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MOBs Continue To See Demand As They Adapt To Market Changes

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The medical office building (MOB) sector continues to be favored by investors as a stable asset despite real estate challenges and disruptions brought on by the pandemic, according to JLL’s (Chicago) new “Healthcare and Medical Office Perspective.”

The recent report explores key themes impacting U.S. healthcare systems and medical office owners, including labor challenges, payor and reimbursement pressures, elevated costs, and industry disruptions

“Facilities offer both risks and opportunities to healthcare providers, and, despite the challenges, the critical nature of healthcare and large tailwinds from a growing and aging population continue to make healthcare real estate one of the most stable asset classes for investors,” Jay Johnson, National Practice Leader, Healthcare Markets, JLL, said in a press release.

Specifically, medical office occupancy is relatively stronger than the commercial office sector and was significantly less disrupted by pandemic. Medical office asking rents averaged 2 percent growth year over year for the past five years and reached an average $23 per square foot triple net by mid-year 2022, reports JLL.

Medical office sales reached $9.2 billion in the first half of 2022 after a record performance and investor interest in 2021. JLL anticipates 2022 to close at another record year. The strong demand for healthcare services and the continued shift to outpatient care is expected to assure healthy investor appetite for MOBs.

 

Source: healthcare design

Allianz Lends $234M For MOB Portfolio Acquisition

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In a $620.4 million deal, Nuveen Real Estate and NexCore have acquired a coast-to-coast portfolio of health-care and life science properties encompassing nearly 1.2 million square feet. The seller was IRA Capital.

The majority of the portfolio is a diversified group of 27 health-care assets that traded for $463 million. The portfolio encompasses properties in multiple states: Arizona, California, Florida, Illinois, Michigan, North Carolina, New Jersey, New York, Pennsylvania, Texas and Wisconsin.

Totaling nearly 750,000 square feet, the properties range from medical office buildings, micro-hospitals and ambulatory surgery facilities to cancer treatment centers. NexCore Group joined Nuveen Real Estate in underwriting the deal and will manage the assets.

The health-care portion of the transaction was led by Nuveen Real Estate’s new U.S. Cities Office Fund and brings the value of the firm’s holdings in the sector to more than $1 billion. Andrew Pike, head of health-care, cited the firm’s plans for aggressive growth in the sector.

Allianz Real Estate provided a $234 million loan toward the medical office acquisition. The loan will provide 51 percent of the total acquisition price, and the sponsors will have $228.9 million of equity in the transaction. The deal is structured on a seven-year term with a fixed-rate tranche of $163.8 million (70 percent) and a floating-rate tranche of $70.2 million (30 percent).

The portfolio is 99 percent occupied by 38 tenants, of which 92 percent are investment-grade credit healthcare systems. The portfolio rent roll has a weighted average unexpired lease term of 12 years, providing for a reasonable lease rollover profile during the loan term, according to Allianz.

Twenty of the 27 properties are in Certificate of Need (CON) states, where local governments require an extensive approval process to demonstrate a need for new healthcare facilities, providing high barriers to entry and regulatory restrictions around new supply.

Medical Sector Recovers

In a prepared statement, Mike Cale, co-head of U.S. Debt, Allianz Real Estate, U.S., said:  “The pandemic has emphasized the need for improved access to health-care. That trend has been illustrated by the demand for both outpatient facilities and hospital space for acute care. The medical office sector represents a unique, resilient asset class.”

This transaction marks Allianz’s second U.S. debt deal with Nuveen Real Estate, following Allianz’s $94 million financing of a six-property industrial portfolio for Nuveen’s U.S. Cities Industrial Fund in 2020.

The lack of demand for routine care and limitations on elective procedures, both in response to the COVID-19 pandemic, contributed to a 6.4 percent loss in health care employment in 2020, according to an April report from CBRE. That loss, however, was much less than in the overall economy, and health care jobs are rebounding rapidly.

