Our REIT heritage, sharp locational intelligence and insights, cultural alignment and time-sensitive execution make us a preferred Development and Acquisition Partner

Build/Acquire

Develop

Manage

Sell

  • Challenge Landlord entities created by physicians often lacks foresight, diligence and end-to-end thoroughness. Most Landlord entities fail to envision evolving needs (physician partners’ retirements, fresh recruitments, real estate expansion, buy-ins and handoffs as well as capital restructuring). This myopia creates glaring inequities and conflicts between stakeholders overtime that leads to lease restructuring and re-syndication
  • Physicians make numerous mistakes when they attempt to plan and develop these facilities without engaging an experienced developer. The 4% development fee seems excessive on the front end. Organizing the right team to design and construct these facilities, and managing the multiple alliance partners through the planning, budgeting, syndicating, site selection, programming, design and construction process is an undertaking that they do not understand. They need to focus on being surgeons or physicians. Orchestrating a development is a time consuming job. Keeping the physicians from making mistakes in the design of facilities that cost $400 PSF + is a skill set few people have. They don’t like to hear this on the front end of a project. They usually get it later. You get one chance to right size this facility, establishing your occupancy costs and profitability for the next 10-20 years. How you plan for future growth is key. Over developing a facility on the front end is a common mistake   
  • Challenge Physicians are not bona fide real estate experts. Most physicians do not have the bandwidth nor the expertise to develop and to manage real estate
  • Physicians may become emotional about a particular location. However property development is much more than site selection. It is about optimizing patient access, right-sizing facility, envisioning and building tech infrastructure, addressing environmental issues and zoning laws, envisioning parking and designing with adequate headroom for flexibility and future service-mix
  • Challenge ASC development and management is exhilarating but can also be overwhelming for Physicians
  • Challenge Tax deferred 1031-exchange make this asset class even more lucrative**. However, high transaction costs (selling fees) cut into the profits
  • **Recession-resistant healthcare remains the most active sector in Real Estate Transaction Market as evidenced by record-breaking consolidation:
    • Acquisition of Physicians’ Practice by Large Facilities
    • Cheaper to Buy than Build
    • CON (Certificate of Need) State Opportunities
    • MOBs Attractive to PE’s (Cash Flow from Doctors)
  • Savvy investors are being drawn to medical office properties due to declining vacancy and market cap rates.  Between 2012 and 2016, vacancy rates dropped from 11.6% to 7.4% and average capitalization rates dropped from 7.7% to 6.7%
  • Private equity roll-ups or leveraged buy-outs are increasingly becoming common

Build/Acquire

Develop

Manage

Sell

  • Our Difference: Our forte lies in structuring, orchestrating and executing imaginative ownership models- Joint Ventures with or without physician partners. We are experts in consultative selling and complex negotiations with physician partners. We take immense pride in “making it right” by structuring and executing future-proof Landlord LLCs in terms of rent, escalation factor, triple net (maintenance, insurance and taxes) and guarantee. We are known for clean structuring of triple net leases and syndicating for private placement. We align priorities, mindsets, and approaches
  • Our domain-specific expertise and unbiased perspective makes us a critical partner. We have a keen understanding of Certificate of Need (CON), Anti-Kickback** and Stark Law***
  • Unlike regional developers limited to a particular state who excel in shell development, we offer a solid national footprint of complete end-to-end medical real estate solutions
  • Stark Law: “Fair market value means the value in arm’s-length transactions, consistent with the general market value. ‘General market value’ means the price that an asset would bring as the result of bona fide bargaining between well-informed buyers and sellers who are not otherwise in a position to generate business for the other party, or the compensation that would be included in a service agreement as the result of bona fide bargaining between well-informed parties to the agreement who are not otherwise in a position to generate business for the other party, on the date of acquisition of the asset or at the time of the service agreement.” [emphasis added]

    Anti-Kickback Statute: “…fair market value in arms-length transactions… not determined in a manner that takes into account the volume or value of any referrals or business otherwise generated between the parties for which payment may be made in whole or in part under Medicare or a State health care program.” 

  • Our Difference: We execute either as a Partner in the Landlord LLC or as a Fee Developer. Constructing the right team is fundamental and perhaps the most important early task. We spearhead, mobilize and align best-in-class architects, general contractors and engineers
  • In a design assist model, we leverage the expertise and market intel of architects and general contractors in the initial programming and budgeting phase. We carefully hand-pick each team based on their local expertise in specific use case and then scale accordingly. We take into consideration the team’s existing work load to purposefully harness the collective brain power and knowledge. We require the A-game from each team member. 
  • Our Difference: We create the ultimate managed experience in property management – vendor & supplier management, lease management, reporting, facility maintenance, tenancy management, safety and security, vacant property management, marketing and disposition. Our robust technology platforms support this neural network in real-time. Our partnership’s profound potential lies in its ability to link various key stakeholders for unsurpassed transparency, visibility, ubiquity and specificity
  • Our Difference: Cap rates are what they are- every auction 1031 platform would reflect it. What matters is that our selling fees are half. We make sure there is no buy side brokerage
  • Our Founder and President, Mark Samples’ Investment Property Sales heritage from CNL-Bank of America (1990-1998) of recycling capital and enhancing the REIT’s portfolio by concept, by geography & by tenant is of special relevance to sellers today. 1031 exchange can minimize significant selling costs by dealing directly with buyers and by reducing the selling commissions by as much as 50%  
  • Mark Samples has originated +$800MM in sale-leaseback, debt financing and strategic advisory to Restaurant real estate in Trustreet Properties- the largest publicly-traded restaurant REIT in the US (2000-2007)
  • We have close ties with leading lenders, equity sponsors and private real estate investment groups

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