Underwrite the opportunity
We review sponsorship, property performance, business plan, and priorities before approaching the market.
Medical office buildings represent a convergence of real estate and healthcare fundamentals that makes them uniquely attractive to lenders and investors. Long lease terms (10 to 20 years) with credit healthcare system tenants, high tenant improvement buildout costs that create switching cost stickiness, and the non-cyclical nature of healthcare demand all support tight cap rates (4.5-6.5% in primary markets) and strong lender appetite. On-campus and near-campus hospital-affiliated MOBs command the best financing terms; off-campus single-tenant and multi-tenant medical office is also broadly lendable. SBA 504 is a compelling source for physician groups and healthcare operators purchasing their own buildings, offering long-term fixed-rate owner-occupied financing.
Structure before pricing: leverage, recourse, reserves, prepayment, and closing certainty can matter as much as the headline coupon. We test those trade-offs before recommending a path.
We do not treat the lender list as a directory. We target the desks whose current appetite fits the asset, sponsorship, market, and business plan, then compare the full execution, not only the rate.
| Capital source | Where it may fit |
|---|---|
| Life Insurance Companies | Long-duration fixed-rate capital for high-quality assets and experienced sponsors, generally with conservative leverage. |
| CMBS Conduits | Non-recourse execution with broad property appetite, balanced against more standardized servicing and prepayment provisions. |
| SBA 504 and 7(a) | Government-supported owner-occupied financing with program-specific eligibility, occupancy, and documentation standards. |
| Banks | Relationship-oriented capital that can offer local market knowledge and structural flexibility, with recourse often considered. |
| Debt Funds | Flexible capital for transitional, complex, leveraged, or time-sensitive executions where conventional credit boxes may not fit. |
We position the transaction, identify the lenders most likely to compete, and compare proposals on economics and execution risk, not just headline rate.
A well-structured financing process should create real choices for the borrower, not simply deliver the first term sheet.
We review sponsorship, property performance, business plan, and priorities before approaching the market.
The transaction is matched to lenders whose current appetite fits the property, market, and structure.
Proposals are evaluated across rate, proceeds, recourse, reserves, prepayment, and closing certainty.
We coordinate lender diligence, third-party reports, and issue resolution until the loan funds.
We arrange medical office financing nationwide while matching each transaction to capital sources active in that market and property type.
The final structure depends on the asset, sponsorship, and market. These are the starting parameters we discuss most often.
Working out equity? Our commercial property down payment guide covers typical requirements by loan type: 20% to 30% conventional, 10% for SBA owner occupied.
Medical office financing covers acquisition, construction, and refinancing of medical office buildings, ambulatory surgery centers, urgent care facilities, and outpatient campuses, starting at $2 million. Lenders treat medical office as a defensive asset class because healthcare demand is non-discretionary and tenant buildouts are expensive to replicate, which keeps renewal rates high and vacancy low relative to conventional office.
Medical office loans price from 5.25% to 8.50%, with terms of 5 to 25 years and leverage up to 75% LTV. Life insurance companies quote the tightest rates on stabilized, well-tenanted buildings at moderate leverage, and CMBS conduits reach the highest proceeds. Physician groups buying their own building can access long-term fixed-rate SBA 504 structures instead.
Underwriting centers on the rent roll: tenant credit (health system versus independent physician practice), weighted average remaining lease term, and whether leases extend beyond loan maturity. Lenders also review hospital affiliation and referral patterns. Multi-tenant buildings with staggered expirations and funded tenant improvement reserves underwrite far better than a building facing near-term rollover.
Bank and debt fund executions typically close in 45 to 60 days. Life insurance company and CMBS loans usually run 60 to 90 days, driven by appraisal, environmental and property condition reports, and lease review. Owner-occupied SBA 504 transactions take longer, generally 60 to 120 days, because of the second-position debenture funding process.
Yes. Buildings on or adjacent to a hospital campus command the best pricing and leverage because the hospital relationship supports tenant retention. Off-campus multi-tenant and single-tenant medical office is broadly lendable but priced wider. The common trap is a ground lease under an on-campus building: lenders require the ground lease term to extend well beyond loan maturity.
Share the property and financing request. We will respond within 24 hours with an initial view.