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
To our valued clients, partners, and dear friends, may this holiday season bring you warmth, laughter, and joy. We wish you a New Year filled with endless possibilities and success.
As we look ahead to 2025, the healthcare real estate market is brimming with optimism, primarily fueled by lower interest rates that are driving valuations to new heights! This positive trend not only enhances the potential for lucrative investments but also signals a robust acquisition activity surge, presenting exciting opportunities for investors.
As we gather around the table this Thanksgiving, HREA extends our warmest wishes to you and your family. This season of gratitude reminds us of the importance of the strong relationships we have built within our healthcare community. We are sincerely thankful for your support.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a modern Class “A” medical office building located in Chapel Hill, NC. The single-tenant medical office building is 100% leased and occupied by UNC Physicians Network.
HREA | Healthcare Real Estate Advisors was proud to title sponsor and speak at this year’s PHA Leadership Summit in Naples, FL.
HREA | Healthcare Real Estate Advisors is honored to sponsor PHA's 2024 Leadership Summit, taking place at Ritz Carlton in Florida from September 21st to September 23rd, 2024.
Transaction volume within the healthcare real estate sector has experienced a significant “bounce-back” in 2024
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a micro-hospital located in a rapidly growing area in Phoenix, AZ, the capital and most populous city of Arizona.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a single-tenant net leased urgent care clinic located in Casper, WY. The state-of-the-art facility was fully renovated in 2022 and is 100% leased and occupied by BestMed Urgent Care.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of a newly built state-of-the-art outpatient surgery center and clinic that is well-located in Vestavia, Alabama, an affluent suburb of Birmingham, and a medical office building in Montgomery, Alabama.
HREA | Healthcare Real Estate Advisors is pleased to announce the real estate sale of three (3) free-standing medical office buildings that were specially designed and built to meet the needs of each of the specialty practice groups, including urgent care, neurology, orthopedics, physical therapy, and dentistry.
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.