/wp-content/uploads/2020/08/florida-medical-space-logo.png00admin/wp-content/uploads/2020/08/florida-medical-space-logo.pngadmin2018-06-27 20:44:382018-06-27 20:44:38Davie Parcel Envisioned For More Medical Offices
Florida’s embattled medical marijuana office continues wading through rulemaking—two years after Florida voters approved the system. But the industry is moving faster than regulators’ ability to govern it, leading to problems.
Last week a California-based medical marijuana company purchased a Florida one for $53 million. There have been a couple of these sales already. Yet only now is the Florida Department of Health’s Office of Compassionate Use coming up with rules to govern ownership transfers. The Office’s Director Christian Bax says the rule is aimed at quality control.
“And so we’re asking for the same information as we would ask another MMTC [Medical Marijuana Treatment Center] applicant,” he said.
The department wants new owners to go through a similar process as the original ones did, including background and financial checks. In the absence of firm rules on everything from how much licenses will cost, to ownership transfers, the Department is trying to put in temporary policies to fill the gap. These temporary rules are called variances.
The Office of Compassionate use has been under fire from all sides. It’s been accused of moving too slow, and earlier this year Florida lawmakers threatened to cut its funding. Some players, such as the Lockwood law firm which represents Medical Marijuana companies, want the department to speed up rule development.
“We have two major concerns with the proposed rule today. The first is that it lacks a turnaround time,” said the Lockwood firm’s Devon Nunneley. She wants to see changes that will get new products to patients faster.
“Any delay in the variance approval process really slows down our client. So we were hoping to see a rule that gives the office a certain timeline—something like 15 days—to approve or deny a variance request so that we could have some certainty in that regard.”
More recently a Leon County Circuit judge gave the state a week to make rules regarding smoke-able marijuana, after the same judge earlier found the state’s ban on smoke-ables unconstitutional. The deadline to make those rules was Monday. The state appealed the decision Friday. In a statement, a Health Department spokesman says patients have access to medical marijuana in different forms under the law and that its making progress in making medical marijuana available to the more than 117,000 Floridians who have licenses.
/wp-content/uploads/2020/08/florida-medical-space-logo.png00admin/wp-content/uploads/2020/08/florida-medical-space-logo.pngadmin2018-06-25 01:29:002018-06-25 01:29:00Florida Regulators Struggle To Keep Up With Medical Marijuana Industry
It’s the non-stop pace of our digital lives. An increasingly isolated and aging population. Rising chronic illness. Climate change. Given the pressures of the modern world, a gym membership and taking the occasional “mental health day” often just aren’t enough to maintain a healthy lifestyle.
One way to achieve optimum wellness, experts and developers say, is by choosing a home that is designed for it.
The wellness real estate boom worldwide, which took off in commercial buildings with the introduction of the WELL Building Standard in 2014 as workers sought healthier office environments, is now poised to explode into the residential market, according to a 2018 report by the nonprofit Global Wellness Institute.
Homes designed for wellness usually start with energy-efficient and sustainable construction. Indoor components like natural lighting, air quality, acoustics, proximity to green spaces and exercise facilities, as well as non-toxic paints and finishes take it to the next level.
Researchers at the Miami, Florida-based Global Wellness Institute say the international wellness real estate market is now a $134 billion industry. The number of wellness-oriented properties (including residential, mixed-use and commercial) has grown 6.4% annually since 2015 and is expected to continue growing at that pace through 2022, to reach $180 billion—half the size of the global “green” building industry, according to the report, which was released in January.
The U.S. leads the market share at $52.5 billion, followed by China, Australia and the U.K. According to the report, there are more than 740 existing or planned residential projects in 34 countries that include large-scale master planned communities and urban/suburban mixed-use developments.
Particularly in the U.S., while health care spending soars, “we’re becoming more unhealthy as we live longer,” said Ophelia Yeung, a senior research fellow at the Global Wellness Institute who co-authored the report, called “Build Well to Live Well: Wellness Lifestyle Real Estate and Communities.” Naturally, Ms. Yeung said, this conflux has led to people asking themselves “why they invested their life savings in a home that is not keeping them well.”
In the heavily polluted metropolises of Asia and India, homebuyers are increasingly looking for a refuge from gritty city streets, so high-end air and water purification systems, indoor landscaping and natural furnishings are priorities.
“In these urban areas, the indoor environment is going to be so important for them — it’s a sanctuary where they’re going to escape to,” Ms. Yeung said. “It’s not just about pampering.”
The luxury real estate industry’s answer to that need is a slate of wellness-oriented properties ranging from shiny beachfront condos to self-contained urban high-rises to private villas nestled within lush private resorts.
