Healthcare Real Estate
Healthcare real estate has evolved into an asset class of its own as healthcare reform continues the ever-increasing demand for better service and lower costs. Healthcare reform is changing not only the nature of healthcare but the landscape in which it takes place. Real estate professionals in the healthcare industry face unique issues, most notably the complex and constantly changing federal and state regulatory schemes. Such regulatory issues, along with religious and ethical considerations, can infiltrate even the simplest of transactions, requiring the guidance of counsel not only skilled in real estate transactions but experienced in the healthcare industry as well.
With one of the state’s premier Healthcare practice groups and the largest Real Estate practice group in Texas, Jackson Walker is uniquely situated when it comes to providing superb legal counsel and advice to healthcare clients in their real estate transactions. Our attorneys are at the forefront of crafting innovative and cost-effective solutions for clients involved in healthcare real estate. We represent clients engaged in every form of real estate transaction involving all sizes of healthcare properties from a single dentist’s office to multibillion-dollar hospital campuses. Our real estate attorneys call on seasoned professionals in our Healthcare, Corporate & Securities, and Tax groups to ensure clients successfully navigate the unique regulatory constraints, business considerations, and tax implications involved in healthcare real estate transactions.
- Represented a Texas Hospital District in the sale of its acute care hospital and related facilities to a national for-profit hospital company with requirements for the company to build the community a new state-of-the-art hospital facility and provide on-going indigent care at specified levels.
- Represented a Texas Hospital Authority to monetize some of its real property by public bid to ground lease it medical office buildings and have the operator agree to update current facilities and develop new additional medical office building and parking garage.
- Represented a national hospital system in the development of a new medical office building for one of its urban campuses.
- Represented a non-profit hospital system in the acquisition of an acute care hospital from a national for-profit hospital company.
- Represented a religious healthcare system in the development of its healthcare campuses across Texas in leasing entire hospital facilities, multiple ground leases to developers for its medical office buildings, and acquisition of land parcels for development of new healthcare campuses and the client’s corporate headquarters.
- Represented the developer of a 72,000 square foot LEED certified medical office building, including site acquisition, land use, private offering documentation, construction, financing and leasing.
- Represented a major San Antonio medical group in the acquisition and assumption of eight medical office building leases.
- Represented a purchaser in the acquisition of a 170-unit retirement and assisted living care facility, and in the acquisition and assumption of 121 existing Residence Agreements.
- Represented a physician group in its purchase of a site at the San Antonio Medical Center; the construction of a 125,000 square foot medical office building and adjacent parking garage; and subsequent leasing of space in the medical office building to other medical service providers.
- Represented San Antonio master-planned, mixed use development in sales of hospital and medical office building sites to healthcare systems.
- Represented a large multi-specialty medical group in Houston in the assumption of 18 practice locations, with related parking agreements, in medical office buildings and hospitals.
- Represented a major non-profit, tax exempt healthcare provider in negotiating a long-term hospital lease with building owner for the client’s development of a short-stay surgical hospital.
- Represented a physician partnership in connection with client’s acquisition of a shell office building and conversion of the building into a surgical hospital facility.
- Represented a medical office developer in the successful appeal and reduction of property taxes on three MOBs on a hospital campus.
- Represented a non-profit, tax-exempt healthcare provider in obtaining property tax exemption on the client’s park adjacent to a healthcare campus and in obtaining reinstatement of a tax exemption on a research lab facility and related parking area.
- Represented a senior living facility in the successful appeal and reduction of property taxes on the client’s healthcare campus.
- Represented a hospital authority in ground leasing and monetizing it medical office buildings and obtaining public bids for construction of an additional new medical office tower and parking complex on its main campus.
- Represented a major non-profit, tax exempt healthcare provider in seven transactions involving the ground leasing of acreage for the development of medical office buildings.
- Represented a national for-profit hospital company in its medical office building development agreements, master leases, and physician leases and subleases.
- Represented a national for-profit hospital company in its development and construction agreements with a real estate development company for the construction of a multi-story medical office facility and its subsequent lease to a large physician clinic.
- Represented a Texas non-profit specialty hospital in the acquisition of over 40 acres via purchase and gift for the development of the hospital’s new west Houston hospital campus.
- Represented a for-profit hospital company in the long term master lease of its entire hospital facility to a non-profit hospital system for operation of the hospital.
- Represented a non-profit specialty hospital in its development and build-to-suit construction agreements with for-profit developers and contractors for the development of several of its satellite health centers for sub-specialty medical services.
- Represented a healthcare company in a construction controversy with a general contractor for a new healthcare facility.
April 18, 2017
In its first-ever Global 200 Real Estate report, The Lawyer has ranked Jackson Walker among the top global real estate firms.
- Representation on all aspects of both small and large-scale mergers and asset acquisition and disposition
- Purchase, sale, construction, financing, and development of medical office buildings, hospitals, and other healthcare facilities
- Solutions to decreasing reimbursements including advice regarding monetization of assets and design of creative entity and joint venture structures that permit development with limited capital
- Due diligence review including detection and resolution of issues related to title, site neutrality, surveys and property condition reports, and environmental reports
- Termination and/or creation of appropriate easements, covenants, and restrictions as needed
- Guidance on land use issues, including zoning, permits, and environmental issues
- Real estate financing, equity syndicates, investment partnerships, and other creative financing solutions
- Issue resolution and support for lender requirements, as well as negotiation and documentation of loans
- Healthcare real estate contract drafting, review, and negotiation, including purchase and sale agreements, leases, options, easements, and construction contracts
- Legal counsel on compliance and licensing issues related to insurance and reimbursement requirements
- Individualized advice for healthcare professionals on office space options, including creative arrangements for office space investment such as net-leased sales, ground leases, office condominiums, timeshare arrangements, and other third party financed transactions
- Exchange agreements and sale/leaseback transactions
- Lease negotiations and drafting for both Landlords and Tenants in transactions involving individual offices, MOBs, hospitals, clinics, ambulatory facilities, and medical labs
- Negotiation and drafting of lease terms including rights of first refusal, premises liability, options to renew, options to purchase, use restrictions, defaults and remedies, termination, insurance requirements, and indemnification
- Experienced counsel on lease issues unique to the health care industry including electricity capacity, hazardous waste, after-hours access, and accessibility
- Advice on structuring, organization, licensing, and operation of ambulatory facilities including repurposing plans for big box conversions
- Design and implementation of physician-hospital ventures, including the syndication of interests and financing for ventures
- Guidance on state and local regulations
- Advice regarding choice of entity, and subsequent negotiation and drafting of Joint venture agreements, corporate structuring, partnerships, and third-party arrangements
- Management of acquisitions and sales of medical practices and shareholder interests and/or physician partnership interests
- Negotiation and drafting of provider-based hospital contracts
- Advice regarding physician practice issues including physician-hospital relationships and development of ancillary services
- Property management including medical office buildings (MOBs)and other healthcare facilities
- Resolution of real estate disputes
- Ground up development and facility expansions for hospitals and health care campuses
- Counsel regarding the structuring of hospital campus transactions, including control issues, monetization structures, and physician alignment strategies
- Analysis of real estate transactions to ensure compliance with ethical and moral or religious directives of non-profit health care entities
- Advice on all tax issues related to both tax exempt and for-profit healthcare real estate transactions
- Representation regarding destressed health care facilities including bankruptcy, reorganization, loan restructuring, and other creative solutions