Anyone who has kept an eye on the healthcare real estate sector over the past several years is aware of the property type’s reliability amidst increasing economic uncertainty, which has resulted in growing interest among investors.
However, for what has become one of the hottest investment sectors in recent years, transformations underway within the healthcare industry will bring changes to the asset class over the next decade.
The market fundamentals are easy to understand. According to a recent report from Real Capital Analytics, United States-based healthcare real estate assets account for over $1 trillion in market value. Physician visits by baby boomers are expected to nearly double in the next decade; it is also projected that by 2060, one in four people will be over 65 years old. These factors make it clear that this already large market is positioned for continued growth.
However, in crowded regional healthcare markets like Philadelphia, which features several large competing healthcare systems and a variety of growing specialty networks, that growth will not just be more of the same.
Changes in Delivery
Traditionally, the American healthcare delivery model centered on hospitals, which meant that medical office buildings tended to be clustered near hospitals and other large inpatient medical facilities. These facilities were easy for doctors to access and provided enhanced services close to individuals’ primary points of care.
In recent years, the healthcare delivery model has undergone a dramatic shift, with outpatient and ambulatory facilities becoming primary points of care. This trend has unfolded almost simultaneously with the wave of consolidations and mergers that has swept through the industry in the last decade.
Working in tandem, these two trends have created a healthcare industry that is dominated by large healthcare systems searching for enhanced geographical footprints to better and more conveniently meet the health and wellness needs of the populations and communities they serve.
Key User Demands
Real estate plays a key role in a healthcare system’s ability to make quality care more accessible. As such, the demand for well-located, quality space continues to rise, attracting a greater number of investors than in prior years
Although location still plays a vital role in healthcare real estate investment, the criteria behind what makes a location desirable has shifted. Since medical buildings no longer need to be immediately proximate to hospitals, today’s best locations are those where people already are living, shopping and working. Whether this comes in the form of a purpose-built medical office building in the heart of a growing community or a retail location next to popular cafés and shopping destinations, today’s healthcare consumers prioritize convenience above all else.
Visibility is also playing a larger role in site selection for new healthcare projects. Expanding networks want their names out in the market, and they want people to be aware of their presence in the local community. This “retailization” of healthcare is highlighted by many medical office tenants’ requirements for signage and high visibility in their search for space.
Flexibility is also a main factor in today’s marketplace. Physician groups and healthcare systems require spaces that can accommodate the shifts in how care is delivered while also provide the flexibility to cater to telemedicine and other technologies that are transforming how people access care.
Project Example
Just outside of Philadelphia in Washington Township, New Jersey, the 35-acre Washington Square Town Center development addresses all of the factors discussed above.. With an increasingly cross-generational population and changing delivery model, medical space was a key component to the mixed-use project.
Working closely with Rothman Orthopaedic Institute, one of the region’s largest independent orthopaedic practices, a 40,000-square-foot, state-of-the-art medical office building was created at the gateway to the community that includes multifamily housing and retail options.
The healthcare trend has even been extended to the project’s residential component, with a 110-bed assisted living facility currently under construction to join the 330 residential apartments and 100 townhomes on the property. Today, the Rothman Medical Building stands fully occupied, and the retail component has seen tremendous interest from both medical and traditional retail tenants.
Not only do projects like the Washington Square Town Center allow the community to enjoy increased access to diverse medical services in a variety of settings, they also provide growing regional networks with a highly visible footprint in new communities to foster their continued growth.
Looking to the next decade, the healthcare real estate industry is positioned for tremendous growth. Leading this growth will be the developers and investors who truly understand the needs of an increasingly consolidated healthcare industry and can creatively imagine projects to meet both its short- and long-term needs.
The Park-Line Miami apartment towers have been completed at the Brightline passenger rail station in downtown Miami.
Brightline, which will be rebranded as Virgin Trains USA, completed the 816-unit project at 100 N.W. Sixth St. It has two 30-story towers atop the rail platform at Virgin MiamiCentral, which also has a food court and offices. That gives residents a direct connection to the train that stops in Fort Lauderdale and West Palm Beach, with future stations in Orlando, Aventura and Boca Raton.