The common denominator, developers, sales managers and researchers told Mansion Global, is that residents’ overall health and well-being is central to the design and function of the home.
That translates to a variety of amenities and services—from the standard on-site restaurant serving gourmet organic meals—to the cutting edge, like a personalized wellness plan for each member of the household, offering professional assistance on nutrition, weight loss goals, meditation practices and more.
“There is a recognition that building for human health is going to be the core (value),” in the real estate market going forward, Ms. Yeung said. “When you look at it from that perspective, it’s a whole lot bigger than the luxury apartment with the spa, the gym, the swimming pool.”
Indeed, at some newer high-end developments, staff begin assessing a homeowner’s health and wellness needs the moment a contract is signed.
At the 120-acre Canyon Ranch resort in Lenox, Massachusetts, residents moving into one of the 19 new condominiums consult with a personal wellness adviser who then assembles a team of specialists to carry out their individualized wellness plan— including on-site physicians, nutritionists, exercise physiologists, behavioral counselors and spiritual wellness experts. Memberships with access to the full range of personalized wellness services are $9,000 annually for one person or $12,000 for a couple, in addition to homeowners association fees, spokeswoman Alexis Chernoff said.
The resort, located in the mountainous Berkshire region of Massachusetts, lends itself to multiple outdoor wellness activities. Residents can partake in weekly yoga sessions on the estate’s sprawling lawn or interactive six-course dinner parties that include lectures by a local farmer as diners gather their own ingredients from the garden, General Manager Mindi Morin said. Access to kayaking, hiking and biking is close by.
The one- and two-bedroom units are priced between $1.35 and $3.5 million; 10 out of 19 have sold since sales began last year. For many residents, the condo is their second or third home, but at least one resident decided to live there full-time after visiting the resort for years, Ms. Morin said.
“It’s the lifestyle that they want to live, and it’s really hard when you’re (only) here for a small amount of time,” she said.
The Canyon Ranch brand has several properties around the U.S., including the long-established Tucson, Arizona, resort, which has 100 luxury residences. The company calculated that prospective buyers who already have a home elsewhere would be willing to pay a premium to hold the keys to a resort property in the Northeast.
The Global Wellness Institute data supports that. According to the report, prospective homeowners are willing to pay 10% to 25% premiums for homes in wellness developments at the middle and upper end of the market, partly because supply hasn’t yet met demand. One survey cited in the report claims an estimated 1.3 million annual potential buyers for “wellness-infused homes and communities” in the U.S.
Wellness is Ageless
While these developments are a natural fit for many active retirees, a significant population of younger buyers is interested in the wellness lifestyle, experts said.
Texas native Will Robinson, 45, bought a two-bedroom, two-bathroom condo overlooking a golf course and pool at Tao Ocean Residences in Mexico, about a 90-minute drive south of Cancún. While beachfront villas at Tao are priced up to US$750,000, Robinson bought his inland unit for a song—$184,000—in 2012, following a decision to pack up his Denver home and retire early from a successful career in sales.
“I liked the idea of living in a community with like-minded people who were healthy and wanted to work out—that was a huge aspect,” said Mr. Robinson, who starts most days in the gym at Tao’s Wellness Center.
About 80% of residents are Canadian and American, sales director Paulina Almeida said, noting that Tao’s unique wellness lifestyle is not for everyone.
“We are not just selling a residence,” she said. “We’re actually selling a community,” comprised of homeowners who are interested in interacting with their neighbors and their environment.
Residents are invited to take Spanish classes on site and volunteer in the surrounding Mayan communities, maybe by teaching English to local children, caring for the endangered sea turtle population or participating in beach clean-ups, Ms. Almeida said.
Wellness Via App
Developers of the Amrit Ocean Resort & Residences in Palm Beach County, Florida, are building twin beachfront towers on Singer Island where all residents get a personalized wellness assistant, via app, that is available 24/7 to guide them on a chosen wellness plan. One might ask for a reminder to eat a healthy lunch and then have the “assistant” search local eateries and order the meal for delivery, said Dilip Barot, CEO and Founder of Creative Choice Group, which is developing the property.
“More and more people have started prioritizing their health, almost like part of a balance sheet,” Mr. Barot said.
The app will be designed exclusively for the property, Mr. Barot said, though it could function similarly to those found on the general market like 8fit.
Sales recently opened at Amrit on 182 units priced between $700,000 and $4 million, with the first occupants expected in 2019. Plans include a meditation garden and outdoor yoga studio, with classes available through a partnership with the Himalayan Institute.
Indoors, options such as heated reflexology floors, remote-controlled aromatherapy walls and vitamin C-infused showers can add an extra $10 to $15 per square foot to the price of the condo, Mr. Barot said.
