What moved the market

One of the most significant developments was the wave of new state-laws targeting private equity and REIT involvement in healthcare facilities. States including California, Indiana, Massachusetts, Maine, New Mexico, Oregon, and Washington have enacted or are enacting legislation requiring greater oversight of acquisitions by private equity firms and REITs in healthcare real estate. For example, Maine passed a one-year moratorium on hospital purchases by private equity or REITs.   This regulatory shift is meaningful because it narrows the pool of acquisition buyers, injects uncertainty into deals, and forces investors and owners to re-look at their transaction risk models when care delivery or ownership structures change.

In the REIT space, Healthcare Realty Trust (NYSE: HR) drew investor attention when institutional investor Nomura Asset Management increased its stake by roughly 3% in the company—adding about 14,800 shares (~$8 million) according to filings.   While this is a small move, it signals that even in a cautious capital market, there are players moving into healthcare real estate equities, which speaks to continued confidence in the sector anchored by stable tenants and long-term leases.

On the transaction front, there were multiple sales of outpatient medical office buildings and ambulatory surgery-center-anchored facilities across states such as Florida, California and North Carolina. For example, an 8,100-square-foot medical office building in West Columbia, South Carolina was sold, and a fully-leased Class A outpatient building in Aliso Viejo, California traded this week.   These deals reinforce that while deal volume may have slowed relative to peak years, capital is still active and focused on high-quality outpatient assets with strong operator covenants.

Another key signal: the longest U.S. federal government shutdown in history concluded on November 12, and that reopening triggered regulatory notes impacting healthcare real estate. A briefing from a healthcare real estate advisory firm flagged that the reopening included extensions for telehealth and hospital-at-home waivers through January 30, 2026.   For medical real estate investors and owner-operators, this matters because these care delivery modalities influence clinic throughput, site strategy, and occupancy all of which feed into underwriting.

Takeaways for medical CRE players

• Regulatory risk is increasing: If you are investing in or leasing healthcare real estate, especially hospital-adjacent or private‐equity backed properties, include state legislative risk scenarios in your underwriting.

• Outpatient and ASC-anchored assets continue to be “go” deals: Even in a slower environment, properties with stable tenancy, location, and quality are trading.

• Government policy still matters: Extensions of telehealth and home-based care waivers influence asset demand and market perception; stay on top of federal action and guidance.

• Equity flow remains modestly active: The HR stake increase is a small but meaningful signal that institutional money still sees value in healthcare real estate equities.

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