It used to be that if your rent roll looked clean and your comps checked out, your appraisal sailed through. In 2025? Not so much. Whether it’s behavioral health, senior housing, or outpatient medical, we’re seeing much more scrutiny on appraisals  — and it’s coming from all sides. Lenders are asking more questions. Buyers are requesting more documentation. Operators are being asked to explain their models in more detail. So what’s going on? → Credit is tighter. → Risk tolerance is lower. → And people want assurance that a valuation actually reflects what the asset can perform like — not just what the comps say. That means appraisers are spending more time on: Operator financials Licensing and regulatory risk Market-specific demand trends Reimbursement realities Real-time capex needs In short, the story behind the numbers matters more than ever. If you’re getting a property appraised—whether for sale, refinance, or internal planning—you need someone who understands how the clinical side affects the financial side. Because a surface-level valuation won’t hold up when it lands on a lender’s desk. 📅 Book a call  if you’re looking for a healthcare valuation that stands up to scrutiny. 📬 Subscribe to the newsletter  for updates on how underwriting and appraisal standards are shifting across the space.

If you’ve spent any time around healthcare real estate lately, you’ve probably noticed something: national headlines don’t always match what’s happening on the ground. Yes, we all feel broader trends — interest rates, credit tightening, construction costs — but when it comes to buying, selling, or valuing a healthcare property, what really matters is local dynamics. How’s the patient demand in that  zip code? What’s the staffing situation at that  hospital system? Is there a behavioral health shortage in that  region? What are the licensing hurdles in that city ? You can’t just say “healthcare real estate is strong” or “healthcare real estate is soft” — it depends where you’re standing. I’m seeing deals in mid-sized markets fly because of undersupply. I’m seeing trophy assets in major metros sit longer because the operator story doesn’t hold up. It’s hyper-specific now. And that’s a good thing. Because it means smart investors, smart operators, and smart advisors can still find real opportunities — if they’re paying attention to the local puzzle, not just the national noise. For valuations? This shift is huge. It’s not about averages. It’s about real rent comps, real patient volumes, real local cap rates. It’s about telling the true story of an asset in its market, not just plugging into a model. 📅 Book a call  if you need a valuation that actually reflects what’s happening where your property is,  not just what the national data says. 📬 Subscribe to the newsletter  for more real-world healthcare real estate insight that keeps it local, not generic.

Everyone loves talking about new leases, new tenants, new wins. But in healthcare real estate — especially in 2025 — the real money is in retention. If you’ve got a strong behavioral health group, an outpatient surgical center, or a solid senior living operator in place, keeping them happy matters more than chasing new names. Here’s why: New leases mean downtime, capex, and marketing costs. New tenants mean new licensing risks and regulatory delays. In healthcare, tenant turnover isn’t just a headache — it’s expensive and operationally risky. A renewal isn’t just a signature. It’s validation that the property still works for their business. Good tenants rarely want to move if they don’t have to. The cost of relocating healthcare operations is high — physically, financially, and clinically. Operators that stay put tend to reinvest in their spaces, build patient loyalty, and stabilize cash flow. From a valuation standpoint, a property with a strong renewal history trades differently than one with constant churn. Buyers (and lenders) value predictable cash flow. They value long-term commitments. They value proven operator performance. The smart owners right now? They’re not just pushing for rent bumps. They’re asking: → How can we make this facility even easier to operate? → How can we support tenant success without overreaching? → How can we stay ahead of licensing or compliance challenges that might cause friction? Healthcare real estate isn’t retail. It’s relationship-driven — and renewal-driven. 📅 Book a call  if you’re navigating lease renewals or planning your next healthcare real estate move. 📬 Subscribe to the newsletter  for more insights into what actually drives long-term value in this market.

