Real Estate

RSS Link

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

…
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

    • …
    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

    …
    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

    • …
    Continue Reading Weekly Hospital Real Estate Briefing

    Significant updates to the ALTA/NSPS Land Title Survey Standards will impact health care real estate transactions beginning February 23, 2026. The American Land Title Association (“ALTA”) and the National Society of Professional Surveyors (“NSPS”) have adopted updated Minimum Standard Detail Requirements for ALTA/NSPS Land Title Surveys (the “2026 Standards”), which take effect February 23, 2026, and replace the 2021 version. Although the fundamental purpose of an ALTA survey remains the same, the 2026 Standards introduce clarifications and new requirements…
    Continue Reading New 2026 ALTA/NSPS Survey Standards: What Developers and Counsel Should Know

    Preferred return and waterfall provisions are the backbone of economic alignment in the operating agreements that govern real estate joint ventures. These clauses dictate how distributions are made between investor members and sponsors or managers. Poor drafting can lead to confusion, misaligned incentives, disputes, and costly litigation, so understanding effective drafting techniques is crucial.
    Continue Reading Drafting Preferred Return and Other Waterfall Provisions in Real Estate
    Operating Agreements: Best Practices for Lawyers and Investors

  • Kaufman Hall published a summary of health system M&A data from 2025 with some interesting charts. A few highlights: (1) transactions involving a financially distressed party hit 43.5%, almost triple the rate in 2022; (2) correspondingly, the credit rating of the smaller party to the deal hit a record low in 2025; (3) the average size of the financially distressed party, in revenue, was $345M last year, which is about 2.5x larger than the same metric in 2023 (i.e.,

    • …
    Continue Reading Weekly Hospital Real Estate Briefing, Jan. 23, 2026

    Health care organizations planning major capital projects, such as hospital expansions, surgical centers and outpatient facilities, often face familiar frustrations: delays, cost overruns, redesign cycles and coordination breakdowns. Traditional delivery models like design‑bid‑build or construction manager‑at‑risk can unintentionally reinforce silos. Integrated Project Delivery Agreements (“IPDA”) offer a collaborative alternative designed to align incentives, reduce waste and improve project performance.
    What Is an IPDA?
    An IPDA is a single, multi‑party contract that binds the owner, architect, contractor and key consultants…
    Continue Reading From Silos to Synergy: Integrated Project Delivery Agreements for Today’s Health Care Facilities

    The health care transactional landscape may have been quieter than anticipated at the beginning of 2025, with providers experiencing financial strains, but the year finished out with a high level of activity, marked by opportunistic growth strategies. Transactions will continue to be anything but “cookie-cutter.” In this article, we highlight eight M&A trends demonstrating how the financial landscape, regulatory considerations, cross-disciplinary strategies and market disruptors shaped deals in 2025 and how these same factors will continue to impact deals…
    Continue Reading Bottom Line: Health Care Transactions Are More Bespoke Than Ever – Lessons Learned from 2025 and What’s to Come in 2026

    We frequently get calls from hospital systems, health care providers and investors regarding negotiating on-campus ground leases. They are certainly unique. Here are 10 business points to consider when negotiating on-campus ground leases.

  • Premises – The land being leased can vary widely. We often see hospitals ground leasing only the footprint of the building. There are some instances, on larger campuses, where the hospital allows the developer to lease the land needed for the footprint of the building, plus

    • …
    Continue Reading Weekly Hospital Real Estate Briefing: 10 Tips for Negotiating On-Campus Ground Leases

    We hope everyone enjoyed some time off over the holidays. As we reflect on 2025 and head into the new year, we spent some time mapping out our hospital real estate predictions for 2026. We believe it will be a mixed bag for hospitals and health systems around the country. Most hospital systems will face financial headwinds, which will result in cost-cutting measures. Those headwinds also create opportunities for strategic growth for those with strong balance sheets or in…
    Continue Reading Weekly Hospital Real Estate Briefing: Our 2026 Predictions

  • Revista published a pair of interesting blog posts: (1) the amount of general hospital space under construction in Q3 of 2025 has continued a multi-year climb that started in 2022; and (2) noting that the least expensive MOB rents (bottom 10th percentile) have grown at just 1.3%/yr since 2018, while moderately priced properties (50th percentile base rent) have grown at 1.7%/yr and the most expensive properties (90th percentile base rents) have grown 2.7%/yr over the same period.
  • At a

    • …
    Continue Reading Weekly HRE Briefing, Dec. 24, 2025

  • Fitch Ratings’ 2026 outlook for the nonprofit hospital sector was “neutral,” and forecasts median operating margins between 1-2%, while noting largely healthy volume trends and strong balance sheets. It expects a roughly equal number of ratings downgrades and upgrades among its portfolio, and noted that the industry is still investing in patient tower and brick-and-mortar facilities.
  • Come join our growing real estate team! Hall Render is seeking a 2-5 year attorney to join our Indianapolis office, which serves health

    • …
    Continue Reading Weekly Hospital Real Estate Briefing, Dec. 12, 2025

    In 2025, we worked on a number of significant land transactions where hospitals acquired land for new hospital campus projects. From our perspective, it seemed like an increase in land transactions when compared to previous years. Here are 10 observations based on our work on these transactions:

  • Arms Race – Hospital systems were aggressive in tying up land in growing markets. In terms of data, markets with high population growth were the primary targets. In states like Indiana, North

    • …
    Continue Reading Weekly Hospital Real Estate Briefing: Our Top 10 Hospital Campus Development Trends

  • According to a recent EY report commissioned by the AHA, nonprofit hospitals provide over $149B in annual community benefits, as compared with $13.2B in forgone federal income tax revenue. Even when factoring in state and local exemptions ($54B per year), community benefits were three times higher than total forgone taxes. The largest share of benefits is patient financial assistance and unreimbursed costs from government payors, valued at $65B.
  • Leaders at a recent Becker’s panel noted that cardiology is becoming

    • …
    Continue Reading Weekly Hospital Real Estate Briefing, Nov. 26, 2025