HCA Healthcare Acquires 55-Acre Land Parcel In Jacksonville For $16M

HCA Healthcare, the parent company of Memorial Hospital, has acquired a 55-acre land parcel in the Wildlight community of Jacksonville for $15.8 million. The property is located at northeast Interstate 95 and Florida A1A.

“This purchase will allow us to establish a future presence in Nassau County and to align with the planned growth in the region,” said Bradley Talbert, CEO of Memorial Hospital, in a statement.

Nearby the land parcel, Baptist Health acquired 26 acres at Florida A1A and Harper Chapel Road in May, and plans to build a 50,000-square-foot medical office building. Also nearby, UF Health Wildlight, a 23,331-square-foot medical office building, is currently under construction.


Source: Connect Florida

Rieber Lands $36M Construction Loan On Florida Medical Office And Hotel Project

BridgeInvest, a lender based in Miami, has originated $36 million of construction financing to fund the development of a mixed-use commercial building in Aventura, Fla.

The property, dubbed Ivory 214 by its builder, Rieber Developments, will add nearly 40,000 square feet of medical office space and 11,000 square feet of retail in the Atlantic coast city, about halfway between Miami and Fort Lauderdale. It will also include a 100-room hotel operated under Hilton‘s Tapestry Collection brand.

The loan refinances prior debt that was provided by the same lender in 2017 for Rieber’s acquisition of the land, according to Alex Horn, one of BridgeInvest’s founders.

“We’ve had the opportunity to work with the borrower for an extended period of time,” Horn said. “They’re very capable of building this project, so we liked the idea of financing the construction.”

The ten-story medical building, which broke ground just over a year ago, is subdivided into office condominiums that Rieber is selling to health-care providers. Though the property won’t be open for business until early 2020, 30 out of 34 office condos have already been sold, the company said.

Meanwhile, the Tapestry hotel will cater towards extended-stay customers, with each room featuring a small kitchen. There will also be a pool, a fitness center, meeting space and a rooftop terrace, with the property operated by Driftwood Hospitality Management.

“Securing the construction financing for Ivory 214 is an especially proud moment and a key step in delivering this compelling project to Aventura,” Bernardo Rieber, a principal at Rieber Developments, said in a statement. “Today’s closing is an endorsement of the continued strength and market appeal of Ivory 214 as we continue our forward momentum.”

The development, at 2820 Northeast 214th Street, will stand a few blocks from Aventura Hospital & Medical Center, a for-profit hospital run by HCA Healthcare. Rieber is also working on a neighboring project, 1212 Aventura, which will likewise include office and retail components but will feature a senior-living complex instead of a hotel.

The South Florida city of just under 40,000 residents is notable to commercial real estate cognoscenti as the home of the Aventura Mall, America’s third-largest shopping center. Last year, Aventura Mall, which is co-owned by Turnberry Associates and Simon Property Group, pulled in one of the biggest retail debt deals in the country, a $1.75 billion single-asset CMBS loan from J.P. Morgan Chase, Deutsche Bank, Morgan Stanley and Wells Fargo.

Source: Commercial Observer

HCA Healthcare Buys 100 Acres In Estero For $52.5 Million

HCA Healthcare purchased nearly 100 acres in Estero for $52.5 million at the end of December, property records show.

The Nashville-based health care system bought the land for a planned hospital in Estero that state regulators approved last year, said Debra McKell, a spokeswoman for HCA West Florida, a division of HCA.

The land is bordered by U.S. 41 to the west, Williams Road to the south and Via Coconut Point to the east. Hertz Global Headquarters sits directly south of the property on Williams Road.

Property records show Fawcett Memorial Hospital, based in Port Charlotte, purchased the 100-acre property Dec. 20 from Estero North Point LTD. Fawcett Memorial Hospital is one of 15 hospitals that belong to HCA West Florida.

A deed for the purchase lists the hospital’s address as One Park Plaza in Nashville, which is the HCA headquarters. McKell confirmed HCA made the purchase. McKell said the land was acquired for the planned hospital and to “explore other uses as well down the road.”

The property purchased by HCA is currently zoned for commercial uses, Estero Community Development Director Mary Gibbs said. HCA would have to rezone the property to allow any medical uses, Gibbs said.