It’s no secret—new medical development projects aren’t flying off the shelf the way they were a few years ago. And it makes sense: → Construction costs are still high. → Interest rates are squeezing margins. → Lending is tighter across commercial real estate. But here’s what’s important: ground-up development isn’t dead.  It’s just getting smarter. Instead of speculative medical office buildings popping up everywhere, we’re seeing much more focused plays: Build-to-suit projects for large behavioral health operators Strategic expansions for senior living campuses Surgery centers and outpatient hubs in underserved markets Medical retail conversions where demand supports it In short — if there’s real tenant commitment  and demonstrated need , projects are still moving. If it’s speculative? It’s sitting. For healthcare real estate investors, this means two things: New supply will stay relatively constrained for the next 12–24 months. Properties tied to strong operator partnerships will keep commanding premiums. From a valuation standpoint, this tightening of the development pipeline could create pockets of rental rate stability—or even modest growth—in certain healthcare sectors. Especially where existing inventory can’t meet the operational needs of expanding providers. It’s not a bad time to build. It’s just a bad time to build without a plan. 📅 Book a call  if you’re evaluating a healthcare development deal and want a real-world valuation perspective. 📬 Subscribe to the newsletter  to keep up with what’s getting built—and what’s not—in healthcare real estate.

If you’ve been paying attention to the broader real estate market, you know it’s a little choppy right now. But here’s what’s interesting: behavioral health properties aren’t flinching the way other asset classes are. In fact, stabilized behavioral health facilities — especially ones with strong operators and long-term licenses in place — are holding value far better than retail, office, or even some medical office portfolios. Here’s why: → Demand is rising.  Behavioral health needs didn’t slow down during COVID—and they’ve only grown since. → Operators are sticky.  Licensing, staffing, and patient continuity make relocations rare. → Reimbursement tailwinds.  More payers are covering behavioral health services now than ever before. → Private equity interest.  Big groups are expanding, and they need real estate to scale. From a valuation standpoint, this means buyers are still showing up — but they’re looking for quality.  They want real tenancy, real licensing, and real operational strength. If you’re holding a behavioral health property with a stable operator, you’re in a strong position. If you’re evaluating one, it’s more important than ever to dig into the operational fundamentals — not just the rent roll. Behavioral health real estate isn’t just a 2020s trend. It’s becoming one of the most resilient sub-sectors in the healthcare real estate world. 📅 Book a call  if you’re thinking about valuing, buying, or selling a behavioral health property. 📬 Subscribe to the newsletter  to stay sharp on what’s moving the healthcare real estate market in 2025.

There was a time when an underutilized healthcare building raised red flags. Now? It’s raising eyebrows—for the right reasons. In 2025, smart investors are taking a closer look at properties that aren’t fully occupied, fully optimized, or even fully understood. Why? Because underutilized doesn’t mean unviable—it often means untapped. Think of a behavioral health facility operating at half capacity, or a former urgent care space that hasn’t been re-tenanted since COVID. On paper, it might not look great. But behind the numbers, there could be: → Existing infrastructure that cuts buildout time → Licensing already in place → Zoning already approved for medical → Locations with unmet demand or low competition And with valuations softening just slightly in Q2, these assets often come at a discount—giving operators and investors room to reposition or re-tenant with real upside. It’s not a “fixer upper” strategy. It’s a “look closer before you pass” strategy. Because what looks like a vacant or underperforming space might be the perfect match for a growing provider—especially in outpatient care, behavioral health, or specialty services. From a valuation standpoint, this is where nuance matters. A vacant building with medical bones and strong comps nearby? That’s opportunity—not dead weight. 📅 Book a call  if you’re looking at a deal others passed on and want a second opinion on value and strategy. 📬 Subscribe to the newsletter  for insights that go beyond the surface of healthcare real estate.

