Daniel Mazure’s Post

Friends – On behalf of Joel Swider and myself, below is our weekly health care real estate briefing:   1. AdventHealth has entered into an agreement to acquire two hospitals in Florida from Community Health Systems for $265M in cash. The hospitals include Shorepoint Health Port Charlotte and Shorepoint Health Punta Gorda. 2. Broward Health and Nicklaus Children's Health System have entered into an affiliation agreement to expand pediatric services in Broward County, FL. 3. CBRE released its 2025 Health Care Real Estate Outlook. Key takeaways: 1) the average NNN MOB asking rate is $24.86/sf; 2) the average MOB cap rate is 6.9%; 3) the average sale price is $291/sf; 4) 80% of new MOBs are being developed further from hospital campuses and closer to residential and retail areas; and 5) the top markets for new construction include NYC, Washington, D.C. and Dallas. 4. Helios Healthcare Advisors issued a Senior Housing Market Trends Report. Key takeaways: 1) developers are planning new senior housing projects after several years of slow construction starts; 2) AL providers are acquiring hospice companies to bring the expertise in-house; and 3) families are negotiating rental rates with senior housing operators by pitting communities against one another. 5. Hall Render Advisory Services is gathering market research on hospital-sponsored mixed-use development projects involving hotels, apartments and retail space. Contact John Marshall if your health system has worked on such a project. 6. A new hospital proposed for West Maui (HI) has stalled after the Maui County Council decided not to vote on the project. The hospital is expected to cost between $120M to $140M. The county is being asked to approve and guarantee a revenue bond for a portion of the project cost. 7. The San Jose (CA) City Council voted last week to approve a $1.2B expansion of HCA’s Good Samaritan Hospital. The process of securing local approvals has made headlines as local officials questioned HCA’s business practices. 8. Kaiser has been making moves to acquire and build ambulatory surgery centers (ASCs) and MOBs. Kaiser announced or executed the following projects during the last 24 months: 1) new ASC and MOB on its West Los Angeles Campus; 2) acquired an ASC in Lancaster, CA from SCA Health; 3) new five-story MOB in Sacramento, CA; 4) acquired a 223K sf MOB in Santa Clara, CA; and 5) acquired a 507K sf MOB in Washington, D.C. 9. Voters in San Benito (CA) approved the sale of troubled Hazel Hawkins Hospital to Insight Foundation of America, a nonprofit corporation. Insight recently took over operations of two Steward hospitals in Dallas and two hospitals in Ohio. 10. Regional Health Properties, a publicly traded health care REIT, plans to appeal the New York Stock Exchange’s plan to delist the company from its NYSE American exchange. The company was notified last year that it did not comply with NYSE listing standards regarding sufficient shareholder equity.

Friends – On behalf of Joel Swider and myself, below is our weekly health care real estate briefing:   1. The HHS OIG recently published nearly $2M in self-disclosure settlements with medical providers that involved real estate arrangements. The most common issues involved rental rates that were outside of fair market value or a failure to timely bill and collect for operating expenses and other services being provided by landlords to tenants. 2. A former hospital in St. Petersburg, FL will be turned into 71 affordable housing units for low-income seniors. The development will also have health care services available on-site. 3. Massachusetts Gov. Maura Healey negotiated preliminary agreements to keep six of the eight Steward hospitals in Massachusetts open under new operators. Part of the plan involves the state seizing control of the real estate of one of the hospitals under powers of eminent domain. 4. Health systems that invest in affordable community housing see “significant” decreases in inpatient and emergency department visits among patients experiencing homelessness, according to a recent report. In 2023, nearly 25 health systems reported investing more than $550M in affordable housing projects. 5. A Mississippi legislative committee recently held discussions to consider abolishing the state’s CON law. Last year, over two dozen bills were introduced seeking to modify the state’s CON in some way. Currently, 35 states have CON programs, while 12 states had CON laws and later repealed them. 6. Sonida Senior Living is under contract to purchase a portfolio comprised of eight assets and 555 units in northern Florida and South Carolina for $103M. The company owns 70 senior housing communities in 20 states and serves as operator of another 13 communities. 7. A recent change to Georgia’s CON law will pave the way for a rural emergency hospital in Cuthbert, GA to reopen after shuttering four years ago due to heavy operating losses. While some state appropriations have been set aside for the reopening, critics say the facility will still face the same economic headwinds that led to its prior closing. 8. The CEO of post-acute focused Sabra Health Care REIT said investments in behavioral health facilities can hit a break-even point with just 50%-60% occupancy, making it a compelling business opportunity. However, these facilities tend to have shorter lengths of stay, making such investments less predictable. 9. Santa Clara (CA) Valley Health will purchase a 258-bed hospital from HCA for $175M. The east San Jose facility covers about a quarter of the county’s total trauma cases. HCA said it has invested more than $500M in the facility over the past 25 years. 10. Lee Health started construction on a replacement facility for Lee Memorial Hospital in Fort Myers, FL, which is expected to have 170 beds and open in 2027. The building is designed to withstand 174-mile-per-hour winds and will have 100% power backup capabilities.

