t’s no secret that healthcare is facing a staffing crisis—but what’s less obvious is how that crisis is showing up in real estate decisions. In 2025, facility location, design, and even lease terms are being shaped by one core question: Can we staff this building? Here’s what’s happening behind the scenes: → Operators are walking away from good sites  if they can’t source enough qualified staff within a 30-minute radius. → Suburban and exurban locations are under more pressure —especially in nursing-heavy environments like senior living or behavioral health. → Some tenants are requesting buildouts  that include break rooms, quiet spaces, or flexible scheduling areas to help with staff retention. → Staffing cost projections are influencing lease terms,  especially in triple net deals where providers are on the hook for everything. And from a valuation perspective, this isn’t just anecdotal—it’s real. If a facility’s viability is dependent on staff, and that staff isn’t there, the risk profile changes. A beautiful facility in a “healthcare desert” might underperform. A modest building in a talent-rich corridor might command a premium. If you’re leasing, buying, or valuing healthcare space, staffing context matters—now more than ever. 📅 Book a call  if you want to walk through how local labor dynamics are affecting your property’s position. 📬 Subscribe to our newsletter  to stay ahead of the subtle—but serious—shifts in today’s healthcare real estate game. Because at the end of the day, it’s not just about where the building is—it’s about who can work inside it.

There was a time—especially post-2020—when urgent care real estate felt nearly risk-free. Strong demand, reliable operators, pandemic-driven tailwinds, and predictable rents made it a darling of medical investors. But in 2025, the conversation is changing. Investors are still buying urgent care—but they’re no longer buying blindly. What’s causing the shift? → Saturation in some markets.  Too many centers opened too fast, and not all of them are hitting volume targets. → Reimbursement headwinds.  Some payers are tightening what they’ll cover at urgent care centers, especially when primary care alternatives are nearby. → Operational fatigue.  Staffing shortages and physician burnout are hitting urgent care chains just as hard as hospitals—and some groups are scaling back expansion. → Private equity recalibration.  Many roll-ups are pausing or restructuring, which affects how buyers view credit quality and long-term tenancy. This doesn’t mean urgent care real estate is falling apart. In fact, well-run centers in high-demand markets are still commanding strong cap rates. But underwriting has changed. Investors want to see: Market-level performance data Clear path to profitability Competitive positioning against PCPs and EDs Stability in lease and licensing structure From a valuation perspective, it’s no longer about the brand name on the door—it’s about the balance sheet behind it and the market it’s operating in. 📅 Have an urgent care facility in your portfolio? Book a call  and let’s take a look at what it’s worth today. 📬 Subscribe here  for weekly insights into how different asset classes are evolving in the healthcare real estate space. Urgent care isn’t dead—but it’s no longer untouchable. Smart investors are adjusting. Owners should too.

In a high-rate environment, liquidity is gold—and healthcare operators know it. That’s why sale-leaseback activity is still going strong  in 2025. Whether it’s behavioral health, dental groups, surgery centers, or senior living portfolios—providers are offloading real estate to free up capital for growth, pay down debt, or just weather the storm. But here’s the part not everyone’s talking about: Not all operators are getting the same deal. The spread between strong-credit, experienced providers and those with shakier fundamentals is wider than it’s been in years. What’s driving that divide? → Creditworthiness.  Buyers are demanding full financial packages, and they’re pricing risk accordingly. Clean books = better cap rates. → Licensing strength.  Operators with state-level compliance, good track records, and transferable licenses reduce risk—and get better lease terms. → Facility condition.  Buyers are willing to pay more when they’re not inheriting deferred maintenance or capex landmines. → Location alignment.  Assets in markets with strong demand, referral pipelines, and staffing stability always get more attention. If you’re considering a sale-leaseback, it’s critical to prep like you’re going public —because that’s how closely investors are reviewing deals now. From a valuation standpoint, we’re looking at a more integrated picture: Real estate value Operator health Lease structure viability Market context 📅 Thinking about doing a sale-leaseback this year? Book a call  and I’ll walk you through how buyers are pricing these in 2025. 📬 Subscribe to the newsletter  to stay ahead of the trends and get your asset market-ready. The money’s still out there. But the bar is higher. Let’s make sure you’re ready to clear it.