Medical office buildings showed similar resilience, with annual investment volume falling by just 12.7 percent, the smallest decline for any major product category. Meanwhile, medical office property sales volume jumped in the fourth quarter of 2020, as cap rates continued a decade-long decrease.

Also part of the deal is the $157 million acquisition of two life science properties in Madison, Wis., and Orange County, Calif. Fully leased to three tenants, the assets comprise 420,000 square feet and will add to Nuveen’s 4 million-square-foot life science portfolio. The properties were acquired via TIAA’s balance sheet, according to Nuveen Real Estate.

Since November 2020, Nuveen and NexCore have teamed up on transactions valued at $687 million, noted Todd Varney, NexCore’s chief development officer & managing partner. The assets include 34 buildings totaling 1.4 million square feet, along with 200,000 square feet in development.

 

Source: Commercial Property Executive

Report: MOB Sector Boosted By Demand And Capital

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The medical office sector was firing on all cylinders before the arrival of COVID-19, and it appears to be well-positioned for a robust rebound post-pandemic, according to a special report by Marcus & Millichap.

In the third quarter forecast titled Beyond the Health Crisis: National Medical Office Outlook, the company notes that the adaptation of patient care and the ongoing rise in health-care needs will buoy demand for medical office buildings despite the disruption brought on by the coronavirus.

“The medical office sector is being tested as operators navigate new challenges created by COVID-19. Medical office was once perceived to be a more resil­ient asset class during a downturn, but the unique uphill battle faced by health-care providers due to the pandemic has choked revenue streams and considerably shrunk margins,” according to the Marcus & Millichap report.

The national vacancy rate rose to 8.9 percent, marking an increase of 40 basis points from the second quarter of 2019. Project abandonment and delays caused construction activity to drop 1 million square feet year-over-year. Additional projects will be postponed or canceled in the upcoming months; however, this will help stave off any threats of overdevelopment in the sector.

Other fundamentals, such as rental rate trends, serve as indicators of strong performance ahead. Most REITs reported a solid level of rent collections even though many tenants pursued deferrals and rent relief. Additionally, rent growth continued its pre-pandemic upswing, climbing to an average of $25.22 per square foot.

A New Age In Health Care

Well in advance of the appearance of the coronavirus, the U.S. health-care industry had begun to decentralize, providing more medical care in outpatient facilities instead of hospitals.

“Excluding some major surgeries, off-campus properties now offer the highest quality of care and complex procedures, driven by the need to provide equal levels of service across a metro,” according to the Marcus & Millichap report. “New hospital and expansion projects continue to target suburban areas as a demographic shift has caught the attention of health systems, placing more modern facilities and specialized care closer to patients’ homes. As these medical districts expand, the need for nearby outpatient clinics and supportive services generates demand for medical office space.”

Telehealth, via phone or online video, increased dramatically as a result of social distancing, and while experts expect the use of virtual care options to continue to rise in the post-pandemic environment, they do not expect it to result in a reduction in the need for medical office buildings. According to the report, the need for certain in-person visits will remain, as will the need for labs and imaging, all of which will translate into continued demand for medical office accommodations.

Finally, the coronavirus has not changed the fact that the considerable Baby Boomer population continues to age, and it’s doing so in an era when medical technology and advancements are supporting longer lifespans. As Marcus & Millichap notes in the report, the population of citizens aged 65 and older will expand by 30 percent over the next 10 years.

And with age comes more visits to the physician’s office. Individuals in the 55-64 age range make an average of 4 physician visits annually, but the number of yearly visits rises to 5.9 for those in the 65-74 age range and jumps to 7.6 for those 75 and older.

“Despite the short-term costs, the health-care industry will be one of the quickest to bounce back from the pandemic since the care needs of a growing and aging population continue to increase,” Marcus & Millichap asserts in the report. “Medical services are returning as states move through reopening phases, and pent-up demand from postponed procedures and office visits provide a positive outlook.”

Read the full report on Marcus & Millichap’s website.

 

Source: Commercial Property Executive