In June, HCA received approval from state regulators to build an 80-bed hospital in Estero. Lee Health also received approval from the state to build an 82-bed hospital at Lee Health – Coconut Point, its $140 million medical campus now open in Estero south of Coconut Road.

Both health care systems have filed legal challenges to each other’s hospital plans.

The 100-acre property purchased by HCA is less than 5 miles north of Lee Health – Coconut Point in Estero, which opened in early December. Also nearby is Collier County-based NCH Healthcare System’s medical facility that recently opened in Bonita Springs, just south of the city’s border with Estero.

The Lee Health – Coconut Point complex had no impact on HCA’s decision to purchase the property in December, McKell said.

“I don’t think we follow other health systems to determine where we’re putting something,” McKell said.

Lee Health has been working with Estero for more than a dozen years to build a hospital in the community, said Mary Briggs, a spokeswoman for Lee Health.

“We think we have the best location. We’ve already built the complementary outpatient services that serve the hospital,” Briggs said. “We’re just moving forward our plans to build that facility.”

Former Florida governor and now Sen. Rick Scott led what was then known as Columbia/HCA between 1987 and 1997. He left amid a federal investigation into its Medicare billing practices, which ultimately forced the company to pay $1.7 billion in penalties and fines between 2000 and 2002.

HCA formerly operated the now-demolished Southwest Florida Regional Medical Center and what was once known as Gulf Coast Hospital. Lee Health acquired both in 2006 in a $535 million deal.

Estero’s Village Center

The 100-acre property purchased by HCA is within Estero’s village center.

Estero has planned the village center to be a walkable, mixed-use downtown for residents and businesses in the community. Land in Estero’s village center stretches from near Coconut Road to just north of Broadway.

Estero Mayor Jim Boesch said the purchase by HCA is great news for the village.

“We’ve waited long for that 100 acres to come to pass,” he said.

Boesch said development on the property will add to the momentum happening in the village center.

He pointed to construction of the Genova condos at the southeast corner of Corkscrew Road and Via Coconut Point and Estero’s pending purchase of 62 acres along the Estero River at the northeast corner of Corkscrew Road and U.S. 41.

The village is expected to close on the Estero River property Monday, Jan. 14.

“My prediction is U.S. 41 and Corkscrew Road will be the center of town,” Boesch said.

Source: Naples Daily News

Metro Orlando To Get 3 New Hospitals

Orlando Health and HCA Healthcare inc. will build a total of three new Central Florida hospitals, thanks to getting approval Dec. 7 from the Florida Agency for Health Care Administration.
Nashville, Tenn.-based HCA (NYSE: HCA) and Orlando Health got the greenlight for their requested new facilities from the August 2018 batching cycle. The approvals are required before any new hospitals can be built.
The general acute-care hospital projects that got the thumbs up are:
• The 100-bed Orlando Health Lake Mary Hospital, planned for a 30-acre site at 380 Rinehart Road in Lake Mary
• The 50-bed Orlando Health Randal Park Hospital slated for 9349 Randal Park Blvd. in southeast Orlando
• The 40-bed Central Florida Regional Hospital International Parkway (CFRHIP) to be built at 4525 International Parkway in Sanford
It’s unknown if competitor Florida Hospital, soon to be known as AdventHealth, will appeal these approvals. Florida Hospital executives couldn’t be reached for comment.
Orlando Health, a $3.4 billion nonprofit health care system, on June 18 paid roughly $9.9 million for 15.13 acres of vacant land at the northeast corner of Dowden Road and Randal Park Boulevard for the Randal Park facility. That new hospital will allow the nonprofit to operate in the growing community near Lake Nona, and will reduce crowding at Orlando Regional Medical Center, Orlando Health said in its proposal.
Phase 1 of the project, which would include a freestanding emergency room and outpatient medical office, would start in 2019 and finish in 2020. Phase 2 would have operations begin in 2022. A third phase would allow expansion of medical office capabilities and inpatient facilities, but a timeline wasn’t included.
Orlando Health also is moving forward on its Rinehart Road project, the site of its $42 million, 30-acre freestanding emergency room and medical pavilion now under construction. This new $140 million to $160 million hospital includes 100 acute care beds being delicensed from South Seminole Hospital, Orlando Health spokesman Desmond Jordon told Orlando Business Journal. Renovating the existing South Seminole campus would have cost $310 million to $320 million, and would cause disruption to the services at the facility, Orlando Health said in its proposal.
Phase 1 of the Rinehart Road project is the medical pavilion, which should be completed in August 2019, and operations for Phase 2 are slated to begin in 2022. The second $360 million phase of the hospital will include the patient bed tower, and other health and wellness concepts. Once complete, Orlando Health’s Lake Mary campus will join a growing medical building hub in the area, informally referred to as the Rinehart Medical Corridor.
Meanwhile, HCA’s project will include a new adult psychiatric program with a minimum of 14 beds, according to the proposal. Central Florida Regional Hospital will relocate 21 of its medical/surgical beds and all of its 19 obstetrics beds to the proposed 40-bed facility. The health care provider does not list a timeline nor a projected construction cost for the facility.
HCA is one of the largest, private health systems in Florida, featuring 50 hospitals across the state and 31 surgery centers. Its local facilities are: Central Florida Regional Hospital, Oviedo Medical Center, Osceola Regional Medical Center and Poinciana Medical Center. It also is partnering with the University of Central Florida on the $175 million UCF Lake Nona Medical Center, which will be a teaching hospital slated to open in fall 2020.
Source: OBJ