Five years ago, behavioral health real estate was considered a niche play—too operationally complex, too license-reliant, and too unpredictable. But in 2025? It’s firmly on the radar of institutional capital. From REITs to private equity funds to family offices, we’re seeing more groups allocate capital to behavioral health facilities—especially stabilized portfolios with seasoned operators. Why the shift? → Market demand is undeniable.  The need for substance abuse treatment, residential mental health care, and transitional living environments continues to rise. → Reimbursement tailwinds.  Payers and government programs are expanding coverage for behavioral services—making these operations more financially viable. → Sticky tenancy.  Operators are often licensed at the facility level, meaning they can’t easily relocate. That translates to lower vacancy risk and longer stays. → High replacement costs.  The infrastructure and zoning hurdles required to build new behavioral health space give existing facilities real value. But it’s not all upside. Institutional buyers still want: → Strong financial reporting → Demonstrable outcomes and census stability → Clean, transferable licenses → Real estate that supports care delivery—not just occupancy Valuation models are adapting to reflect the “going concern” component of these deals. Cap rates are tightening, but only for stabilized, well-documented assets. If you own or are evaluating behavioral health real estate, now is the time to sharpen your data, strengthen your lease structures, and tell the story clearly. 📅 Want to talk valuation, prep, or market timing? Book a call . 📬 Stay in the loop  with ongoing insights into this rapidly evolving sector. Behavioral health isn’t fringe anymore. It’s core—if you know how to position it.

In 2025, the demand for healthcare real estate is still there. The capital? Still out there too. But more deals—good ones—are dying late in the process. Everything seems fine until it isn’t. Buyer signs the LOI. Lender gives the nod. Due diligence starts… and then everything grinds to a halt. So what’s going wrong? → Incomplete or outdated valuations.  Comps from 2022 don’t cut it anymore—especially in markets where cap rates and tenant performance have shifted. → Licensing red flags.  Operators that don’t have clean, transferable licenses—or facilities that are out of compliance—send buyers running. → Ambiguous lease terms.  Leases without clear escalation, renewal, or expense clauses raise uncertainty and underwriting delays. → Undisclosed capex needs.  HVAC systems, roofs, or outdated surgical infrastructure can become deal breakers when they show up on inspection reports. → Tenant financials not matching the story.  Buyers are digging deeper. If the rent’s high but the operator’s margins are thin, trust starts to erode. The result? Buyers pull out, lenders get cold feet, or pricing gets retraded. None of which help a seller close strong—or a broker maintain credibility. What’s the fix? → Get valuations updated with fresh data and realistic assumptions. → Clean up lease language before the property hits the market. → Package tenant and licensing info clearly. → Disclose issues early and frame them correctly. 📅 Want help tightening up your deal prep? Book a call . 📬 Subscribe here  for weekly insights on how to get healthcare real estate deals across the finish line in this market. Because in this cycle, the win isn’t getting interest—it’s getting to closing.

The phrase “build-to-suit” used to mean long-term commitment, fixed layout, and a stable return for the developer or owner. In 2025, that model’s still alive—but it’s changing fast. Healthcare operators, from behavioral health to multispecialty groups, are still pursuing build-to-suit deals—but they’re demanding more flexibility  and faster timelines. Here’s what’s shifting: → Operators want optionality.  Many providers want spaces that can evolve with clinical trends—like adding telehealth pods, exam room reconfiguration, or shared back-office space. → Lease terms are shorter.  The 15–20 year lease is being replaced with 10-year deals, often with carve-outs or early-exit language tied to reimbursement or regulatory changes. → Shared risk is becoming standard.  Some tenants are requesting cost-sharing or phased TI funding structures, especially when investing in specialty buildouts. → Location strategy is data-driven.  Operators are less concerned with trophy addresses and more focused on access to referral networks, demographics, and staffing pipelines. From a valuation and dealmaking perspective, this means developers and owners need to: Design with flexibility in mind Understand clinical use cases Be realistic about exit strategy and re-tenanting risks It’s no longer enough to just build for a provider—it has to work for where healthcare is going, not just where it is today. 📅 Book a call  if you’re evaluating a build-to-suit opportunity or need help structuring it for long-term value. 📬 Subscribe to the newsletter  to keep up with the shifting trends in how healthcare spaces are being built—and what tenants actually want in 2025. Because in this market, a “custom build” needs to come with a backup plan.