The role of a manager or in-charge of an old age home is one of immense responsibility and compassion. The way they manage the home and interact with the elderly can greatly impact the quality of life for the residents. Here are 15 examples of how a manager or in-charge should conduct themselves to create a caring and supportive environment: 1. Kind and Compassionate: Treat every resident with kindness and empathy. Understand their emotions and be there to support them in their times of need. 2. Respectful Attitude: Always speak to the elderly with respect, acknowledging their life experiences and the dignity they deserve, regardless of their physical or mental state. 3. Patience: Elderly residents may take more time to express themselves or complete tasks. Patience is key to ensuring they feel valued and understood. 4. Daily Care: Ensure that the physical and emotional needs of every resident are met through consistent attention, personal care, and routine health monitoring. 5. Focus on Health: Prioritize the health of residents by providing regular medical checkups, timely medication, and encouraging a healthy lifestyle through proper diet and exercise. 6. Clear Communication: Always communicate in a clear and straightforward manner, making sure that residents understand important information and feel comfortable asking questions. 7. Creating Peace: Strive to maintain a peaceful and stress-free environment, helping residents feel at home and relaxed in their surroundings. 8. Family-like Atmosphere: Foster a family-like atmosphere within the home, encouraging connections between staff and residents so that no one feels isolated. 9. Problem-Solving Skills: Resolve conflicts or issues quickly and peacefully, ensuring that any problems that arise are handled with care and fairness. 10. Nutritious Meals: Ensure that residents are provided with healthy, balanced, and nutritious meals that suit their dietary needs and preferences. 11. Organizing Social Activities: Keep residents engaged and mentally active by organizing social, recreational, or cultural activities that they can enjoy together. 12. Maintaining Connections: Help residents stay connected with their families and loved ones by facilitating communication through phone calls, video chats, or even in-person visits when possible. 13. Effective Management: Ensure the smooth running of the old age home by managing staff, resources, and daily operations efficiently, ensuring that all aspects of the facility are well-maintained. 14. Encourage Participation: Encourage residents to engage in activities that align with their interests and abilities, such as arts, music, reading, or even gardening, so they can continue to feel purposeful and fulfilled. By embodying these behaviors and principles, a manager or in-charge of an old age home can create a nurturing, respectful, and supportive environment where elderly residents feel cared for, safe, and valued. Yameen

📈 **UK Care Home Occupancy Highest Since 2019** We have some positive news for the elderly-care sector! Recent findings from Knight Frank's 2024 Healthcare Trading Performance Report reveal that UK private care home occupancy has surged to 88%, the highest level since 2019. This impressive figure marks a complete recovery from the pandemic-induced dip, highlighting the sector's resilience and the increasing demand from an ageing population. The study showed that London saw a 14% increase in yearly fees, with the Northeast representing the largest proportion of self-funded care residents at 60%. Remarkably, Northern Ireland experienced the greatest year-on-year growth in occupancy, up by 6.4%, followed by Wales with a 5% rise. These statistics illustrate that the demand for quality care homes is high across the entire UK. With weekly care home fees up 11% year-on-year to £1,182, the financial health of the sector shows incredible promise. Earnings have also risen significantly, with EBITDARM increasing by 26% in 2024. This upward trend is a testament to the sector's adaptability and essential role in society. For us at Stephen James Consulting, this reinforces the importance of expert recruitment in ensuring our clients and candidates thrive in this evolving landscape. What are your thoughts on the rising demand for care homes? We'd love to hear from you. Visit https://lnkd.in/dDU33H6 to find out how we can support your recruitment needs. #CareHomes #ElderlyCare #UKHealthcare

📈 **UK Care Home Occupancy Highest Since 2019** We have some positive news for the elderly-care sector! Recent findings from Knight Frank's 2024 Healthcare Trading Performance Report reveal that UK private care home occupancy has surged to 88%, the highest level since 2019. This impressive figure marks a complete recovery from the pandemic-induced dip, highlighting the sector's resilience and the increasing demand from an ageing population. The study showed that London saw a 14% increase in yearly fees, with the Northeast representing the largest proportion of self-funded care residents at 60%. Remarkably, Northern Ireland experienced the greatest year-on-year growth in occupancy, up by 6.4%, followed by Wales with a 5% rise. These statistics illustrate that the demand for quality care homes is high across the entire UK. With weekly care home fees up 11% year-on-year to £1,182, the financial health of the sector shows incredible promise. Earnings have also risen significantly, with EBITDARM increasing by 26% in 2024. This upward trend is a testament to the sector's adaptability and essential role in society. For us at Stephen James Consulting, this reinforces the importance of expert recruitment in ensuring our clients and candidates thrive in this evolving landscape. What are your thoughts on the rising demand for care homes? We'd love to hear from you. Visit https://lnkd.in/eEcUYpP8 to find out how we can support your recruitment needs. #CareHomes #ElderlyCare #UKHealthcare

