Ask any healthcare operator who’s built out a new space in the past 12 months, and they’ll tell you the same thing: it’s expensive. Plumbing for sinks in every room, lead-lined walls, oxygen lines, soundproofing, ADA compliance, specialty lighting, backup power — the list goes on. Even modest outpatient clinics are pushing well into the $100–$200 per square foot range  (or more), depending on complexity. And that’s before furniture, licensing, or tech installs. So what does that mean for real estate? It means the stakes are higher. A tenant who drops half a million on a buildout isn’t looking to bounce in 3 years. They want stability. They want favorable lease terms. And they want a space they can grow into — not out of. For landlords, this changes the conversation. If you’re marketing medical-ready space, showing proof of recent upgrades or infrastructure investments (like med gas or power capacity) can go a long way. For brokers, it’s a powerful leverage point: showing clients how upfront capex on the real estate side might be worth it for long-term operational savings. And for valuation? Medical buildout costs absolutely play into replacement cost, tenant commitment, and property performance. They’re not just line items — they’re value drivers. Healthcare operators want partners who understand the real  costs of doing business. If you’re in the real estate side of that equation, helping them avoid unnecessary buildout expenses—or at least plan for them wisely—will put you ahead. 📅 Book a call  if you’re planning a new healthcare space or reviewing a deal that involves significant buildout costs. 📬 Subscribe to the newsletter  for grounded, real-world insight into what actually moves the needle in healthcare real estate.

For a while, a lot of people looked at behavioral health real estate like a quick flip. Get in, get it stabilized, and sell it at a premium. And honestly — that worked for a little while. But here in 2025, I’m seeing a shift. The smart money is starting to treat behavioral health real estate more like medical office or industrial. Buy it, lock in good operators, and hold it. Why? Because behavioral health isn’t a trend — it’s becoming infrastructure. More demand. More operators. More private equity backing. But also? More sticky tenants. Behavioral health groups put a ton of time and money into their locations — licensing, buildouts, branding, staff recruitment. They don’t want to move unless they absolutely have to. And for owners? That’s gold. It means: → Longer lease terms → Renewal likelihood goes up → Steady rent escalations → Lower turnover costs I’m seeing investors pivot their mindset from “How quick can I flip this?”  to “How long can I cash-flow this?” That’s a smart move — especially as cap rates adjust and debt stays higher than we’ve seen in recent years. Behavioral health real estate is proving itself to be stable, essential, and operator-dependent — and that’s exactly what makes it a great hold for the right owner. 📅 Book a call  if you’re evaluating a behavioral health facility or looking at long-term strategy for your assets. 📬 Subscribe to the newsletter  for more straight-shooting insights from the healthcare real estate world.

There was a time when every healthcare group wanted bigger spaces. More rooms. More square footage. But 2025? That trend is shifting fast. Across behavioral health, outpatient care, and medical office, I’m seeing more and more operators say: “Give me exactly what I need — and not an inch more.” Why? A few reasons… → Healthcare has gotten more specialized. → Staffing is tighter. → Rents have gone up. → Patients want convenience over luxury. Smaller healthcare spaces mean lower overhead. Simpler operations. And faster speed to market. Behavioral health groups, in particular, are driving this trend. Many can operate perfectly with a few therapy rooms, a group room, and a clean admin space. No massive waiting rooms. No extra buildout costs. I’m seeing the same thing with outpatient surgical centers and med spas — operators are figuring out that smart, flexible space beats oversized footprints every time. And from a real estate standpoint? Smaller spaces lease faster. Sell quicker. And open the door to tenants who otherwise might’ve been priced out. This isn’t to say big healthcare campuses are dead — not at all. But there’s a clear lane opening up for smaller, well-designed healthcare properties that fit the way providers operate today. Because in healthcare real estate right now? Efficient is attractive. 📅 Book a call  if you’re evaluating a healthcare property or planning a reposition. 📬 Subscribe to the newsletter  for more real-world insights from the frontlines of healthcare real estate.

