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.
Why Considering Selling Now?
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 is pleased to announce the successful sale of the Duke LifePoint HOPD, a high-quality, on-campus facility located in Bryson City, North Carolina.
Jeff will advance facility performance through energy efficiency, renewable solutions, and data-driven strategies that lower operating costs, increase property valuations, and support long-term sustainability.
HREA is pleased to announce the successful sale of the Pocono Medical Outpatient Buildings, a multi-tenant medical office park strategically located directly across from Lehigh Valley Hospital – Pocono, a 249-bed acute care hospital featuring ten surgical suites and a 41-bed emergency department.
HREA is pleased to announce the successful sale of Pinnacle Medical Outpatient Building, a 100% leased, Class “A” multi-tenant medical outpatient facility located in Bend, Oregon’s premier healthcare corridor.
HREA is honored to have sponsored the Becker's 31st Annual Business & Operations of ASC Conference, a premier event bringing together leaders and innovators from across the healthcare industry.
HREA is pleased to announce the successful sale of the Atrium Health System Medical Outpatient Building, a Class A facility located in the Blakeney area of Charlotte, North Carolina.
HREA is proud to announce our participation in the 31st Annual Becker’s Business & Operations of ASCs Conference, taking place October 16–18, 2025, at the Swissotel in Chicago, IL.
HREA | Healthcare Real Estate Advisors was proud to be a sponsor and attend the PHA’s 2025 Leadership Summit, held in Santa Fe at the Eldorado Hotel and Resort.
Healthcare Real Estate Advisors Announces Sale of Action Behavior Centers Medical Outpatient Building in Southlake, Texas
Healthcare real estate (HCRE)—particularly medical outpatient buildings, ASCs and Surgical Hospitals continue to stand out as one of the most resilient sectors in commercial real estate at mid year 2025.
HREA | Healthcare Real Estate Advisors is pleased to announce the successful real estate sale of Clinton Park Health Park, a premier Class “A” medical outpatient building located in Clifton Park, NY.
HREA | Healthcare Real Estate Advisors is pleased to announce the sale of a 27,793 square foot outpatient healthcare portfolio in Southlake, Texas.
HREA | Healthcare Real Estate Advisors is pleased to announce the successful sale of two (2) single-specialty Medical Outpatient Buildings (MOBs) located in Kentucky.
Supporting the Future of Spine Care: HREA | Healthcare Real Estate Advisors Sponsors Becker’s Annual ASC Conference.
HREA | Healthcare Real Estate Advisors is pleased to announce the expansion of its team in Nashville, Tennessee, reinforcing the firm’s continued commitment to serving healthcare providers, physician groups, and investors nationwide.
The Levin HC team recently spoke with Chris Stai, Managing Director at HREA | Healthcare Real Estate Advisors, to discuss their latest transaction involving a Kansas Medical Outpatient Portfolio.
HREA | Healthcare Real Estate Advisors is pleased to announce the successful sale of the HCA College Park MOB Portfolio located in Overland Park.
We are pleased to announce the promotion of Ryan Michaels to Associate Director at HREA. This well-deserved advancement marks a significant milestone in Ryan's impressive five-year journey with our company.