Areas of Expertise

Leasing for an Existing Practice

  • Renegotiating an existing lease to accommodate growth
  • Renegotiating a lease extension
  • Finding a new location due to:
    • Expiring lease
    • New satellite office
  • Subleasing existing space
  • Leasing non-owner space in a medical office building or investment property

Leasing for a New Practice

  • New partner practice
  • Breaking off from an existing practice
  • Relocation

Ambulatory Surgical Centers (ASCs)

  • Site Selection and land/facility acquisition
  • Development assistance

Investments for Medical Practitioners

  • Buy/Leaseback – shifting from lease-only model
  • Purchase/disposition of Medical Office Buildings
  • Adding income properties to financial portfolio
  • 1031 Exchanges
  • Land acquisition for new construction projects

Starting and maintaining a successful Healthcare practice is a significant undertaking. In addition to finding, treating and retaining patients, there is a multitude of additional challenges that must be addressed—staffing, billing, collections, and hospital affiliations, just to name a few. It goes without saying that the location where all of this magic takes place is one of the most important decisions that a healthcare provider will make during their professional career!

For new independent practitioners, the first decision is whether to lease or buy. A knowledgeable Healthcare CRE agent can play a critical role in this assessment. Using tools like REIS© and CoStar©, the agent can establish a baseline for market rent, expenses and concessions, thereby allowing the provider to project annual costs for a multi-year lease. Lease costs can then be compared to acquisition costs and the return-on-investment (ROI) associated with a potential purchase.

Unlike residential real estate, valuation of commercial real estate is typically based on revenue generating potential rather than the recent sales of comparable properties (in real estate terms, this is referred to as the income approach vs. the sales comparison approach to valuation[1]). Understanding the income approach to valuation is vital to properly assessing the potential ROI of a prospective property. A knowledgeable CRE agent can guide a provider through the process of understanding and estimating Net Operating Income (NOI), debt service, cash flow, cash-on-cash return, and internal rate of return (IRR) over the projected life of an investment. Once that analysis is complete, it can be quantitatively compared to the advantages and disadvantages of a multi-year lease, allowing the provider to make an informed business decision.

If this analysis sounds complicated, it’s because for someone whose primary focus is not commercial real estate, gathering and evaluating the data and metrics associated with property valuation can be an uphill battle. Fortunately for my clients, I take the lead and simplify the process immeasurably by providing accurate, detailed and reliable market data and combining it with a systematic approach to CRE valuation.  Moreover, because I understand the challenges of running a successful healthcare practice, the results of the valuation and lease vs. buy analysis can be assessed in the proper business context, thus empowering the provider to apply the same principles of success to their real estate transactions that they uniformly apply in their medical practice.

As a former member of the healthcare profession, I am optimally positioned to understand the needs of your practice and correlate them to your real estate objectives. As your Healthcare CRE agent, I will make sure that you have all the information you need to make your real estate transactions an exciting part of your business planning[2].

[1] Although I will assist my clients in determining the market value of various commercial properties using one or more methods of valuation, I am NOT an Appraiser and any opinions I provide regarding property value should NOT be considered an appraisal under the Uniform Standards of Professional Appraisal Practice ("USPAP") and should NOT be used or relied upon as such.

[2] Disclaimer: The Information provided on this site and, at times, provided by me to my clients, is deemed reliable but not guaranteed. Similarly, because all information provided by me (on this site or otherwise) is based on my personal opinion and experience, it should NOT be considered financial investment advice. The ideas and strategies expressed by me (herein or otherwise) should never be used without first assessing your own personal and financial situation and/or consulting with a financial professional. Finally, this site is not meant to offer legal or tax advice.

 

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