Sale Leasebacks Are Fueling the Next Wave of Healthcare Real Estate Deals

Hospitals and healthcare operators are sitting on billions of dollars in real estate—and more of them are deciding that owning it all no longer makes sense. The sale leaseback model, where an operator sells a property to an investor and immediately leases it back under a long-term agreement, is becoming one of the most active tools in the market right now.

The motivation is clear. Health systems need liquidity, and private capital needs stability. A sale leaseback frees up cash for system priorities like technology, staffing, or debt reduction while giving investors access to high-credit tenants with predictable rent streams. These transactions are not new, but they are becoming a strategic lever for balance sheet management as margins tighten and interest rates stay elevated.

For investors, the draw is straightforward. Healthcare operators rarely default, and they tend to stay in their locations for decades. The leases are long, the tenants are sticky, and the returns are steady. That combination is hard to find anywhere else in commercial real estate right now.

But the structure matters. Investors are increasingly selective about lease terms, renewal options, and escalation clauses. Operators, for their part, are making sure the deals preserve operational control and flexibility. When these elements align, the result is a win-win—fresh capital for providers and stable yield for investors.

If you are evaluating sale leaseback opportunities or looking for insight on where capital is flowing in this space, let’s connect and break down what makes a deal sustainable in today’s market.

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