Everything Is Taking Longer. If You’re Not Planning for That, You’re Already Behind

The timeline you think you’re on probably isn’t real.

Medical real estate deals are dragging. Entitlements are slower. Lenders are pickier. Attorneys are taking longer to paper leases. Buildout timelines are slipping by 30 to 60 days in markets that used to move fast. And a lot of groups are still acting like they can go from LOI to open in six months. Not happening.

Right now, if you’re not planning for delay, you’re planning to blow your budget. That’s especially true in behavioral health and specialty outpatient. You’ve got licensing timelines, inspection windows, local planning meetings, and TI costs that shift week to week.

This is where deals fall apart. Operators assume the landlord will deliver space by September, but the city doesn’t approve permits until October. Capital groups assume licensing will be fast, but the provider still needs to hire a program director and pass a fire inspection. Suddenly the rent clock starts, and the building is empty.

You don’t solve this with more emails or asking everyone to hustle. You solve it by building real timelines, not wishful ones. Add time for approvals. Budget for delays. Map out what actually needs to happen to open the doors and bill revenue—and then add 15 percent.

The deals that are closing right now are the ones that started early, planned realistically, and stayed ahead of the curve.

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