In New York City, residents of the new Gramercy Square development can use an app to book meditation classes in a tranquil 600-square-foot sanctuary a short walk from their homes. The classes are offered by the MNDFL meditation studio through an exclusive partnership with the property. Residents get two free 30-minute meditation classes per month, with additional classes, private sessions and special events priced a la carte, said Heather Cook, a senior vice president and managing director at Douglas Elliman Real Estate.
Wellness for all?
For now, the high end of the real estate market seems to have a firm grip on the value of wellness properties, but experts agree it will soon gain wider appeal in lower segments of the market. As the products and materials used to construct such homes become more popular, costs will come down, said Kavita Kumari, principal engineer at Cundall, a London-based multidisciplinary engineering consultancy, who works with developers of ultra-lux sustainable properties in the UK, Asia and elsewhere.
“That’s where … the lower end of the real estate market will catch on,” Ms. Kumari said.
Ms. Yeung, the Global Wellness Institute researcher, said broad consumer awareness is “just being awakened.”
Within three to five years, she said, the mid-market will catch up with the luxury segment and it is “going to come like a tsunami.”
/wp-content/uploads/2020/08/florida-medical-space-logo.png00admin/wp-content/uploads/2020/08/florida-medical-space-logo.pngadmin2018-06-20 18:04:262018-06-20 18:04:26Wellness Real Estate Has Blossomed Into A $134 Billion Industry Worldwide – And It’s Growing Fast
Healthcare systems and physicians groups once viewed their real estate operations as a line item on a ledger and not as high a priority as staffing, education or equipment. In the years since reimbursements from Medicare began tightening as it went from a fee-for-service model to an outcome-based one, healthcare systems and physicians are getting more savvy when it comes to their real estate strategies.
“With respect to real estate, healthcare systems used to be naïve,” said Mark Curtis, director of Greenville Health System, a not-for-profit system serving the Upstate South Carolina area. “Now they’re far more sophisticated than they were five years ago.”
Curtis was one of five healthcare real estate experts on stage at a panel entitled “What Do Hospitals & Systems See Coming in 2018?” Rex Noble, senior vice president of asset management at Flagship Healthcare Properties, moderated the discussion.
The panel was the closing act at the eighth annual InterFace Healthcare Real Estate Carolinas show, which took place on May 31 at the Hilton City Center hotel in Uptown Charlotte. The event drew 160 attendees in the healthcare real estate space from across North and South Carolina.
Operations Are Under The Microscope
Spurred on by lower reimbursements and increasing expenses due to inflation, healthcare systems are taking a holistic view of their business strategies. As a result, a higher priority is given to real estate than ever, according to the panel.
“We’re absolutely trying to be more sophisticated with our real estate,” said Tony Perez, vice president of real estate at Atrium Health. Formerly known as Carolinas HealthCare Systems, the not-for-profit group operates more than 7,600 beds across 900 care locations. “Five years ago we weren’t talking about yields coming in and cap rates going out, we were talking about rental rates.”
Atrium Health recently announced it plans to invest more than $1 billion in the next seven years around the metro Charlotte area. At the same time, Perez said the company is focused on cutting expenses, including on the real estate side.
“We are absolutely trying to cut expenses — $300 million by 2020,” said Perez. “Last year we did $35 million and we’ve already done $35 million this year, but our goal this year is $95 million. Everyone is going to bleed, and on the real estate side, capital is scarce.”
Healthcare real estate professionals are looking internally at doctors’ daily practices in order to drive efficiencies as well. Elisa Cooper, director of property management at Roper St. Francis Healthcare, a nonprofit healthcare system in Charleston, says that real estate sustainability is now prioritized over expansion.
“We’re driving down operations to the metrics of how many patients touch an exam room,” said Cooper. “If a physician can’t put five patients a day in that exam room, they don’t need it. We take it out and add another doctor’s office.”
On the development side, site selection is in the limelight for healthcare real estate professionals because patients now want ease of access to their medical care more than anything, according to the panel.
“The ‘build it and they will come’ days are long gone,” said Greenville Health’s Curtis.
Perez says that healthcare groups are still novices when it comes to site selection for hospitals and medical centers, but soon they will have the capabilities and resources on the same level as major retailers.
“I don’t theorize a lot, but I’d say that large health systems will be as proficient as Target and Walmart about sites in the future,” said Perez.
Physicians themselves are looking at real estate in a different light too, according to the panel. Curtis said that physicians are more actively involved in operation expense discussions as they look to get better returns on their real estate investments.
“If I look at where physicians are in those conversations, they’re partners at the table,” said Curtis. “Physicians are looking at what we do and how we deliver care and what that cost is.”