Hospitals File Petitions To Keep Competitors Out Of Southwest Florida Market

Hospital competitors in Southwest Florida have filed petitions to oppose three new hospitals that state regulators approved June 1.

The challenges were filed to contest the state Agency for Health Care Administration’s decisions on license applications from Lee Health, HCA Healthcare, and Braden Clinic. The petitions seek formal hearings.

For residents of Estero and Ave Maria, where the hospitals would be built, the legal wrangling means delays and the potential of project approvals getting overturned or dropped.

Once an administrative judge has been assigned, the hearings must begin within six months and a continuation is only allowed when the judge finds extraordinary circumstances, according to state law. In general, hearings are held in Tallahassee. It is likely the petitions involving the Lee County projects will be consolidated.

The publicly operated Lee Health was approved for an 82-bed hospital at its Coconut Point outpatient campus in Estero. HCA’s 80-bed hospital was approved for a site near Corkscrew Road and U.S. 41. Ten of the HCA beds would be for inpatient psychiatric care. Lee Health and HCA are fighting each other’s projects.

The state’s approval of both projects in the same region contrasts with its 2013 denial of Lee Health’s bid for an 80-bed hospital at Coconut Point.

The NCH Healthcare System and Physicians Regional Healthcare System, both in Collier County, are opposing the two Lee County projects.

NCH also is fighting the state’s approval of a 25-bed hospital by Braden Clinic in Ave Maria.

The challenges reiterate objections the competitors filed earlier this spring after the three applications were submitted. The objections say more beds will harm the existing hospitals, will result in higher health care costs, and will dilute the quality of care provided by health professionals.

The petitions also raise questions about whether the state properly balanced statutory criteria in evaluating the applications. The state may face greater scrutiny because it approved all three applications for Southwest Florida. The agency also green-lighted hospital projects in Marion, Volusia and Orange counties.

Nashville-based HCA Healthcare sold two hospitals in Fort Myers in 2006 to Lee Health. One was closed and the other, Gulf Coast Hospital, was expanded and renamed Gulf Coast Medical Center. In its argument against HCA aiming to re-enter the market, Lee Health says HCA “abandoned” the community in 2006.

Physicians Regional similarly said the monopoly that Lee Health has today is due in large part because HCA left the county in 2006. Physicians Regional said HCA should not be allowed to build a hospital and potentially divest again to the benefit of Lee Health.

In its objection to the Lee Health project, HCA said the abandonment argument is irrelevant and the issue is whether Lee Health should be permitted to expand its market dominance.

“The clear answer to this question is that Lee County residents should have the same degree of choice of inpatient providers as is available in other Florida counties and that enhanced competition will be beneficial to residents, the medical community, and payors of health care services,” HCA said.

Lee Health controls 95 percent of hospital beds in the county and handled 85 percent of all admissions, HCA said.

Lee Health spokeswoman Mary Briggs said the system’s project is the best choice for Estero.

“Our hospital will be built adjacent to Lee Health — Coconut Point, which opens later this year,” she said.  “An acute care bed tower will naturally complement the emergency room, surgery center and other comprehensive outpatient services to be offered at that location.”

