As her first vertical medical city for seniors, a $1.1-billion, 1.4-million-sq.-ft. project, is starting construction in Orlando, Fla., Tabitha Ponte, CEO of Ponte Health, is planning her second medical city. Work on the next site, in downtown Chicago, will start in several months, with the project costing $600 million at a much smaller scale than the Orlando one. Ponte has also located future project sites within the U.S., including three more in Florida, possible sites in Portland, Ore. and Denver, and then Ponte “leaves the country to expand.”

The concept of a vertical medical city originates from the need to solve problems surrounding transportation and time constraints for seniors between medical appointments, to streamline their healthcare, according to Ponte. “Unless someone is in the ER, getting a CAT scan could be a several week process,” Ponte says.

In Orlando, Ponte’s facility covers three acres, and is densely built for 955 apartments, some of which are two-bedroom, two-bath units for married couples or siblings. There will be a total of 1,300 beds. This site encompasses half-a-million square feet of medical outpatient territory and 200,000 to 300,000 sq. ft. of research and pharmacology space, a kind of all-in-one medical facility in a dense living space, geared toward convenience.

(This Q&A has been edited for length, style and clarity.)


NREI: What was your process for finding and constructing the Orlando site?

Tabitha Ponte: We didn’t have a market sector or focus, but instead saw the concept of a pure medical city to solve major transportation and time problems. As it evolved with research, we began targeting the geriatric sector. We started to understand the statistics and projections of the market when it comes to chronic conditions in those over 65, and the necessity of solving the problems for this group. Vertical Medical City is both residential and outpatient, as well as a research facility with geriatric doctors and additional doctors doing research on targeted projects.


NREI: What are the costs associated with creating a medical city and what are the rents for potential residents?

Tabitha Ponte: My response about incurred costs is counter to the market. People think that the rent would be higher, but because of the way we’re building the site, it actually creates a density, and we can lower the rent to 30 to 40 percent of market cost. We are also able to take on this project because offsite we have other high-performing properties, which aren’t residential, and the research opportunities for residents to participate get compensated in a way that will offset the cost. It’s a unique microcosm of economic restructuring. Rents will be $5,000 to $9,000 for extreme care, end of life or stroke recovery assistance problems.


NREI: How does the Chicago vertical medical city concept compare to Orlando’s site?

Tabitha Ponte: Chicago is a leaner development with fewer units at 250, but it still has a medical outpatient and medical research component. Due to the urban infill, it won’t take up more than half an acre.


NREI: What are the data points for the Chicago site? Are there any special amenities included?

Tabitha Ponte: There will be between 150,000 and 200,000 sq. ft. for medical research, which is leaner than the Orlando space. Orlando has the capacity for biomedical and pharmaceutical research, prosthetics, and more. Chicago’s density is better suited for more data-based scientific research. The rent is similar to Orlando, with some wiggle room for market changes. Ideally, it will be designed in 16 months, with final construction by 2024. The site will be comprised of 23 stories.

Additionally, our restaurants in both facilities will include a vegan lifestyle, and in Orlando, there will be a farm-to-table component. In Chicago, we will partner with a farm. The idea is to bring down the pricing, so it cuts the cost of paying the prices of an organic grocer like Whole Foods, because this will literally be farm-to-table on a 3,000-person scale. There is no precedence for this kind of facility with these types of amenities.


NREI: Why is now a good moment to build a vertical medical city?

Tabitha Ponte: Statistics say there should be one everywhere for chronic conditions, especially for seniors with Alzheimer’s. In fact, we’re not building fast enough for what the market will need 25 years for now.


NREI: How many mixed-use developments in downtown areas are out there with these kinds of medical research and laboratory components?

Tabitha Ponte: There are no buildings like these out there. Some people are trying to build geriatric and assisted living spaces in the urban setting, but they are not reaching into innovative food and technology.


NREI: Why didn’t this trend catch on earlier?

Tabitha Ponte: My team and I are not driven by money; we are driven by the quality outcomes we can achieve and what’s needed in this sector. Most business is structured by profit and cost alone, and no one would take on this project based on costs alone because it would be insane to take on this much of an expense. For me, it’s worth spending because of what it will do for the senior population. The real estate task is a vehicle to get us there.


NREI: Why did you choose Chicago for your next location?

Tabitha Ponte: A vertical medical city should exist in every city in the world. Chicago is specifically appropriate with developed urban conditions without the extreme density and costs of New York City. Statistically, we looked at dementia and Alzheimer’s, and Illinois is in mid range in terms of projections, in a similar way as Orlando. High projections for Alzheimer’s are in the Southern belt, such as in Georgia and Texas. The Pacific Northwest has the [lowest] projections.


NREI: What are some of the challenges of doing this type of project in terms of mixing assisted living with other complex real estate users?