If your deal is taking longer to close this quarter, you’re not alone. Across the healthcare real estate space—from behavioral health to outpatient medical to senior living—we’re seeing one consistent trend: buyer underwriting is getting heavier. Gone are the days of quick reviews and soft commitments. Today’s buyers are diving deep. They’re asking for: → Detailed financials from operators → Verification of licensing and compliance status → Market-specific comp support → Updated capex schedules → Proof of patient volume stability And it’s not just institutional capital. Even regional buyers and private investors are pushing for more data before signing off. Why? Because between tighter lending, lingering macro uncertainty, and rising operational costs, everyone wants to validate performance before committing capital. For owners and brokers, this means one thing: Be ready. The more proactive you are with documentation, data, and valuation rationale, the smoother the process will be. If you’re selling, get ahead of the underwriting—don’t wait for the buyer to start the process. From a valuation standpoint, it’s also shifting how we look at value. Buyers aren’t just pricing assets—they’re pricing risk . And that risk is tied to everything from tenant strength to licensing complexity to local demand dynamics. Q2 isn’t a slowdown. It’s a sift. The capital is still out there—it’s just more cautious, and it’s asking smarter questions. 📅 Book a call  if you’re prepping for a deal or need a valuation that speaks the language of today’s buyers. 📬 Subscribe to the newsletter  for grounded insight on what’s actually happening in healthcare real estate deals this quarter.

A year ago, a clean behavioral health or medical office listing in a good market would get quick attention. Now? Not so much. We’re starting to see healthcare properties—especially smaller, owner-occupied, or niche buildings—sit longer than they did in 2023 and early 2024. So what changed? It’s not demand. Healthcare is still growing. Operators still need space. But the buyer profile  has changed. Interest rates are higher. Lenders are more cautious. Private equity is still active—but not chasing marginal deals. And buyers? They’re looking deeper at operator strength, buildout costs, licensing flexibility, and long-term scalability. A lease that once felt “good enough” isn’t always cutting it now. A great building in the wrong layout? Pass. A provider who’s not expanding? Pass. That doesn’t mean there’s no market—it just means you’ve got to know how to position the asset. If you’re holding: A stabilized behavioral health facility A medical office with below-market rent Or a property with unique infrastructure (like a surgery center or IOP facility) …then valuation accuracy and marketing strategy matter more than ever. What used to move on rent comps and cap rate math now moves on operator story, tenant credit, and regulatory readiness. 📅 Book a call  if you’re preparing to list or reprice a healthcare property and need valuation guidance that reflects today’s market. 📬 Subscribe to the newsletter  for grounded insights on what’s really driving (or delaying) deals in healthcare real estate.

Not all the effects of COVID hit immediately. Some are just now starting to show up—especially in healthcare real estate. We’re seeing it in a very specific way: Pandemic-era leases are coming due. Back in 2020–2021, many healthcare providers signed short-term leases to stay flexible. Landlords offered concessions. Tenants took space they could open quickly—often without the usual long-term planning. Fast forward to 2025, and those 3–5-year deals are hitting the end of their run. And now, everyone has to ask: → Did this space actually work? → Is the rent still viable in this market? → Is it worth renewing, relocating, or expanding? That question is showing up in valuations, too. Some providers are walking from spaces that never really fit. Others are doubling down and negotiating longer terms. Some landlords are facing re-tenanting costs they didn’t plan for. And a few are discovering the rent they locked in back then no longer reflects today’s market. It’s creating pockets of movement—and opportunity. For appraisers and brokers, this is a critical moment to reassess: What are the real market rents now? What’s the likelihood of renewal? How do buildout investments affect negotiations? Is there upside—or risk—coming with this tenant? This isn’t a crash. It’s more like a quiet reshuffling. But it’s enough to impact cap rates, leasing comps, and long-term projections—especially in medical office, behavioral health, and outpatient care. 📅 Book a call  if you’re evaluating a property with a lease coming up or already seeing movement in your market. 📬 Subscribe to the newsletter  for practical, valuation-minded takes on what’s shifting in healthcare real estate.