If you feel like you’re seeing fewer healthcare properties hit LoopNet or Crexi lately… you’re not crazy. Off-market deals are alive and well in healthcare real estate — maybe more than ever. And it makes perfect sense. Operators expanding in behavioral health, senior living, or medical office aren’t always looking for a “listed” property. They’re looking for the right property. Quietly. Directly. Without a bidding war. And on the ownership side? A lot of landlords are happy to sell… but only if the right buyer comes along with the right terms. → Less noise → Fewer commissions → Smoother deal process → Fewer eyes on sensitive operational details Off-market doesn’t mean shady. It often just means efficient.  Especially in healthcare, where licensing, patient flow, and operations make confidentiality more important than ever. Behavioral health, in particular, is driving a lot of this. Big operators expanding into new markets don’t want to risk losing deals to competitors by broadcasting what they’re after. Same goes for senior living groups quietly upgrading locations or outpatient providers trying to pick off smaller sites. For brokers, owners, and investors in this space — the takeaway is simple: relationships matter more than listings. If you’re waiting for the perfect healthcare property to pop up online, you might be waiting a while. If you’re actively having conversations and staying in front of people? That’s where the deals are happening. 📅 Book a call  if you’re buying, selling, or just want to talk strategy around healthcare real estate deals. 📬 Subscribe to the newsletter  to stay in the loop on what’s actually happening in this market — not just what’s online.

Walk into a new medical office building in 2025 and you might notice something… It doesn’t feel like your grandpa’s doctor’s office anymore. More glass. More natural light. Lounge-style waiting rooms. Easy check-in kiosks. Branding everywhere. And if you think that looks a lot like retail — that’s not an accident. Healthcare operators have figured out something retail brands have known forever: experience matters. Patients want convenience. They want comfort. They want fast, frictionless visits — just like they get ordering a coffee or shopping online. We’re seeing this play out in medical office design all over the country: → Ground floor access → Visible signage → Curbside pickup zones for prescriptions → Digital check-in → Open, welcoming layouts For owners and investors, this means one thing: buildings that feel cold, clinical, or outdated? They’re getting passed over. Healthcare providers want space that supports their brand just as much as their operations. Behavioral health groups especially care about how patients feel  in the space. So do outpatient surgical centers competing for cash-pay clients. If you’re holding medical office property, now’s the time to think about upgrades. It doesn’t have to be a full gut-renovation. Sometimes it’s as simple as fresh paint, modern lighting, or creating better flow. Because in healthcare real estate today — retail isn’t the competition. It’s the inspiration. 📅 Book a call  if you’re evaluating a medical office space or considering improvements. 📬 Subscribe to the newsletter  to stay on top of what healthcare tenants are looking for in 2025.

It’s funny how fast the headlines flip. One day it’s record highs. The next it’s tariffs, interest rates, inflation, bank drama, layoffs, wars, or whatever else the market decides to worry about that day. Right now, March and April 2025 have felt like whiplash. Tech stocks swinging hard. Crypto being crypto. A lot of nervous energy floating around. But here’s what’s happening quietly in the background: medical real estate is still doing exactly what it’s supposed to do. → Steady rents. → Long-term leases. → Sticky tenants who have  to be near their patients. → Demand driven by need — not hype. Healthcare real estate has never been sexy like a growth stock. That’s not the point. The point is durability. The point is income. The point is stability when everything else is noise. Behavioral health? Still expanding. Senior living? Still needed. Outpatient care? Growing like crazy. What I’m seeing in deals right now is this — capital is still very much out there. But it’s getting more careful. More selective. Chasing assets that cash flow right now. Not assets that might  work if rates come down or the market cools off. Medical real estate checks that box. Is pricing adjusting? In some markets, yes. But the fundamentals for well-located, healthcare-ready properties with real tenant demand are about as strong as you’re going to find in commercial real estate in 2025. When the markets get loud, healthcare real estate just keeps doing its job. 📅 Book a call  if you’re evaluating a healthcare asset or need a valuation grounded in real-world operator insight. 📬 Subscribe to the newsletter  to stay level-headed while everyone else panics at the headlines.

