Institutional Real Estate Execution Without the Overhead
We step in as your interim Head of Real Estate—owning site selection, lease strategy, capital alignment, and execution oversight—so you can focus on building clinical momentum and raising capital.
Real Estate Is a Strategic Function—Whether You Structure It or Not
Healthcare real estate decisions compound. The early ones compound fastest. Each decision carries financial and operational consequences that shape your growth trajectory.
What Typically Breaks
- Licensing timelines extend beyond projections
- Capital is absorbed by redesign and preventable change orders
- Expansion velocity slows as complexity increases
- Runway compresses while founder bandwidth is consumed
- Board confidence erodes as execution becomes unpredictable
What We Do
- Embed as interim Head of Real Estate with clear accountability
- Own site selection, lease strategy, and entitlement positioning
- Align capital deployment with clinical and growth priorities
- Manage architect, contractor, and landlord relationships
- Provide board-level reporting with institutional rigor
What Changes When We're Embedded
External parties respond to disciplined leadership. Boards respond to clarity.
Real Estate Conversations Reset
Brokers prepare underwriting with greater precision. Landlords engage with discipline. Architects define scope more clearly. Contractors document assumptions before mobilization.
Landlord Risk Is Managed with Fluency
We understand how institutional owners, regional family offices, and private landlords assess tenant credibility and risk. We know which provisions materially affect exposure and where flexibility exists.
Healthcare Operating Realities Stay Central
We've led real estate from within a scaling healthcare organization—building facilities, presenting capital strategy to boards, and executing multi-market expansion. Clinical requirements drive real estate decisions, not the reverse.
The Intersection Is Managed as a System
Capital strategy, clinical operations, site and lease structure, design/entitlement, and construction execution are managed through one decision framework—not fragmented across vendors.
Scaled to Your Growth Stage
Healthcare companies reach different inflection points. Our engagement structure reflects that reality.
Strategic Guidance
For founders evaluating sites, lease structures, or early expansion decisions.
- Broker proposal review
- Lease economics analysis
- Entitlement exposure assessment
- Capital assumption validation
Interim Leadership
For companies actively expanding or managing facility execution.
- Site selection
- Lease negotiation
- Entitlement coordination
- Architect/contractor oversight
- Capital tracking
- Board-level reporting
Development Alignment
For complex development, adaptive reuse, or multi-site growth with capital partners.
- Asset-level underwriting
- Lease-to-development structuring
- TI risk control
- Capital stack alignment
- Investor reporting
- Stabilization strategy
Operating Experience
Embedded leadership requires operating experience. We've led real estate and facilities strategy from inside a scaling healthcare organization—establishing design standards, executing adaptive reuse projects, and managing multi-market expansion.
- Founding real estate leadership for a healthcare startup
- Executing $12M+ in adaptive reuse and clinical build-out projects
- Leading national expansion for a primary care platform later acquired in a multi-billion-dollar transaction
- Presenting site selection, lease strategy, and capital deployment frameworks to executive teams and boards
- Advising a growth-stage pediatric behavioral health platform on early facility strategy and market entry
- Embedded real estate leadership for a PACE operator directing acquisition + development for two simultaneous centers
Expansion Requires Structured Real Estate Leadership
Real estate is often the least structured function inside a growing healthcare company. That lack of structure absorbs capital, extends regulatory timelines, and pulls executive attention into day-to-day execution work. Let's change that.
Schedule a Strategy Call