Working in the public sector over the past 11 years has never been easy for me. Some days, the challenges seem to outweigh the opportunities to make a meaningful impact. But it’s real estate projects like this one that remind me why I continue to challenge myself in public service every day. Today, the Miami Dade County Board of County Commissioners unanimously approved a ground lease for the construction of a large scale mixed use development project on Jackson Memorial Hospital campus that will include 800+ apartments, the majority of which will be affordable for those making between 50-80% of the Area Median income; a hotel; a childcare center; Metrorail station improvements; numerous community spaces; and much more. The critical need for affordable housing for healthcare workers has been well documented. Many of these individuals come to work every day to care for the sickest and most vulnerable patients while struggling to afford a dignified place to live in the very same communities that they serve. This real estate development project is a giant step toward a sustainable solution. Not only is this development the first project of its kind in Jackson’s 106+ year history, but it’s easily the most impactful response to the current housing crisis of any healthcare system in the United States. Projects like these don’t happen without leaders who have the vision to dream beyond what has been done in the past and the courage to pursue it. At Jackson, I’m incredibly fortunate to work for some of the absolute best healthcare leaders in the world. To Jackson’s caregivers, frontline workers, and support staff, thank you so much for everything you do. You deserve this (and more) and I very much look forward to seeing the impact that this project, and other transformative real estate projects like it, will have in combating Miami’s housing affordability crisis and improving the overall quality of life for our healthcare heros. #miamirealestate, #affordablehousing, #workforcehousing, #realestate, #realestatedevelopment, #healthcarerealestate, #publicprivatepartnerships, #p3, #livelocalact https://lnkd.in/gw-rNBY7

Such an important topic 👏 So many people are misinformed about life within a care home. Take a look at the link below to find out how Care Homes can improve the lives of residents. 💗 #Improvinglives #Vacancies #Keepingfit #Local #Residentialproperty

The Critical Intersection of Housing, Health, and Wellbeing In a compelling recent article by UCL (https://lnkd.in/eQDVHBPN), experts argue that health and wellbeing must be central to housing strategy to not only enhance lives but also save them. This underscores the undeniable link between the quality of housing and the health outcomes, advocating for a holistic approach that prioritises these aspects in housing development and policy. Maybe history can offer us direction here - when the NHS was established, Nye Bevan held the dual roles of Minister of Health and Housing... #HousingPolicy #PublicHealth #Wellbeing #UrbanPlanning #SustainableDevelopment

Having spent a good few years now advising businesses in the Children's Residential Care Sector, recently completing an acquisition for CFS Care, we have yet again seen ‘noise’ from the UK Government around excessive profits being made by private sector children’s residential care providers. Let’s consider the backdrop - There is a growing number of young people entering the care system. The removal of unregulated providers being a very sensible policy, but nonetheless further exacerbates a 'supply' problem. A pure supply / demand equation therefore means demand is outstripping supply in the sector - stats from providers are unequivocal on this. Against this backdrop the government has announced they want to interfere with market dynamics by: ·      Introducing greater public sector provision; and ·      Limit the profitability of private sector providers. The first option will take years to make any inroads after a policy of relying on the private sector, given public sector provision was deemed to deliver lower value for money (against all metrics, including quality) many years ago. How this policy will be delivered in the current labour market remains to be seen. The second option has a range of impacts, I only suggest two below (to avoid this post being excessively long!): ·      Where is the desire to be efficient and innovate? A business with a more efficient operating model has no greater value to a business owner than an inefficient business where profits are limited. The flow of capital to the sector (to satisfy demand) will cease where there is a risk of government interference and profit limitation - leading to lower supply levels. ·      A new children’s residential care home (assume 2 - 4 registered bed model), with start-up costs requires an investment of c.£500,000. If profits are limited to the stated ONS figures of 8.8% to be able to invest in ONE new care home per year, revenues would need to be >£8m per annum. This would mean only the larger national providers would have the ability to grow, consolidate the market, reduce competition and (ultimately) quality. Surely the right approach would be to better regulate (and remove) poor quality providers than penalise those businesses that are well run, investing their profits in creating more (well run) homes to satisfy demand, delivering good (or outstanding) outcomes for the young people they care for? Ultimately, the focus should be on reducing the demand requirements at source (rather than dealing with the resultant issue), but that is a much wider discussion. We see and act for fantastic providers of children’s services and rhetoric around excessive profits in what is a challenging sector is unhelpful, will create uncertainty and likely exacerbate the demand / supply problem in the near term as providers of capital remain uncertain on the UK Government’s stance and potential intervention policies. 

Good insights here from recent Australian research on how home modifications can be tailored for current and future needs of people occupying their homes while navigating MS. Although homes can be modified to enhance accessibility and usability for people with MS, their suitability may change over time. MS Australia is a strong advocate, calling for improved housing and living supports that meet individual needs an more timely access to home modifications and supported accommodation. I particularly resonate with one point that we see a lot in our work here at Inclusive OT - independence means different things to different people, and starting with the individual's goals is absolutely key. #MS #homemodifications #housingexperience