It sounds simple — but parking is still one of the fastest ways to kill a healthcare real estate deal. We’ve seen it time and time again. Perfect location. Beautiful building. Everything lines up… until you realize there’s nowhere for patients or staff to park. And in healthcare, that’s a non-starter. This isn’t retail. Patients aren’t window shopping. They’re often elderly, in a hurry, stressed, dealing with mobility issues, or bringing family along. If parking is tight, confusing, or a hassle — they won’t come back. For healthcare operators, bad parking isn’t just an inconvenience — it’s lost revenue. It affects appointment volume, patient satisfaction, and even staffing (nobody wants to circle a lot for 15 minutes before a shift). And from a valuation perspective? It absolutely impacts NOI. Buildings with clean, accessible, and plentiful parking consistently trade better — especially in outpatient care, behavioral health, or senior-focused facilities where patient turnover is high and visit length is short. A few things that matter more in 2025 than they maybe did a decade ago: → Clear signage and wayfinding → Covered drop-off zones → ADA accessibility right up front → Room for rideshare pickups (UberHealth is a real thing now) → Dedicated staff parking separate from patients If you’re evaluating a medical office building or healthcare facility and parking hasn’t come up yet — it needs to. Because in this space, parking isn’t just part of the site plan… it’s part of the patient experience and part of the value. 📅 Book a call  if you’re looking at a healthcare property and want a real-world valuation perspective. 📬 Subscribe to the newsletter  for practical healthcare real estate insights every month.

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. 📬 Subscribe to the newsletter  for more on how valuation and strategy intersect in today’s market.

More and more, we’re seeing providers teaming up under one roof. A behavioral health practice shares space with a primary care group. A PT/OT clinic operates out of the same building as a med spa. Sometimes it’s one landlord—sometimes it’s two tenants splitting a lease. It’s called co-tenancy, and it’s becoming a trend in healthcare real estate. There’s a lot to like. You get shared waiting rooms, lower overhead, cross-referrals, and better space utilization. For landlords, it can help fill space faster and build synergy within a property. But it’s not all upside. Co-tenancy also requires tight operational coordination , strong legal agreements , and clear communication about brand identity and patient flow. Here’s where it gets tricky: If one tenant is seeing high volume and the other isn’t, tension can build fast. If patients show up confused about where to go or who they’re seeing, the experience suffers. If services overlap too much—or not at all—you miss the opportunity for real synergy. From a valuation perspective, a co-tenanted facility can still perform well, but only if the business model is stable and the layout supports both tenants effectively. If it feels like two practices crammed into one lease, you lose value. Done right, though? It works. Especially for newer providers, niche specialties, or health systems testing the waters in new markets. Co-tenancy might not be the future of all healthcare real estate, but in the right circumstances, it’s a smart way to maximize revenue per square foot while minimizing risk. 📅 Book a call  if you’re considering a co-tenant setup or have a space that could support multiple providers. 📬 Subscribe to the newsletter  for practical, up-to-date insight on trends shaping healthcare real estate.

Yesterday we talked about what makes a medical office truly turnkey—but let’s go a step deeper. Because in today’s market, simply being “move-in ready” isn’t always enough to get a deal done. Healthcare tenants—especially those expanding fast or backed by private equity—are getting more intentional about what they expect from a space. It’s not just about paint, sinks, and square footage. It’s about functionality, growth potential, and patient experience. Let’s say a space has the basics. That’s great. But now the tenant wants to know: Can we expand here if we grow? Is there room to add imaging, a lab, or surgical capacity later? Does the layout support patient flow and provider productivity? Are we in a location with strong referral patterns and payer mix? In other words, they’re not just looking at the lease—they’re projecting five years ahead. They want to know if this space helps them scale, serve, and stay compliant as regulations shift and patient expectations evolve. That’s why understanding operator priorities  is key to positioning and valuing a healthcare asset. A site may check all the traditional boxes, but if it doesn’t support efficient staffing or meet specialty care needs, it’s a pass. This is especially true in behavioral health and outpatient services. The bar is higher now. A building that worked for general practice five years ago may not cut it for an IOP program or a hybrid primary/mental health care model. So what’s the move for owners and investors? Know your tenant. Think beyond the floor plan. Understand what they need today —and what they’ll want tomorrow . That’s how you attract the right operators and drive long-term value. 📅 Book a call  if you’re rethinking how your property fits into the evolving healthcare landscape. 📬 Subscribe to the newsletter  to keep up with what real operators care about—and what drives valuation.