“When I first came into the business 14 years ago, our meetings with the doctor groups were all about how big could we build it and how pretty could we make it,” added David Park, senior vice president of Novant Health. The Winston-Salem, N.C.-based healthcare network operates 14 medical centers and more than 500 physicians clinics and outpatient centers across North Carolina, South Carolina, Georgia and Virginia.
“The conversation today with the doctors are more around trimming the size down and cutting the costs,” said Park. “It’s a new level of education for the entire core of the healthcare industry.”
Caring for Millennials
In addition to dwindling reimbursements, healthcare systems are also feeling the pinch from the rise of millennials, who by and large are shifting the way healthcare is provided. Atrium Health’s Perez doesn’t think that millennial preferences will eliminate the need for brick-and-mortar medical office buildings, but their presence is certainly felt.
“Millennials will bend the curve for some specialties, family practices and maybe urgent care,” said Perez, who emphasized what Atrium Health is preparing for in its consumer readiness program. “Our view is that one day you’ll be able to use your phone, be able to virtually talk with a physician who will order your drugs and then a drone will drop it off at your house.”
“We’re planning for today, but really we can’t plan for today. We have to plan for 10 years from now,” added Cooper of Roper St. Francis.
Cooper said that millennials are propping up the urgent care business model and are electing not to visit or even select a primary care physician. She doesn’t envision this as a long-term trend as millennials are aging and will eventually need more services than they currently receive.
“They don’t go to primary care doctors unless they’re really sick and they don’t go in for checkups unless they’re forced to by their employer,” said Cooper. “Millennials today will actually need the healthcare service that they don’t think they need today.”
Jeff Brown, principal of healthcare real estate advisory firm Meadows & Ohly LLC, said that millennials’ preferences for healthcare are forcing healthcare systems to walk a tightrope between planning for an uncertain future and making sure that the current needs of aging baby boomers are being met.
“It’s going to be a balancing act,” said Brown. “Being on the real estate side, we’re trying to figure out where the right bets are.”
In the near-term, Brown said that millennials are changing the way healthcare groups are looking at their operations as they strive to maximize traffic in that age cohort.
“More than anything healthcare systems are talking about their ambulatory and digital strategies,” said Brown. “It’s been proven urgent care doesn’t work from a profitability standpoint, but from a need and access standpoint it does work for millennials.”
/wp-content/uploads/2020/08/florida-medical-space-logo.png00admin/wp-content/uploads/2020/08/florida-medical-space-logo.pngadmin2018-06-17 16:52:172018-06-17 16:52:17Healthcare Systems, Physicians ‘More Sophisticated’ When It Comes To Real Estate, Says InterFace Healthcare Panel
In what could be the largest medical office building (MOB) portfolio sale since last year’s Duke Realty sale, multiple healthcare real estate (HRE) industry sources tell Healthcare Real Estate Insights that CNL Financial Group plans to sell the MOB portfolio owned by its Orlando-based CNL Healthcare Properties real estate investment trust (REIT).
Sources say CNL has hired HFF and KeyBank to market the properties.
Efforts to contact executives of CNL, HFF and KeyBank have been unsuccessful. However, multiple HRE industry sources have told HREI that they have heard that a sale is in the works.
Not to be confused with CNL Healthcare Properties II, which was launched in 2016 and is still open to new investors, CNL Healthcare Properties is a non-traded REIT closed to new investors on Sept. 30, 2015.
According to a fact sheet available on its website, CNL Healthcare Properties developed and acquired properties with a total investment of about $3.02 billion from 2012 to 2015. The REIT consists of 58 percent senior housing, 31 percent MOBs, 6 percent post-acute and 5 percent acute care facilities, based on purchase price, development budget and/or capitalized cost.
Sources say that at this time CNL plans to sell only the MOBs, not the other assets. The REIT’s portfolio includes 54 MOBs totaling about 3.26 million square feet, according to the fact sheet.
The MOBs with the greatest valuation include: Midtown Medical Plaza, Charlotte, N.C., $54.7 million; Presbyterian Medical Tower, Charlotte, N.C., $36.3 million; Bend Memorial Clinic MOB, Bend, Ore., $36 million; Center One, Jacksonville, Fla.; $34.4 million; and UT Cancer Institute Building, Knoxville, Tenn., $33.7 million.
The total investment amount for the MOBs was $931.4 million, according to the fact sheet, which would almost certainly mean they would fetch more than $1 billion if sold in a competitive bidding situation.
/wp-content/uploads/2020/08/florida-medical-space-logo.png00admin/wp-content/uploads/2020/08/florida-medical-space-logo.pngadmin2018-06-13 22:01:182018-06-13 22:01:18Industry Sources Say CNL Healthcare Properties Plans To Sell Its MOBs