The Hidden Value of Real Estate in M&A Deals for Healthcare Operators

Healthcare M&A activity isn’t slowing down. If anything, it’s picking up steam again in 2025—especially in behavioral health, dental, and outpatient surgical groups. Everyone’s chasing scale, efficiency, and new markets.

But here’s what often gets missed in the flurry of due diligence: the real estate.

It’s easy to focus on the enterprise value of the operating business—staff, revenue, contracts, systems. But what about the facility? The land? The lease? The licensing tied to a specific building?

These things can turn out to be deal-makers or deal-breakers.

In a recent transaction we looked at, the operating entity was thriving—but the real estate hadn’t been properly maintained, the lease terms were unfavorable, and the licensing was tied to a building the buyer didn’t want. That changed the valuation. Fast.

In some cases, the real estate carries as much weight as the EBITDA. And in other cases, it’s the overlooked asset that could either strengthen the deal—or derail it completely.

This is especially true for behavioral health or senior care groups where licensing and patient care are tied directly to the property. Move the operator and you might lose months of revenue.

Buyers are getting savvier. They’re not just acquiring companies—they’re acquiring operations tied to physical space. If you’re on the seller side, knowing the true value of your real estate ahead of time is a competitive edge.

If you’re on the buy side, don’t skip that part of your diligence. Because in healthcare, the building isn’t just a shell—it’s part of the value.

📅 Book a call if you’re involved in a healthcare M&A deal and want a clear picture of the real estate component.

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