Real Estate Transactions

Acquire
Dispose
Sale-Leaseback
Valuation

Expanding — Additional Facilities

For operators growing their footprint, BHTA helps work through where and how to expand:

Inherent challenges to plan for
Zoning
  • Generally, the higher the acuity, the more difficult the zoning — historically the single biggest barrier to entry for inpatient psychiatric or residential treatment
  • BHTA has been navigating this exact issue since 2008
  • Lower-acuity models (PHP/IOP/MAT/outpatient/sober living) still carry zoning considerations worth discussing
Building upgrades
  • Placing a newly licensed use into a building with a different prior use typically requires upgrades
  • BHTA can connect clients with architectural and construction contractor referrals
Certificate of Need (CON)
  • Whether a state is a Certificate of Need state, and whether the level of acuity will require state CON approval, is worth confirming early
  • This directly affects timeline and site selection
Buy the real estate, or lease it?
  • For operators scaling now but planning to eventually sell, it's worth weighing buying vs. leasing — capital spent growing the business often returns more than capital spent owning real estate
  • When growth capital is tight and the business is profitable, leasing can be the better option
  • Owning the real estate at the time of a business sale creates more flexibility in how that sale is structured — BHTA can walk through the options

Right-Sizing — Disposing of a Facility

Initial Due Diligence Request to Send to BHTA
Coming soon

Sale-Leaseback

Valuation

Expanding — Additional Facilities

For operators growing their footprint, BHTA helps work through where and how to expand:

Inherent challenges to plan for
Zoning
  • Generally, the higher the acuity, the more difficult the zoning — historically the single biggest barrier to entry for inpatient psychiatric or residential treatment
  • BHTA has been navigating this exact issue since 2008
  • Lower-acuity models (PHP/IOP/MAT/outpatient/sober living) still carry zoning considerations worth discussing
Building upgrades
  • Placing a newly licensed use into a building with a different prior use typically requires upgrades
  • BHTA can connect clients with architectural and construction contractor referrals
Certificate of Need (CON)
  • Whether a state is a Certificate of Need state, and whether the level of acuity will require state CON approval, is worth confirming early
  • This directly affects timeline and site selection
Buy the real estate, or lease it?
  • For operators scaling now but planning to eventually sell, it's worth weighing buying vs. leasing — capital spent growing the business often returns more than capital spent owning real estate
  • When growth capital is tight and the business is profitable, leasing can be the better option
  • Owning the real estate at the time of a business sale creates more flexibility in how that sale is structured — BHTA can walk through the options

Right-Sizing — Disposing of a Facility

Sale-Leaseback

Valuation

Right-Sizing — Disposing of a Facility

Valuation

Expanding — I need additional facilities

Congratulations — your business is growing, and it's time to think through where and how you expand. A few questions worth working through together:

Inherent challenges to plan for
Zoning
  • Generally, the higher the acuity, the more difficult the zoning — historically the single biggest barrier to entry for inpatient psychiatric or residential treatment
  • I've been navigating this exact issue since 2008
  • Lower-acuity models (PHP/IOP/MAT/outpatient/sober living) still carry zoning considerations worth discussing
Building upgrades
  • Placing a newly licensed use into a building with a different prior use typically requires upgrades
  • I can connect you with architectural and construction contractor referrals
Certificate of Need (CON)
  • Do you know if your state is a Certificate of Need state, and whether your level of acuity will require state CON approval?
  • We should figure this out first — it directly affects timeline and site selection
Buy the real estate, or lease it?
  • If you're scaling now but plan to eventually sell, it's worth weighing buying vs. leasing — capital spent growing the business often returns more than capital spent owning real estate
  • If growth capital is tight and the business is profitable, leasing can be the better option
  • If you own the real estate when you're ready to sell the business, you have more flexibility in how the sale is structured — ask me how

Right-Sizing — I need to dispose of a facility

Sale-Leaseback — I own the real estate and want to sell while staying on as tenant

Valuation — What's my real estate worth?

Acquire
Dispose
Sale-Leaseback
Valuation

Real Estate Transactions

Whether you're expanding, right-sizing, monetizing owned real estate, or simply need a valuation, here's where to start.

Expanding — I need additional facilities

Congratulations — your business is growing, and it's time to think through where and how you expand. A few questions worth working through together:

Where do I want to expand? If you're still narrowing down the right market, I can refer you to regional or national behavioral health consultants who specialize in market selection. Once you've identified your target market(s), come back to me to talk through the challenges of entering it.

I know exactly where I want to go and have the capital to move fast. Let's build a game plan for a multi-market acquisition.

I've already underwritten a specific market — competition, staffing, payor rates — and I know where I want to be. Let's talk about how to execute.