A great building. A solid operator. A long-term lease. But no one noticed the state license was tied to a different address—and now the deal’s on hold. Welcome to the world of licensing risk in healthcare real estate. In 2025, this issue is coming up more often—and it’s quietly derailing transactions. Whether it’s behavioral health, assisted living, or surgical centers, the regulatory landscape is tight. And real estate that looks  good on paper can hit unexpected delays—or outright collapse—if the licensing component isn’t rock solid. Here’s how it plays out: → Buyers discover during diligence that a facility’s operating license isn’t portable → A change in ownership or use triggers a reapplication or site inspection → A delay in re-licensing halts occupancy, which halts rent, which kills financing And on the seller’s side, it can mean retrades, reputation damage, and lost time. So what should owners, brokers, and investors do? Understand what licenses are in place, and whether they’re address-specific Confirm how changes in ownership or tenancy impact the license status Factor licensing into your due diligence checklist—not just your financial one For appraisers, this also affects value. A facility that’s licensed, compliant, and transferable is worth more than one with regulatory gray areas—even if the rent rolls are identical. 📅 Want to make sure your property is ready for market—or that your purchase won’t stall over licensing issues? Book a call  and let’s walk through it. 📬 Or subscribe here  to keep up with the behind-the-scenes risks that are shaping deal success in 2025. Licensing isn’t just a clinical issue—it’s a real estate one. And it’s showing up more than ever.

There’s still demand in healthcare real estate. There’s still capital out there. And in many cases, there are buyers on the sidelines, ready to move. So why are so many deals stalling or falling apart at the appraisal stage? Because the valuation model isn’t keeping up with the market. In 2025, we’re seeing a widening gap between what owners think  their properties are worth and what valuations (and buyers) are coming in at. Here’s what’s causing the disconnect: → Outdated cap rate assumptions from pre-rate hike environments → Ignoring tenant credit deterioration or license risk → Using overly optimistic rent comps in shaky submarkets → Not adjusting for real-world operating cost increases For owners, this creates frustration. You know your asset has value—you’ve got occupancy, you’ve got lease term, you’ve got demand. But if the story isn’t supported by clean, up-to-date data and market logic, it won’t hold up in underwriting. For appraisers and advisors, this is the moment where precision matters. It’s not enough to drop in comps and average the cap rates. It takes a deep understanding of healthcare operations, licensing nuances, and the subtle shifts happening on the provider side. The good news? Deals are still getting done— when the valuation is dialed in. 📅 Book a call  if you want a valuation that reflects today’s market and actually supports your exit or refinance goals. 📬 Subscribe here  for real-world insight that goes beyond surface-level comps. Because in this market, guesswork kills deals. Precision gets them across the finish line.

When people talk about real estate value, they usually talk location, rent, lease terms, cap rates. But in healthcare? Reimbursement trends are just as important. In 2025, we’re seeing operators make real estate decisions based on what services they can get paid for—and how well. That’s showing up in: → Smaller primary care footprints in lower-reimbursement zones → More demand for outpatient behavioral health in Medicaid-expansion states → Caution around rural expansion in areas with payer instability → Renewed interest in cash-pay and hybrid-model geographies From a valuation standpoint, this matters. A facility in a high-Medicaid area might look attractive based on comps—but if the operator is struggling to stay profitable due to reimbursement cuts, your rent roll isn’t as secure as it looks. On the flip side, locations aligned with strong payer mixes or growing value-based care arrangements? Those are commanding tighter cap rates and real buyer interest. It’s no longer just about square footage—it’s about what can be billed inside that square footage. If you’re underwriting, buying, or repositioning healthcare real estate and you’re not considering reimbursement trends—you’re flying blind. 📅 Book a call  if you want a valuation or strategy review that actually accounts for operator and payer reality. 📬 Subscribe to the newsletter  to keep getting real-world insight into what’s shaping healthcare real estate—behind the spreadsheets. Because in 2025, it’s not just about what’s being built—it’s about what’s being reimbursed.