Tabitha Ponte: When you enter the healthcare sphere, one of the biggest challenges is liability. Operators need clean and concise tools in place for the residents and physicians in protection of rights and liability. We have had a significant legal team early on because we are entering an unexplored AI program, which involves who owns what and privacy rights. We fully intend to use facial technology through the building for the benefit of the residents and the physicians, for identification and safety reasons. If understood, every different type of user, resident and guest, will be willing to subject themselves to this technology, but it is still very new.


NREI: What kind of demand do you expect from seniors and when will the greatest demand occur?

Tabitha Ponte: There’s a huge demand, especially if you are 75 and older with chronic illnesses, which often includes recurring strokes. The goal is to bring the elders back to the urban core, which is often closer to their families and to cater to them as their physical bodies deteriorate.  We are caught in a culture where we’re taught not to think about health problems, and then suddenly someone ends up in the ER, and everyone has to deal with healthcare issues. We’re trying to make a cultural shift into how people feel about deterioration and help those who live with two or three chronic health conditions by improving their quality of life, deleting transportation and time issues, and adding a research and development component.


Source: NREI

Real estate investment trust Welltower purchased Jacksonville, Fla.-based CenterOne Surgery Center’s medical office building for $25.7 million from CNL Healthcare Properties, the Jacksonville Daily Record reports.

What you should know:

1. The three-story medical office building is around 100,000 square feet.

2. CNL sold the medical office building to Welltower as part of a $1.25 billion property bundle.

3. CNL Healthcare Properties President and CEO Stephen Mauldin said, “The sale of our 55-building, class A medical office portfolio to Welltower represents a strong, early-value realization step for CNL Healthcare Properties.”

Source: Becker’s ASC Review

Eduardo Egea remembers when he got the drone that would inspire his latest architectural creation.

Egea’s father, who was in his late 70s and has dementia, piped up one day a few years ago.

“‘I want a drone,'” Egea remembers his father saying. “They have a drone for sale at Walmart, and you have to get it for me.’ I bought him the drone. He couldn’t figure it out. He put it back in the box and said, ‘There. A present for you.’ I got stuck with this drone.”

To this day, Egea doesn’t know how to fly the drone without crashing it. But the architect, who is vice president and managing principal of Leo A Daly’s Miami design studio, has invented a drone-powered hospital. If certain last-mile pharmacy, food service and storage functions were moved off-site and handled via drones, a standard hospital could reduce its footprint by 15% to 17%, he says.

Egea grew up in Puerto Rico and studied architecture at Clemson. When his mom was diagnosed with cancer, he decided to get a master’s degree in architecture and health, thinking he could help patients like her through design. Fast forward to 2017 — by which time Egea had designed medical facilities around the world — when Hurricane Maria hit Puerto Rico.

Power was out and roads were impassable. Supplies at the port couldn’t be distributed — not even medicine that was destined for hospitals. Egea worried about his parents, then 78 and 79. What if they had an emergency?

Egea has been designing hospitals for 25 years, and knows that the bulk of any hospital’s budget consists of the reimbursement it gets from insurance companies for patient care it provides. Because hospitals in Puerto Rico are reimbursed at a lower rate than hospitals in the mainland U.S., he already knew to design in creative ways that stretched available dollars.

But for all his experience, Egea wasn’t quite prepared for Hurricane Maria.

“Puerto Rico is seismic. We follow structural design guidelines to make sure a hospital would stay upright after an earthquake and can tolerate wind loads so the exterior does not get impacted by flying debris,” Egea said. “There’s always more than one source of electrical power — a power line will feed from two sources, in case one goes down, or we incorporate generators. But it had not occurred to me that the roads would be destroyed, trees would be blocking the way and workers couldn’t get to work. “Well, there’s a drone here and it’s in a box. My mind started going.”

Months prior, Amazon had purchased Whole Foods. Egea was inspired by one of the company’s ideas: a centralized distribution center that looks like a beehive, from which drones could fly across a city making deliveries.

“That’s smart, but that’s dumb at the same time,” he thought. “How will someone receive that package if I live in a high-rise? In a single-family home, that drone can land in my backyard, but what if I am in a condo? Is it going to land on my balcony? Does the balcony have the right dimensions?”

Meanwhile, Egea’s team had been designing flexible patient rooms that could be used for all levels of care: acute, intermediate and intensive. Making such a room universal would help lower costs of construction.

He thought about adding a little drone port on an exterior wall that would allow for someone to deliver medicine or food directly to the patient.

“That would bypass the need for a centralized kitchen in a hospital, a centralized pharmacy,” he thought. “I would liberate and empower the patient to have a completely different experience.”

He imagined patients using apps to order off their own doctor-approved menus rather than waiting for an overworked nurse to bring trays of red Jell-O. He started sketching.