“Turnkey” gets tossed around a lot in commercial real estate—but in the medical world, it carries a little more weight. For a provider, a turnkey medical office means being able to sign the lease, outfit the exam rooms, and start seeing patients—fast.  But what actually qualifies as turnkey in 2025 has shifted, especially with evolving tech, tighter margins, and increasingly specific provider needs. So what should brokers, owners, and investors really be looking for? It starts with the bones: Plumbing in place  for sinks in exam rooms ADA compliance  already handled Proper zoning  for medical use (not just “office”) IT and electrical setups  that support EMR systems and diagnostic equipment Then there are the small things that make a big difference—waiting room layout, staff workflow, private offices for physicians, and even biohazard disposal access. These aren’t luxuries—they’re operational necessities. The more of this that’s already built into the space, the faster a provider can move in. That’s where value is created—not just in the square footage, but in the ability to generate revenue without six months of permitting and construction. From a valuation perspective, a true turnkey space can justify higher rents and faster lease-up  because it minimizes downtime. For investors, it’s a play on speed and certainty. For providers, it’s a business advantage. In 2025, providers are prioritizing properties that let them hit the ground running. So whether you’re selling, leasing, or investing, understanding what “turnkey” really means in today’s healthcare landscape is a must. 📅 Book a call  if you’re evaluating a space or planning a reposition for healthcare use. 📬 Subscribe to the newsletter  for more no-fluff insights into the real world of medical real estate.

When most people look at a piece of real estate, they see the building, the location, maybe the rent roll. But in healthcare, there’s a layer under the surface that can carry just as much weight— licensing. Whether you’re dealing with a behavioral health facility, a surgical center, or a residential treatment property, the licensing status of the building can either open doors… or slam them shut. Why? Because for many healthcare providers, a license isn’t just a regulatory box to check—it’s a time-sensitive, location-specific asset  that determines whether they can operate at all. Take behavioral health, for example. Let’s say a facility has a state-issued license for 40 beds. That license is tied to that address. If the provider moves, they have to reapply—and depending on the state, that process could take months, or even longer. So when a building already has the right license in place, it becomes instantly more attractive. It shortens the provider’s ramp-up time, reduces risk, and in many cases, makes lease or purchase negotiations smoother. In some cases, the license is worth more than the building itself. On the valuation side, this is where nuance matters. Appraisers have to factor in not just replacement cost or market comps, but also the value of the license and what it enables the operator to do. A building with no license might need a significant discount—or a longer timeline to secure the right tenant. Even in senior housing or post-acute care, things like assisted living certifications, memory care approvals, or even kitchen permits can impact operational value. It’s not always obvious, but it’s critical to the long-term health of the asset. Brokers, investors, and owners who understand the licensing game will have a huge advantage. They’ll know which properties to pursue, how to position them, and how to speak the language providers care about. If you’re in this space, don’t ignore licensing. Embrace it. Understand it. And use it to make smarter decisions—because in healthcare real estate, what you can  do with a building matters more than how it looks on paper. 📅 Book a call  if you’re evaluating a licensed facility or navigating a deal where licensing could be a factor. 📬 Subscribe to the newsletter  to stay ahead of what’s shaping healthcare real estate in 2025.