services are still dominated by municipal or church-run clinics and regionally focused companies, but consolidation efforts have been gathering pace to attain economies of scale and rein in costs.
Ameos, which employs 15,700 staff in Germany, Switzerland and Austria, has been continuously acquiring hospitals in recent years, but hitting occasional antitrust roadblocks, as Carlyle also owns a stake in German clinic chain Schoen Kliniken.
($1=0.8224 euros)