Monetize Your Real Estate Through a Hybrid Sale-Leaseback
HREA offers the Hybrid SLB which allows physician-owners to sell the majority of their MOB, ASC, or Surgical Hospital and retain continued physician-ownership in a tax-deferred manner.
WHAT IS A HYBRID SALE-LEASEBACK?
With a Hybrid Sale-Leaseback (“Hybrid SLB”), the ownership monetizes all or a portion of their real estate and leases it back, which allows ownership to unlock up to 100% of their passive equity to invest in their core business, modernize facilities and equipment, expand an existing facility, build a new facility, reduce debt, or make partner distributions.
THE OUTCOME
Take chips off the table in a seller’s market Maintain physician alignment between the real estate and the practice Retain control through a long-term lease with multiple renewal options Ability to reinvest proceeds tax-deferred into a larger diversified medical office portfolio.
Benefits of a Sale-Leaseback
Practice Focus: Free up time to focus more on the care aspects of medicine and less on the real estate ownership and management issues.
Improved Economics: Unlike traditional debt financing with a loan-to-value ratio of 65-75%, a sale-leaseback unlocks 100% of the value.
Practice Alignment: Creative transaction structures that allow for continued physician-ownership in the real estate, providing lower buy-in for physician recruitment.
Portfolio Reinvestment: The ability to structure a tax-deferred transaction and diversified income through an UPREIT transaction.
Improved Financial Statements: The lease can be structured as an operating lease in order to reduce any impact on the balance sheet and loan covenants.
Operational Control: Maintain long-term full operating control over the facility with the ability to modify the space as the business evolves.
Tax Benefits: Rental payments are fully deductible whereas a fully depreciated asset does not offer any tax benefits.
Reduce Conflict: Eliminate challenges of having future physicians as owners in the practice but not in the real estate.
Recent Case Study
The Objective: The original founders of a physician-owned hospital and ASC were interested in monetizing their real estate to prevent a potential imbalance between retiring physicians and incoming physicians but also wanted to maintain a level of control and alignment with the real estate.
The Solution: HREA’s Hybrid Sale-Leaseback Model allows physicians to monetize 51% - 90% of their real estate ownership in a tax-deferred manner and maintain physician-alignment, maximum control, and future ‘buy-back’ rights.
The Result:
HREA’s discreet marketing process ensured a competitive and transparent bid process generating 15 qualified purchase offers
The physicians sold 80% of their ownership generating a 16x valuation multiple
The tax-deferred reinvestment was more than 2x their original investment
Included a purchase option to ‘buy-back’ the real estate in the future Maintained continued alignment between the practice and the real estate.
HREA News
HREA | Healthcare Real Estate Advisors is pleased to announce that Joe Karnes has joined the company as a Senior Associate in its Denver office.
In 2023, HREA’s team of professionals advised on the sale of 22 healthcare real estate assets throughout the U.S totaling $245 million in transaction volume. With a primary focus in representing healthcare providers, HREA leverages its unique experience in the industry by navigating advanced transaction structures that are tailored to each client’s goals and objectives, including a variety of tax-deferred structures.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a multi-specialty outpatient surgery located in Effingham, IL. Effingham Surgery Center consists of 17,201 rentable square feet and is 100% leased and occupied by the practicing physicians in partnership with USPI and Sarah Bush Lincoln Health System.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of Specialists Hospital Shreveport (“Hospital”), a physician-owned surgical hospital, and four (4) affiliated medical office buildings, totaling approximately 192,640 square feet (“Portfolio”).
HREA | Healthcare Real Estate Advisors was honored to attend and sponsor the Becker’s 29th Annual Meeting: The Business & Operations of ASCs at Swissotel in Chicago, Illinois.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of seven (7) single-specialty medical office and outpatient surgery centers located throughout northwest South Carolina.
HREA | Healthcare Real Estate Advisors is proud to be a sponsor of the Becker’s 29th Annual Meeting, The Business & Operations of ASCs.
HREA | Healthcare Real Estate Advisors and Realti Ventures is pleased to announce the real estate sale of a single-specialty medical office building portfolio located in Rock Hill, SC, Fort Mill, SC, and Lancaster, SC. The portfolio is 100% leased to Carolina Cardiology Associates (“CCA”) and consists of 25,258 square feet.
HREA | Healthcare Real Estate Advisors, along with Merritt Healthcare Advisors, title sponsored the PHA’s 23rd Leadership Summit at The Boulders Resort in Scottsdale, Arizona.
Discover how collaborative partnerships with investment banking and real estate experts can lead to optimal financial and non-financial M&A outcomes in our new white paper.
One of the common topics we hear from our clients are the challenges of succession planning involving the real estate. Partnering with HREA ensures a smooth transition when considering the sale or partial sale of your medical real estate.
HREA | Healthcare Real Estate Advisors, a national leader in providing healthcare real estate advisory and capital market solutions, is pleased to announce that Timothy J. Cajka has joined the company as Director of Investment Sales.
HREA | Healthcare Real Estate Advisors is proud to be a sponsor of the Becker’s 20th Annual Spine, Orthopedic + Pain Management-Driven ASC Conference, which is being held in Chicago from June 15th, 2023 through June 17th, 2023.
HREA | Healthcare Real Estate Advisors, a national leader in providing healthcare real estate advisory and capital market solutions, is pleased to announce that Mike Spisak has joined the firm as Director of Healthcare Real Estate - Investment Sales.
HREA’s Private Client Group consists of specialized Net-Lease and §1031 Exchange professionals that offer access to a large pool of §1031 exchange and private capital buyers that specifically target net-leased medical properties.
HREA | Healthcare Real Estate Advisors is pleased to announce that Anthony Naticchioni has joined the firm as Director of Healthcare Real Estate Investment Sales. Located in Orange County, California. Anthony serves HREA’s clients by advising and executing financial and real estate strategies that address both the operational aspects of the practice or surgery center and the real estate.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a multi-specialty outpatient surgery located in Corbin, KY. The single-tenant ASC consists of 16,354 rentable square feet that is 100% leased and occupied by the practicing physicians in partnership with Baptist Health.
The HREA team would like to express our sincere appreciation to our clients and partners for making 2022 a successful year. We greatly value our relationship and wish you a healthy and successful 2023. HREA’s team of professionals advised on the sale of 22 healthcare facilities throughout the U.S., totaling $365 million, including physician-owned hospitals, ASCs, and Medical Office Buildings.
HREA | Healthcare Real Estate Advisors has announced the sale of an 11-property medical office portfolio located in eight states for a total value of approximately $130 million.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of West Valley Medical Plaza located in Goodyear, AZ. West Valley Medical Plaza is a multi-tenant medical office building and outpatient surgery center that is conveniently located approximately 20 miles west of Phoenix Sky Harbor International Airport.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of Copper Peak Medical Building located in American Fork, UT. Copper Peak Medical Building is a multi-tenant medical building that was built in 2004 adjacent to the affiliated American Fork Hospital.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a medical office building located in Arlington, TX. The building was originally built as a build-to-suit for TMI Sports Medicine & Orthopedic Surgery providing high-quality orthopedic care to the residents of Arlington and the greater Dallas Metro area since 2004.