Rahul Chhajed Profile picture
Jan 14, 2023 7 tweets 2 min read Read on X
Healthcare sale leasebacks are one of #CRE’s best kept secrets.

The upside potential is great, and achieving it is simple.

Best part, your tenant does all the work.

🧵
To understand this, let’s look at a couple trends in healthcare -

1) PE-backed groups are rapidly acquiring medical practices all over the country

2) Hospital system M&A activity hit an all-time high in 2022

Pretty much, hospitals and PE firms are on a buying spree!
However doctors aren’t the only ones gaining from their hard work…

Real estate investors are too!

When a doc group sells their practice, the RE owner gets what’s called a “credit enhancement.”
This is where the upside part comes in.

What was once a lease to a private practice, is now one to a PE-backed company or health system.

This is huge!
Why? Answer this.

What’s the difference in value b/w a corporate lease and mom & pop one?

125 bps? 150 bps?

That 15 year dental deal you bought at an 8 cap? Now its a 6.5 cap.
This is one of the strongest cases for buying healthcare RE.

Ride the consolidation wave.

Buy deals leased to well-performing dentists, veterinarians, surgeons, etc. that are prime for acquisition.

Sit on it and have your property value increase overnight.
Consider this the next time you’re in the market for a value-add deal.

But remember to please keep this between us! 🤫

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More from @RahulChhajedHRE

Oct 4, 2023
There’s a crisis in healthcare that nobody talks about. 🚨

It’s the severe lack of healthcare real estate development in the U.S.

But HRE may have a savior…

Retail developers. ⬇️
You’ve seen it…👀

Brand new urgent cares popping up in shopping centers.

Health systems backfilling and modernizing vacated department stores.

Fresh new dialysis clinics opening up right beside big-box retailers.
Providers are choosing to bring care to their patients.

This is for a variety of reasons:

- lower-cost settings vs. hospitals
- wider population access to care
- patient comfort + convenience

It turns out that great care isn’t enough on its own - location matters too! 📍
Read 10 tweets
Feb 6, 2023
Should you keep your rent low when you do a sale leaseback, or keep it high to maximize proceeds?

A short thread on the rent arbitrage between the real estate & OpCo 🧵
Most owner-operators we structure sale leasebacks for plan on eventually selling the OpCo, so rental rate matters.

The OpCo's valuation is usually a multiple on EBITDA, so it makes sense to keep rents low.

Right...?

Not always!
To understand why let's think in terms of multiples.

Take a medical practice that's valued at an 8x. Every $1 of lower EBITDA results in an $8 valuation loss.

Now take a sale leaseback priced at a 7 cap. That's ~14x. For every $1 in additional rent, you extract $14 from the RE.
Read 6 tweets
Feb 4, 2023
I’m 48 hours into a 72 hour (3 days) water-only fast.

Here’s why I’m doing it 👇🏽
1) Your body goes through autophagy, which means “self-eating” in Latin.

Think of it as a cellular clean-up, removing ruptured cells in the body.

There’s incredible research on its anti-aging effects and protection against neurological disease.
2) You enter a state of ketosis.

This is where your body starts depleting its fat reserves for energy, after it burns past its primary fuel source, glucose.
Read 5 tweets
Jan 30, 2023
In light of all the recent DMs asking for tips on investing in net-lease RE -

Here’s a crash course on “Net Lease 101” for anyone looking to get in the game… 🧵
The value of a net-leased deal is primarily influenced by the following:

1) Location
2) Lease Terms
3) Guaranty

In that order.

Always remember, you are buying the real estate. That is the dirt, and the improvements on that dirt.
If all fails, your last line of defense is the underlying real estate.

If your tenant leaves, will others want to be there?

What’s unique about the location, and what makes it desirable?

Is the deal located in a market your tenant will thrive in?
Read 10 tweets
Jan 21, 2023
There’s a crisis in healthcare that nobody talks about. 🚨

It’s the severe lack of healthcare real estate development in the U.S.

But HRE may have a savior…

Retail developers. ⬇️
You’ve seen it…👀

Brand new urgent cares popping up in shopping centers.

Health systems backfilling and modernizing vacated department stores.

Fresh new dialysis clinics opening up right beside big-box retailers.
Providers are choosing to bring care to their patients.

This is for a variety of reasons:

- lower-cost settings vs. hospitals
- wider population access to care
- patient comfort + convenience

It turns out that great care isn’t enough on its own - location matters too! 📍
Read 8 tweets

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