In its opposition to the planned 25-bed Braden hospital, NCH said the rural hospital proposed off Arthrex Commerce Drive near Oil Well Road would face numerous challenges.

“The area remains a medically underserved area, lacking necessary support services as well as sufficient health care professionals,” NCH said. “That lack of support raises issues as to 24-hour staffing and adequate emergency coverage for a hospital, and the sustainability of a rural hospital with 25 beds.”

Braden Clinic opened outpatient services for Ave Maria in 2015. The hospital application included letters of support from 650 residents, community leaders and businesses.

NCH took issue with the hospital planning to have an emergency room, but the hospital would not offer inpatient surgery.

“The lack of inpatient surgery, when explicit statements occur as to full emergency care, overreaches as to the capability of the proposed hospital,” NCH said.

Financial documents included in Braden’s application said investors would be tapped to help build the $34.5 million hospital, or $1.4 million per bed. Braden clinic showed net revenues of $525,000, and a net loss of $86,000 at the end of 2017. NCH raised questions about whether investors would have a controlling role in the hospital.

Braden officials issued a statement that its project has widespread support and that a new hospital is overdue in the community. Supporters include Collier County’s Emergency Medical Services, the Healthcare Network of Southwest Florida, and the Collier County Rural Health Network, Braden said.

“Everyone knows that eastern Collier County is in dire need of a hospital that actually serves our patient base,” the statement reads. “The state healthcare administrative body has ruled in favor of our application. The community is supportive at every level.”

Braden officials said only NCH is challenging the new hospital based on its own financial interests.

“Shame on the powerful executives, lawyers, and governing bodies of NCH for suing the state of Florida in a sad attempt to protect their market share,” the statement reads.

Source: Naples Daily News

Florida Approves Three New Hospitals For Collier And Lee Counties

Florida regulators have approved plans for three new hospitals in Lee and Collier counties, a decision that reverses the state’s view four years ago that no new health centers were needed in the region.
This means that Lee Health may proceed with plans to build an 82-bed hospital on a medical campus it is already building in Estero.
But it also means that HCA Healthcare, which left Southwest Florida more than a decade ago, may open its own 80-bed hospital and inpatient psychiatric facility near Corkscrew Road and U.S. 41 in that same community. The hospital also would become Lee County’s third receiving facility for people undergoing involuntary mental health evaluations under the state’s Baker Act.
The Florida Agency for Health Care Administration’s ruling on Friday said that both hospitals are needed to meet the needs of a rapidly growing county and to diversify its health care offerings:

“The Agency finds that approval of both applicants, collectively, will increase accessibility and availability of inpatient services while enhancing health care and fostering competition to promote quality and cost effectiveness to residents of the subdistrict.”

A third approved plan from Braden Clinic in Ave Maria calls for the construction of a 25-bed health center in that community.
NCH Healthcare System, which operates the largest hospitals in Collier County and competes with Lee Health for patients in south Lee County, had opposed all three bids.
None of the hospital systems had commented on the decision as of Friday morning.

The Players

The 102-year-old Lee Health, formerly known as Lee Memorial Health System, is a public hospital system governed by an elected 10-person governing board. It operates four acute-care hospitals in Lee County and a variety of specialty clinics and health centers, including The Golisano Children’s Hospital of Southwest Florida.
Lee Health also operates the only trauma center between Sarasota and Miami.
It frequently faces criticism for being a “monopoly” because it operates roughly 95 percent of the adult acute-care hospital beds in Lee County. For now, its only competitor is the 88-bed Lehigh Regional Medical Center in Lehigh Acres.
Nashville-based HCA Healthcare is the nation’s largest hospital operator with 179 hospitals, 120 freestanding surgery centers and a number of medical facilities in 20 states and the United Kingdom.
Its Florida holdings include Fawcett Memorial Hospital in Port Charlotte, Englewood Community Hospital and Doctors Hospital of Sarasota.
Gov. Rick Scott led what was then known as Columbia/HCA between 1987 and 1997. He left amid a federal investigation into its Medicare billing practices, which ultimately forced the company to pay $1.7 billion in penalties and fines between 2000 and 2002.
At the time, it was the largest health care fraud in the nation’s history, according to Politifact.
HCA formerly operated the now-demolished Southwest Florida Regional Medical Center and what was once known as Gulf Coast Hospital. Lee Health acquired both in 2006 in a $535 million deal.
Braden Clinic has been in Ave Maria for several years and provides a number of outpatient medical services, including primary medical care, urgent care and pediatric care. It also offers lab services.
Its hospital would serve Ave Maria, Immokalee and the surrounding rural communities, according to its website. It is expected to offer 24/7 emergency services, a pharmacy, a lab, rehabilitation care, imaging, an infusion center and cardiorespiratory.
Source: Naples Daily News

