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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 night;
  • The opportunities generating the most optimism;
  • The legal, regulatory and business trends likely to affect organizations in 2027; and
  • The topics on which you

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Continue Reading Weekly Hospital Real Estate Briefing: Share Your Perspective with our Hospital Real Estate Survey

  • 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 of the state’s rural population.
  • Revista reported that U.S. MOB inventory has grown about 10.6% since 2019, while ambulatory health care employment has grown 21.2%.

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    Continue Reading Weekly Hospital Real Estate Briefing: Spotlight on Regional Rural Hospital Networks Cooperating to Remain Independent | MOB Inventory Tightening

    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 financing. Regardless of the name, it’s a unique way for hospitals to tap into long-term, low-cost financing based on the hospital’s credit profile. This type

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    Continue Reading Weekly Hospital Real Estate Briefing: What Hospitals Need to Know About Credit Tenant Lease Financing

    Summer is in full swing across Wisconsin. Lakefront and riverfront property owners have their piers in, boats are on the water, and families are making the most of the season. It is also the time of year when disputes between neighbors begin to surface, most often over where a pier may be placed, and how each owner is permitted to access the water.

    While the basic concept of riparian rights has not changed, recent developments make one thing increasingly…
    Continue Reading What Are Riparian Rights and Why Are They Important? (2026 Update)

    Timeshares are not for everyone.

    Many people appreciate the regularity of knowing they have a block of time reserved to vacation in a specific resort each year. However, preferences change, the ability to utilize the timeshare may not be as initially advertised, and annual resort fees and maintenance costs often increase each year.

    Owners often conclude the time has come to divest themselves from their timeshare interest and find themselves stuck in a contract of indefinite length.

    For…
    Continue Reading Wisconsin Victory Highlights Legal Tools to Fight Timeshare Exit Scams

    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 that may weaken their finances, shift disproportionate value to private-sector investors or jeopardize access to essential services by saddling providers with long-term lease obligations.

    As…
    Continue Reading Weekly Hospital Real Estate Briefing: A Flurry of Legislation Restricting Hospital Real Estate Transactions – What You Need to Know

    New house building at the construction site.
    New house under construction, front view from garage door entry with clouds blue sky. Framing of home exterior structure with a pile of lumber and siding plank leftover. Real estate business industry.

    In the world of real estate, what lies beneath the surface can be just as important as what stands above it.

    Buyers frequently focus their commercial real estate due diligence on topics including structural integrity, environmental factors, title and survey, zoning, and financing. However, there is one critical issue that is frequently overlooked: the condition of underground sewer and drain systems.

    Sewer and drain systems are essential infrastructure for any building, whether that be industrial, retail, office, or multifamily…
    Continue Reading Real Estate Due Diligence: Sewer Inspection Risks and Buyer Protections

  • 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 office space is increasingly difficult for health care tenants to secure, with competition intensifying in many markets as demand shifts toward suburban markets. The supply

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    Continue Reading Weekly Hospital Real Estate Briefing: $300M Novant Campus | Baystate/Mercy Announce Transaction | Growing Sale-Leaseback Restrictions

    In 2025, the FBI received more than 12,000 complaints of real estate fraud, resulting in over $275 million in losses. Wisconsin property owners are not immune, as industry professionals have reported a sharp increase in seller impersonation fraud. The consequences of deed theft are dire and can take months or years to unravel.

    While deed theft has existed for decades, advances in technology, remote closings, online public records, and identity theft have made these schemes easier to execute and…
    Continue Reading Deed Theft in Wisconsin: What Property Owners Need to Know

    If you’ve been watching the real estate news over the past two years, you have probably noticed an increase in senior housing transactions. A number of the health care real estate investment trusts (“REITs”) and specialty REITs that have historically focused on nursing homes have pivoted to investing in senior housing communities that offer independent living, assisted living and memory care services. It seems like the major real estate investors can’t get enough of senior housing.

    We’ve seen it…
    Continue Reading Weekly Hospital Real Estate Briefing: 5 Reasons Why Hospital Systems Should Consider a Senior Housing Partnership

  • Two legislative bills in the Tennessee General Assembly could change the hospital and health care landscape in the state. The first bill would remove the Certificate of Public Advantage given to Ballad Health, a 20-hospital system in the state, which receives certain protections. The other bill would repeal the state’s Certificate of Need (CON) law. Both bills are designed to increase competition in the state.
  • A new report from CBRE indicates that new ambulatory surgery center lease transactions were

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    Continue Reading Weekly Hospital Real Estate Briefing: TN Considers CON Reform | Children’s Hospitals Make Headlines | ASC Leasing Activity Increases 145% | New Free-Standing ED Projects in FL and VA

    All-terrain vehicles (ATVs) and utility terrain vehicles (UTVs) are popular across Wisconsin for recreation and work. Livestock similarly plays a vital role in the livelihood of many families as well as having a recreational purpose.

    ATVs, UTVs, horses, and other livestock must often travel along or across roadways in many Wisconsin regions. It is important to be aware of the specific laws that govern operating ATVs, UTVs, or horse-drawn vehicles on public roads as operators can receive citations or

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    Continue Reading ATVs, UTVs, and Livestock on Wisconsin Roads

    For years, we’ve heard that outpatient services and home care are the future of health care in the U.S. To a certain extent, that’s true. We’ve seen tremendous growth in outpatient care across the country. Procedures that were once provided in inpatient settings are now provided in ambulatory surgery centers and physician offices. Payers, providers and patients are all pushing for care that can be provided at a lower cost, in a more convenient setting and in a manner…
    Continue Reading Weekly Hospital Real Estate Briefing: Understanding the Hub and Spoke Model

  • The Centurion Foundation has financially stabilized Roger Williams Medical Center and Our Lady of Fatima Hospital in Rhode Island and returned them to local nonprofit management through a bond-financed recapitalization exceeding $100M. The hospitals had been at risk of closure after their prior owner, Prospect Medical Holdings, filed for Chapter 11 bankruptcy in 2025.
  • U.S. Senators Jerry Moran and Michael Bennet introduced the Rural Hospital Revitalization Act, which would allow eligible rural hospitals to apply for five-year, interest-free loans

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    Continue Reading Weekly Hospital Real Estate Briefing: VA Approves $672M in New Hospital Projects | Rural Funding Bill Introduced | Centurion Closes RI Hospital Deal

    If you’re a homeowner in Illinois, especially in areas like Lake County, there’s an important warning you shouldn’t ignore: the property deed scam Illinois residents are receiving by mail is back—and it’s targeting unsuspecting homeowners with official-looking notices.
    These solicitations can be confusing, and even savvy professionals have been caught off guard. As part of smart estate planning, protecting your assets doesn’t stop with legal documents—it also means staying alert to scams that try to exploit public records.

    What

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    Continue Reading Property Deed Scam Alert: What Illinois Homeowners Need to Know

  • New federal law will require hospitals to obtain separate NPIs and submit provider‑based attestations for off‑campus hospital outpatient departments (“HOPDs”) as a condition of Medicare payment starting in 2028. The changes remove prior flexibility for HOPDs by stiffening ownership, compliance and structuring requirements for these facilities.
  • Echoing other recent reports, a recent VMG Healthcare M&A Report found that overall health care M&A deal volume in 2025 remained below pre‑pandemic levels, while total deal value rebounded due to larger, strategic

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    Continue Reading Weekly Hospital Real Estate Briefing