Articles and Blogs

Each year, hospital and health care real estate leaders face a rapidly evolving landscape of market, regulatory and operational challenges. To better understand where the industry is headed, we’re conducting a brief survey of hospital and health care real estate professionals across the country. We’re interested in learning: The issues keeping you up at... READ MORE

A recent report highlighted how independent rural hospitals are increasingly forming regional networks in order to gain negotiating leverage, reduce costs and participate in value-based care while maintaining independence amid health system consolidation. One example is North Dakota’s 23-hospital Rough Rider High-Value Network, which was launched with state support and serves a large share... READ MORE

Connecticut adopted sweeping changes to its certificate-of-need (“CON”) program. Among other changes, the reforms are intended to narrow certain review requirements, adjust thresholds for when approval is needed and create a more predictable path for some facility and service-line projects. The changes reflect continued state-level attention on streamlining CON approvals. Intermountain Health and AdventHealth... READ MORE

According to a recent report, cardiology outpatient strategy is shifting towards ambulatory surgery centers (“ASCs”) and away from hybrid office-based lab/ASC models to streamline staffing, space and back-office functions. Many health systems are prioritizing cardio ASC developments that are physically connected to, or in close proximity with, hospitals to support clinical integration and quality oversight. Nearly one... READ MORE

Over the past few years, we’ve seen an increase in hospitals and health care systems using credit tenant lease (“CTL”) financing for new outpatient projects. Below is an overview of CTL financing. Overview – CTL financing has been around for many years. In some circles, it’s referred to as lease financing or synthetic lease... READ MORE

Williamson Health’s (Franklin, TN) Board of Trustees has voted to sell the county-owned health system to Ascension. The total value of the deal is over $950M, including a $700M purchase price and over $250M in commitments for facility improvements, electronic health records and other strategic projects. The deal remains subject to approval by the Williamson County Commissioners. Bridgepoint... READ MORE

Following a series of hospital sale-leaseback transactions that preceded bankruptcy filings in 2024 and 2025, lawmakers at both the federal and state levels have taken notice. In response, legislators have introduced measures aimed at regulating, or increasing oversight of, certain health care real estate transactions. These efforts seek to protect community hospitals from transactions... READ MORE

The Surry County (NC) commissioners unanimously approved a deal to transfer Northern Regional Hospital to Novant Health. The agreement protects more than 1,000 jobs, with Novant committing more than $135M in investment. After the Charity Hospital building in New Orleans sat empty for over 20 years, Tulane University has announced plans to buy and... READ MORE

Atrium Health has submitted a certificate of need application to develop a new hospital in Wilmington, North Carolina. Atrium’s application follows applications submitted by Novant Health and UNC Health for new hospitals in Wilmington. State regulators have determined the Wilmington area is in need of 225 more hospital beds. Cone Health has submitted a... READ MORE

The Veterans Health Administration and HCA occupy the largest amount of REIT- and investor-owned outpatient space, according to a recent Revista post; however, most health systems overwhelmingly favor owner-occupied outpatient space. On the development side, third-party development accounts for about 30% of health system MOB projects, with the remainder being self-developed. High-quality, well-located medical... READ MORE