Trauma Centers vs. Emergency Rooms: In Florida, New Rules Will Settle Long-Running Feuds

In Florida, a long-running healthcare industry legal battle could be coming to an end, thanks to the rare feat of passing bipartisan legislation affecting trauma centers.
The legislature this week passed a bill that will change how trauma centers are distributed throughout the state. It will also designate some HCA facilities as trauma centers, thus ending several legal challenges. And it will establish an advisory council that can help resolve future conflicts.

What exactly is a trauma center?

“Emergency rooms are not trauma centers,” according to the Florida Committee on Trauma. Whereas any emergency room has staff who can treat a broken bone or mild burn, a facility that is designated as a trauma center “has highly trained specialists in-house or immediately available 24 hours a day, 7 days a week.”
Trauma centers must meet certain state standards and are specially prepared to handle things like major car accidents, severe burns and gunshot wounds. A trauma center can be part of a hospital or in some cases, a stand-alone facility.
Like it or not, healthcare in America is a business, and hospitals must compete for patients, their paying customers. Because hospitals are expensive to run, the state wants enough of them to serve the population, but no so many that patients are spread thin and rates increase. Like about 30 other states, Florida regulates how many hospitals can open, and where. The state regulates trauma centers in similar fashion.
There are 303 hospitals in Florida, 209 of them with emergency departments, according to the Florida Hospital Association. Yet the state has only 27 trauma centers.
Under current regulations, which have been in place for 26 years, a hospital can receive a designation as a Level I, Level II, pediatric or provisional trauma center depending on its offerings. Florida’s 67 counties are divided into 19 “trauma service areas” and only a certain number of trauma centers are allowed in each.
In recent years, for-profit HCA Healthcare pushed to open trauma centers at more of its hospitals. Competitors balked, filing legal challenges that have wound through the courts for a decade.
Some have argued the market should be opened and hospitals should be allowed to open more trauma centers in crowded or lucrative areas. Others have argued that such a move would siphon patients from needier areas and disadvantage rural and community hospitals.
Legislators this year, after exhaustive meetings with hospital industry leaders, said they have finally worked out a compromise. New rules would dictate that no service area can have more than five trauma centers, nor more than one stand-alone pediatric trauma center. The service area borders would be adjusted and the number of areas would drop from 19 to 18. The Department of Health would establish an 11-member Florida Trauma System Advisory Council, which would begin meeting in 2019.
The new rules would also settle the litigation by approving three HCA trauma centers: at Kendall Regional Medical Center, Orange Park Medical Center and Aventura Hospital & Medical Center. One HCA facility, Northside Hospital in St. Petersburg, would not be allowed to proceed with trauma center designation.
The bill passed the state House and Senate unanimously and will go to Gov. Rick Scott for his signature.
Income from red-light camera violations has helped fund trauma centers in Florida to the tune of $12.6M in 2012. Following a mass shooting incident at Marjory Stoneman Douglas High School in Parkland Feb. 14, state lawmakers have been considering measures that would take money collected from applications for firearm licenses and direct those funds to trauma centers as well.

Source: Bisnow

Palm Beach County Hospital Buys Nearby Office Building From Public Company For $11M

JFK Medical Center acquired a neighboring medical office building from HCP Inc. for $11.25 million.
The hospital, part of HCA Healthcare (NYSE: HCA), already owned the 2.2-acre site at 5503 S. Congress Ave.
But the 30,745-square-foot building on the property was owned by the Irvine, California-based medical office REIT (NYSE: HCP), which had a ground lease on the property.
The office building was developed in 1993 by Atlantis Medical Center, which sold the underlying land without the building for $1.44 million in 1998 to JFK Medical Center. At that time, the company signed a 99-year ground lease with the hospital. Atlantis Medical Center later became part of HCP through a merger.
The recent sale price of the building equated to $366 per square foot.
In a current online listing, the building has 2,889 square feet available for lease at $20 per square foot.
Source: SFBJ

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