Inherent challenges to plan for
Zoning

Generally, the higher the acuity, the more difficult the zoning — historically the single biggest barrier to entry for inpatient psychiatric or residential treatment. I've been navigating this exact issue since 2008. Lower-acuity models (PHP/IOP/MAT/outpatient/sober living) still carry zoning considerations worth discussing.

Building upgrades

Placing a newly licensed use into a building with a different prior use typically requires upgrades. I can connect you with architectural and construction contractor referrals.

Buy the real estate, or lease it?

If you're scaling now but plan to eventually sell, it's worth weighing buying vs. leasing the real estate. Capital spent growing the business often returns more than capital spent owning real estate — if growth capital is tight and the business is profitable, leasing can be the better option.

If you own the real estate when you're ready to sell the business, you have more flexibility in how the sale is structured. Ask me how.

Want to buy the business and the real estate together? See Business Transactions

Right-Sizing — I need to dispose of a facility

Can I lease it instead of selling? Either to a competitor, or to a non-competing occupant.

Selling the real estate while the business infrastructure is still in place is generally worth more than selling after the business has shut down — let's talk through what that looks like for your situation.

We can market this confidentially, as a public listing, or a hybrid of both — ask me about the tradeoffs.

Sale-Leaseback — I own the real estate and want to sell while staying on as tenant

I can walk you through what the real estate investment market is currently looking for in sale-leaseback transactions.

Lease terms and obligations can be structured differently depending on your goals and risk tolerance — let's discuss what fits.

We can market this confidentially or via public listing — ask me about the pros and cons of each.

Valuation — What's my real estate worth?

Formal appraisal: I'm not a credentialed appraiser myself, but I work with several healthcare real estate appraisers who specialize in behavioral health properties — ask for a referral if you need one for a bank refinance or other purpose.

Broker Opinion of Value (BOV): A more streamlined valuation I can prepare as part of an engagement to sell or lease your property. Priced similarly to a formal appraisal — but if you engage me to sell the property, that cost is credited back to you.

Real Estate Transactions

Whether you're expanding, right-sizing, monetizing owned real estate, or simply need a valuation, here's where to start.

Expanding — I need additional facilities

Congratulations — your business is growing, and it's time to think through where and how you expand. A few questions worth working through together:

Inherent challenges to plan for
Zoning
  • Generally, the higher the acuity, the more difficult the zoning — historically the single biggest barrier to entry for inpatient psychiatric or residential treatment
  • I've been navigating this exact issue since 2008
  • Lower-acuity models (PHP/IOP/MAT/outpatient/sober living) still carry zoning considerations worth discussing
Building upgrades
  • Placing a newly licensed use into a building with a different prior use typically requires upgrades
  • I can connect you with architectural and construction contractor referrals
Buy the real estate, or lease it?
  • If you're scaling now but plan to eventually sell, it's worth weighing buying vs. leasing — capital spent growing the business often returns more than capital spent owning real estate
  • If growth capital is tight and the business is profitable, leasing can be the better option
  • If you own the real estate when you're ready to sell the business, you have more flexibility in how the sale is structured — ask me how
Want to buy the business and the real estate together? See Business Transactions

Right-Sizing — I need to dispose of a facility

Sale-Leaseback — I own the real estate and want to sell while staying on as tenant

Valuation — What's my real estate worth?

Certificate of Need (CON)

Also worth confirming as part of Inherent Challenges: do you know if your state is a Certificate of Need state, and whether your level of acuity will require state CON approval? We should figure this out first — it directly affects timeline and site selection.

Acquire
Dispose
Sale-Leaseback
Valuation

Real Estate Transactions

Buy-Side

We help investors and operators identify, evaluate, and acquire behavioral health real estate that fits their strategy, from single-facility purchases to multi-site portfolio acquisitions.

Sell-Side

We represent owners of behavioral health real estate through the full sale process: positioning, marketing to a qualified buyer pool, and negotiating to close. Our engagements typically fall into one of the following categories:

Operating Treatment Facilities
Businesses currently operating, available for sale (OpCo or combined OpCo/PropCo).
NNN Real Estate Investments
Leased real estate with an operating tenant, sold as an income-producing investment.
Vacant Facilities — Previously Operating
Available for sale or lease, not currently operating.
Conversion Opportunities
Vacant properties, often former assisted living, suitable for behavioral health conversion.

Valuations

Independent, sector-specific valuation guidance for behavioral health real estate — site feasibility, market positioning, zoning and conversion potential, and objective insight for owners and investors making a decision.

Sale-Leaseback

We structure sale-leaseback transactions for behavioral health operators — unlocking the equity in owned real estate while allowing continued operation of the facility under a long-term lease. This strategy is well suited to operators looking to redeploy capital into growth while retaining full operational control of their sites.