Medical Offices and Urgent Care Centers Find Their Place in the Net Lease Market

The Net Lease Medical Sector is rapidly evolving. In the past it has been heavily dominated by dialysis companies like Fresenius and Davita Dialysis, but in recent times hospitals, healthcare systems, and urgent care centers have begun to create a commanding presence in the net lease market.

The emergence of medical offices as a popular single tenant net lease asset is due in large part to the Stark Law and Anti-Kickback Statute, which penalize hospitals for referring patients to a physician with whom they have a financial association other than payment for services. This includes rent payments from tenant physicians to hospitals.

As a result, hospitals have begun to build medical office buildings through developers and sale leaseback transactions. The structure of these arrangements shifts the hospital from the role of the landlord, to the role of the tenant. Hospitals are a more secure guarantor than individual practitioners, and they tend to sign long term leases of 15-20 year minimums.

These full service medical office buildings and urgent care facilities are prime investments for investors interested in single tenant net lease assets. Here are four reasons why.

1) Medical Offices and Urgent Care Facilities Offer Strong Tenant Retention

Capital improvements of $200 psf are common for medical tenants due to the high cost of equipment and trade fixture installation. The high cost of switching locations, leads tenants to sign long term 15-20 year leases and dictates they will remain in your facility for a long period of time. The lease is signed by one guarantor. However, there is usually a wide mix of tenant specialties, each supplying patients to another sector. This prohibits tenants from changing location.

2) Net Lease Properties in the Medical Sector have Higher Returns for Similar Levels of Risk

According to Calkain’s in-house research, the average STNL cap rate for 2016 was 6.25% excluding properties in the medical sector. The overall medical sector for STNL in 2016 came in higher at 6.83%. This spread has narrowed in 2017 due to the increase in demand for medical properties.

3) Medical Office Buildings and Urgent Care Centers Are Recession Proof

There is a high demand for healthcare services no matter the economic conditions. In fact, the operational strength of these facilities increases in hard times. According to the David Lawrence Center, in 2009 Urgent Care admissions increased by 47%, Adult Medical Services increased by 27% and Children’s Outpatient Services rose 90%.

4) Medical Sector Single Tenant Net Lease Properties Have Great Locations

The industry is still in its infancy, allowing for new operations to be developed in highly visible locations within prime real estate markets. Thereby reducing the re-tenant risk investors take on, should the tenant decided to opt out of their lease at the end of the 20 year term.

When the credit of the guarantor, location of the properties, long-term leases, stable cash flows, and higher returns are taken into account, it is easy to see why the net lease medical sector is currently one of the most attractive property types for single-tenant net lease investors. The outlook for the Medical Net Lease Sector is very bright over the next 10 years.

Thanks to our friends and contributors from Calkain for their insight into a look at the business side of medical offices and urgent care centers.

Lower Back Pain After A Car Accident

There are two injuries that are common in car accidents, whether it is a small rear-ending collision or something larger than that. Neck pain and back pain. One or both are a frequent symptom, and the injured party doesn’t always feel it right away as it often becomes worse after a few days.

The spine and back are made up of an intricate array of muscles, tendons, vertebrae, spinal cord, and discs, all of which take the full force of the impact when a car behind you collides with yours. The severity of the injury depends on the impact on the vehicle, whether a seat belt was worn, and if an airbag went off. Seatbelt and airbag safety features are designed to prevent further injuries to you. They do this by cushioning the blow and minimizing strain on your back.

Seeking Help

This is one of the reasons that it is important to see a medical professional right after an accident. Pain in the legs, numbness and general pain in the back that comes and goes are all symptoms of a back injury. Waiting to get help will not only slow your healing but also will affect the viability of your insurance claim.

There are many different injuries that may cause lower back pain which is why it’s important to determine their cause. To process an insurance claim, the company needs to know how the extent of your medical bills, if you will miss work, or if it’s debilitating enough that you can no longer work.

Some of the back problems that commonly occur after a car accident include:

  • Soft tissue tearing and bruising
  • Compression fractures
  • Herniated discs
  • Axial bursts
  • Dislocation or fractures

All of these have back pain as the main side effect, and the pain can range from mild to excruciating. Also, to diagnose these injuries, the doctors will need to perform tests which are often expensive. They may order any of the following types of diagnostic tests:

  • CAT/CT scans
  • X-rays
  • MRIs

These tests focus on different things, whether that’s soft tissue, bones and fractures, or cartilage damage.

Treatment

Treatment depends on the nature of the injury, whether you need surgery, medication, chiropractic visits or physical therapy appointments to help ease the pain and let your back heal. These can also get expensive but are included in the economic damages you may be able to recover from those responsible.

Who Pays For It?

The liability of the accident will determine who pays for it unless you live in a no-fault state. No-fault states require that you use your insurance company to cover damages to the car, medical bills, and any required medical visits in the future. However, if you live in a tort state, which makes up the majority of the states, then it would depend on the who is responsible for the accident.

It may be advisable to seek the legal advice of a car accident attorney Des Moines IA relies on who can provide guidance after a review of your case.


Thanks to our friends and contributors from Johnston | Martineau PLLP for their insight into car accident cases.

Office Workers Suffering From Lower Back Pain: Do You Have a Case?

A report by the Occupational Health and Safety Administration concludes that work related back injuries are the second most prevalent injury in the workplace. Common back injuries in the workplace include lower back strain, fractured vertebrae, pinched nerves, spinal cord damage, and herniated discs. Are you suffering from lower back pain caused by job related circumstances? You may be eligible to file a workers comp claim.

What are You Entitled To?

If your back injury is sustained at work, you can make a claim for worker’s compensation benefits. These benefits can pay for the costs of therapy and other medical bills, medications, out-of-pocket costs, and two thirds of your lost wages.

Filing a Claim For Workers Compensation

The process for claiming worker’s compensation starts when you report that you are having lower back pain to your employer. The initial report will be recorded on a form that they will provide you. You will be required to record specific details concerning the date, time, and the cause of the back injuries.

Medical Treatment

After you file your paperwork, you will be given a list of approved physicians you can consult for treatment. The physician you choose will be charged with evaluating you and referring you to specialists such as chiropractors and podiatrists. After your physician concludes that you have attained the level of maximum medical improvement, you will be approved to return to work.

Disability Level

Your doctor may diagnose your back injury as either:

  • Temporary partial disability- In this case, you are permitted to return to work after your recovery period is over.
  • Permanent partial disability- In this scenario, if you are physically unable to return to your position, your employer may be required to transfer you to a job that fits your disability. If there is no such position, you may be required to look for employment elsewhere. A workers comp attorney can advise you on your rights specific to the circumstances of your case.
  • Permanent total disability- In this case, you cannot go back to your former employment. For those workers diagnosed with a permanent total disability due to circumstances related to their job, it’s very important to get a Palm Beach County workers compensation attorney. This is because the amount of money you will lose from not working is likely to be substantial. In addition, you may be faced with significant medical costs. It’s not unusual for those suffering severe physical disabilities to be required to undergo a major home renovation. They may be unable to use the existing stairs, toilet, sink, shower, kitchen counters and cabinets, etc. without modifications. A lawyer can help you obtain a fair settlement to pay for these and other costs you incur due to your disability.

Lower back pain can have debilitating effects on a person’s ability to function in their daily life. It can also cause emotional pain and suffering. If the injury is severe enough it can force a person to leave their career that they have dedicated themselves to for years. If you are suffering from a serious work injury, consider contacting a workers comp attorney who can help protect your rights.


FKThanks to our friends and contributors from the Law Offices of Franks, Koenig & Neuwelt for their insight into back injuries and workers compensation claims.