Egea’s team spent about three days brainstorming and creating renderings for their drone-powered hospitals. Patient rooms would have a drone port — basically, a valve — at the outer wall. Outside, a drone would drop its load into a net. The cargo would then slide through the valve, which keeps out moisture and dirt, into a cabinet in the patient’s room.

Cost would depend on factors such as room sizes and number of beds. But Egea thinks that savings from this nimble hospital model could be used to build more, smaller facilities in rural areas.

Egea hasn’t had any discussions with Amazon, and he concedes that there are still details to be worked out. Infection control is always a top concern for hospitals, and he has thought about people who might shoot down the drones to steal cargo. “It could have a bulletproof casing, and a lock with a specific combination.”

For now, it has been a fun thought exercise. His other current work includes redesigning birthing rooms at Mount Sinai and adding gardens — a “farmacy” — in buildings for Baptist Health South Florida.

“I’m trying to push the boundaries,” Egea said. “I’m trying to disrupt what a hospital can be.”


Source: Bisnow

Welltower Inc. (NYSE: WELL) and CNL Healthcare Properties announced yesterday that Welltower has completed the purchase of a Class A health care facilities portfolio for $1.25 billion.

“We are extremely excited to close on this transaction and are pleased with the progress we have made to date that further enhances the value of these high-quality assets,” said Keith Konkoli, Senior Vice President and leader of Welltower’s Medical Office and Outpatient segment. “By leveraging the strength of our platform, we have made substantial progress in extending ground leases, have experienced increased leasing velocity, and have identified additional opportunities to deploy capital that helps our health system partners improve care delivery to the communities they serve, further demonstrating our unique ability to drive long-term value through meaningful collaborations with the nation’s premier health systems.”


“The sale of our 55 building, Class A medical office portfolio to Welltower represents a strong, early value realization step for CNL Healthcare Properties and our approximately 45,755 stockholders,” said Stephen H. Mauldin, president and CEO of CNL Healthcare Properties. “This is the first sizeable transaction in our carefully orchestrated strategic alternatives process to provide liquidity to investors, and we are very pleased with the outcome.”


Miami Jewish Health Systems sees its garage taking shape during phase one of constructing its S. Donald Sussman Empathicare Village. Phase one is to be completed by the summer and lead to construction for another year and six months of the residences and programming centers for individuals with Alzheimer’s disease and other forms of dementia.

The S. Donald Sussman Empathicare Village is expanding Miami Jewish Health Systems’ footprint. The nonprofit offers a 438-bed nursing facility, 95 units for living space, another building for 81 assisted living units, a memory care facility with 19 spaces, and an acute care hospital with 32 beds.

The S. Donald Sussman Empathicare Village will offer a memory care facility licensed to host assisted living units, a nursing center, and a range of amenities, including an arts theater, café, creative arts program studio, community spaces, fitness center and garden. Florida is in the process of designating the site as an official memory center.

The village sits between Northeast 53rd Street, Northeast Second Avenue, Northeast 50th Terrace, Northeast Miami Place, Northeast 52nd Street and North Miami Avenue. The team plans to partner with artists in Wynwood and the Haitian community near its site.

“One important factor is that it will have residences there for people to live but it will also will have programming and unique centers for people to come from the community to participate,” said Marc E. Agronin, senior vice president for behavioral health and chief medical officer for the Miami Jewish Health Systems Memory and Research Center. “It is meant to create a world for individuals and their families with dementia.”

Dr. Agronin is part of the development team for the project, alongside the organization’s board members and CEO Jeffrey P. Freimark.

Miami Jewish Health Systems plans to hire from the local community and train staff on empathic care.

Dr. Agronin says the focus on empathy-based care or EmpathiCare will set the project apart from other similar communities: “In order to help someone you have to have a deep understanding of what they are going through. That is where empathy comes in. All roads lead to that understanding, because whether you are trying to make a diagnosis, trying to pick the best research study, counsel a family member who is feeling a lot of stress, everything comes down to, not just your scientific understanding of the disease’s state, but an understanding of the person behind the disease.”

The approach to empathy-based care stems from Dr. Agronin’s 20 years in the Miami Jewish Health System and writing several books on aging and Alzheimer’s disease.

The current phase focuses on completing the garage. Workers are constructing the parking ramp. The garage is expected be completed by summer and offer 300 parking spaces.

The process of bringing the remaining parts of the village to life will occur in the next year and a half, says Dr. Agronin.

Half of the $50 million capital campaign goal has been raised for the project. Miami Jewish Health Systems continues to search for more donations.

The S. Donald Sussman Empathicare Village is entering the market when the public needs it the most, says Dr. Agronin. Alzheimer’s disease and other forms of dementia are growing more common in Florida due to a larger aging population as well as these diseases being related to age.

He encourages folks with memory concerns, regardless if mild or severe, to contact the research hotline at (305) 514-8503.


Source: Miami Today