Valuing healthcare real estate has never been simple. But in 2025, there’s one factor that’s climbing higher on every appraiser’s checklist: operator strength. It’s not just about lease rates or capex anymore. It’s about who  is running the show inside the building. Are they regional? National? Private equity-backed? Are they expanding—or holding on by a thread? Strong operators are driving stronger valuations, period. Why? Because lenders and investors want predictability. A 10-year lease sounds great, but it means a lot more if it’s with a provider that has scale, margin, compliance controls, and a track record of patient volume. On the flip side, even great real estate can get discounted if the operator is new, unstable, or tied to risky reimbursement streams. We’re seeing this in behavioral health, where licensing and reputation mean everything. We’re seeing it in senior living, where staffing, census, and care quality drive value as much as rent. And we’re seeing it in outpatient groups that are consolidating fast—but not always building the internal strength to match. From a valuation standpoint, this means more than just checking rent rolls. It means understanding who the operator is, what they’ve built, and how durable their business model really is. In other words, good real estate doesn’t save a bad operator.  But a strong operator can elevate an average facility. If you’re preparing for a valuation or positioning a property for sale, understanding how the operator story affects value isn’t optional—it’s essential. 📅 Book a call  to get a valuation that accounts for real-world operator dynamics, not just comps. 📬 Subscribe to the newsletter  for insights on what’s really shaping healthcare real estate in 2025.

There wasn’t a big headline in healthcare real estate this past week—but there was  a signal. Credit spreads in the commercial real estate world started to widen. It’s being driven in part by rising tariff tensions, which have added a layer of economic uncertainty just as things were starting to stabilize. And while that may sound like a capital markets issue, it’s already working its way into valuations —especially in niche spaces like behavioral health, medical office, and senior living. Here’s why: Valuation isn’t just about cap rates and comps. It’s about understanding the real-time cost of capital, the risk profile of the asset, and what buyers and lenders are willing to take on right now. When spreads widen, debt gets more expensive. When debt gets more expensive, buyers get more cautious. And when buyers get more cautious, values shift. Lenders are also tightening up—asking more questions about tenant quality, lease terms, buildout risk, and licensing exposure. That changes how appraisals are being approached and how underwriters are modeling income and risk. For owners, investors, and even operators trying to refi or position a facility for sale, it’s critical to understand that the financing environment is no longer neutral. It’s leaning conservative again. A behavioral health facility with strong tenancy and licensing in place still holds weight—but gone are the days of casual underwriting and aggressive growth projections. If you’re preparing for a valuation in this environment, you need someone who speaks the language of lenders, understands operational nuance, and can defend the value from both a clinical and capital markets perspective. That’s where we come in. 📅 Book a call  to make sure your property valuation reflects what today’s market—and lenders—are actually thinking. 📬 Subscribe to the newsletter  to stay up to speed as this credit environment continues to evolve.

It’s a question that comes up in almost every strategy meeting: Should we buy the building, or just lease it? And in 2025, the answer isn’t as straightforward as it used to be. Owning gives you control. Leasing gives you flexibility. But in healthcare real estate, the real decision comes down to how central the facility is to your long-term operations—and how much capital you’re willing to tie up. If you’re running a high-performing behavioral health or outpatient surgery center, owning can make sense. You’re already investing heavily in the buildout, licensing, and staff. Having control of the real estate means you’re not at the mercy of a landlord when renewal time comes around. But ownership also means responsibility—repairs, taxes, deferred maintenance. And in a rising-rate environment, the cost of capital can make even a solid investment feel tight. Leasing, on the other hand, allows operators to test markets, scale faster, and stay nimble.  It can be especially useful for multi-location groups or PE-backed rollups trying to move quickly and preserve cash for growth. From a valuation standpoint, owned real estate gives healthcare groups a real asset on their books—but it also complicates things during M&A or restructuring. Sometimes, separating the opco and propco is the smarter long-term play. What I’m seeing is this: → Groups that are stable, local, and focused on a single market are leaning toward ownership. → National groups and rapid-scale operators are leasing. → Everyone else is looking for the right hybrid. There’s no perfect answer. But there is a right answer for your model. 📅 Book a call  if you’re weighing the decision between leasing and ownership for a healthcare facility. 📬 Subscribe to the newsletter  for insights grounded in what real operators and investors are actually doing.