Private equity is still busy. Health systems are still acquiring. And independent physician groups? They’re feeling the pressure. In 2025, consolidation among physician groups  is reshaping how real estate is used, leased, and valued across the healthcare space. Instead of leasing 2,000–3,000 sq. ft. in a suburban strip center, these larger groups are looking for: → Centralized, multi-specialty hubs → Shared back-office space for billing and admin → Clinical layouts that support higher patient volume and efficiency → Infrastructure that can scale with regional expansion As these groups grow, they want real estate that reflects their new size and sophistication—not just whatever suite they’ve been renting since 2012. For landlords and owners, this has a few key implications: Older, chopped-up suites may sit longer unless repositioned Larger tenants want longer leases—but more say in buildouts Consolidated groups bring more credit… and more negotiation power Valuation-wise, this means medical office assets with flexible layouts, updated infrastructure, and strong anchors are becoming more attractive—especially if they align with emerging regional healthcare networks. On the flip side, properties designed for now-defunct solo practices may face more downward pressure unless re-tenanted or repurposed. 📅 Book a call  if you’re navigating physician group negotiations, or just want to understand how consolidation is affecting value. 📬 Subscribe to the newsletter  to stay sharp on what physician-driven demand looks like today. Consolidation is changing everything—including the four walls those practices work in.

We’ve all been talking about interest rates, cap rates, and credit tightening. But there’s another factor quietly pushing its way into every valuation conversation right now: operating costs. In 2025, healthcare property owners—especially those in senior living, behavioral health, and outpatient care—are feeling the pinch. Staffing costs are up. Utilities are up. Insurance premiums are up. Maintenance and compliance costs? Also up. And even if those expenses aren’t directly on the landlord’s books, they’re affecting the tenant’s margins —which impacts rent stability, renewal likelihood, and overall perceived risk. This is especially important in triple net leases, where the operator is technically responsible for everything. Because if the operating burden gets too high, even a strong lease might become unstable. From a valuation standpoint, we’re looking more closely at: → The tenant’s ability to absorb rising costs → The sustainability of base rent vs. market realities → The property’s infrastructure efficiency (or lack thereof) → Lease clauses around escalation and pass-throughs This isn’t panic territory—but it is a new lens. One that buyers, lenders, and appraisers are all using more aggressively in 2025. If you haven’t reassessed how your property’s operating profile impacts its value, now’s the time. 📅 Book a call  to talk through how cost pressures might be affecting your asset’s value today. 📬 Subscribe to the newsletter  to stay ahead of the subtle shifts shaping the healthcare real estate market. Margins are tightening—and valuations are evolving in response. Let’s make sure you’re not caught flat-footed.

In a market full of complexity, investors are chasing simplicity. That’s why 2025 is shaping up to be the year of the single-tenant healthcare deal. Whether it’s behavioral health, dialysis, imaging, or dental groups—buyers are looking for stabilized, single-use properties with long-term leases and strong operators. The model isn’t new, but the momentum behind it is growing fast. Why? Because single-tenant healthcare properties offer: → Predictable cash flow → Clear capex expectations → Easier underwriting → Faster due diligence → Simpler lease enforcement In an environment where capital is selective and lending is cautious, these assets reduce friction. But here’s the catch: not all single-tenant deals are created equal. If the operator doesn’t have strong credit, or if the lease is short, or if the rent is well above market—it’s not low-risk, it’s just disguised risk. Smart investors are asking: Is this operator profitable and licensed? Is the lease term long enough to justify the pricing? Is this location core to their service delivery model? From a valuation standpoint, single-tenant deals often trade tighter—but only when those fundamentals check out. The narrative still has to hold up. 📅 Got a single-tenant asset or evaluating one? Book a call  and let’s walk through what the market would say about it. 📬 Want to stay current on where healthcare capital is flowing each week? Subscribe here . Simple deals don’t mean easy deals. But in this market, they’re getting the most attention.