Units range from 630-square-feet studio apartments to 1,336 square feet with two bedrooms and a den. There are also a few penthouses. The studios start at $1,900 a month. The smallest two-bedroom unit goes for $3,345.
Retail in South Florida is defying the harsh reality facing the rest of the country.
Even with delivery of approximately 178K SF of new retail product in Q4 2019, vacancy rates remained at 4.5% in Miami-Dade County, same as the prior quarter, according to Colliers International research. Net absorption for the year was over 671K SF.
Dave Preston, Colliers executive managing director of retail services, marveled at the continuing strength of the sector. The average asking rent per SF was $38.18, up from $34.81 the year prior.
“Something at some point is going to have to give, but right now we’re still seeing upward trajectory,” he said.
Notable big-box leases included a 37K SF 24-Hour Fitness in the airport submarket, a 34K SF Ross Dress for Less in Downtown Miami and a 30K SF Pinstripes at The Plaza Coral Gables. Ross alone added 98 stores nationwide last year.
“Discount stores like Target, Marshalls and Ross Dress for Less continue to be thriving in today’s market and absorbing vacated box space,” Colliers officials wrote in the report. “Their business models have protected them from the threat of e-commerce, as well as their convenient location in busy grocery-anchored plazas.”
Colliers pointed out the strength of entertainment retail concepts, evidenced by the growth of Pinstripes, and also noted the record sale of The Shops at Merrick Park in Coral Gables — part of Brookfield’s acquisition of four top-tier malls across the country. Brookfield intends to redevelop surrounding land with complementary uses such as hotel, office and residential.
“I would say that, as usual, South Florida is doing a pretty good job bucking some national trends,” Preston said. Miami’s density, tourist dollars and foreign money make it so that “our market is a different animal in a lot of ways.”
“Your Ross or Marshalls in South Florida, a 20K or 30K SF space, will do anywhere between $6M to $15M-$20M in sales,” Preston said, adding that even though customers can now get nearly any product delivered to their door, “nobody wants to sit in the house day and night. People want get out of their houses for something.”
Stores like Marshalls, TJ Maxx and Yoyoso (a Chinese retailer that recently leased a prime 41K SF space on Lincoln Road) give shoppers a reason to return frequently because they offer high turnover of product.
“People want to be a little bit surprised,” he said. If and when the economy contracts, Preston said, weaker players may fall out, but he expects health and fitness to remain strong.
“If the sales are there, they’re opening more stores,” Preston said.
While many areas of bricks-and-mortar retailing face headwinds, one shows signs of growth and promise: health care and medical services offered within stores and shopping centers. These services extend beyond the pharmacies and optical shops that have long had a presence within many retail outlets, and now include checkups, vaccinations and management of chronic conditions like high cholesterol.
Two large drug store chains are among those at the front of this trend. Working with health care provider partners, Walgreens operates more than 230 retail clinics run by nurse practitioners. On top of that, since 2018 the Chicago-based retailer has introduced primary care centers staffed by physicians in about a dozen stores.
In 2006, CVS acquired MinuteClinic and now operates 1,100 MinuteClinic locations in 33 states and Washington, D.C. The clinics offer vaccinations and help with minor illnesses and diabetes monitoring, among other services.
Drug store chains aren’t the only companies mixing retailing and health care. In late 2019, the Mall of America in Bloomington, Minn., opened a walk-in clinic in partnership with M Health Fairview, itself a partnership between health care provider Fairview and the University of Minnesota. The 2,300-square-foot clinic offers five exam rooms and services including laboratory and radiology.
Now open in two Georgia locations, Walmart Health offers primary care services.
Walmart Health, now open in two Georgia locations, offers primary care. The company plans to expand to other communities and is opening a handful of additional sites in 2020, says Walmart spokeswoman Marilee McInnis.
Driving factors
Several considerations are behind the desire to bring health care to retail locations. “Patients can benefit from more convenient access to high quality care,” says Jim OConor, Walgreens’ senior vice president of U.S. health care strategy and development. Many retailers and shopping centers are positioned to address this need; about 78 percent of Americans live within five miles of a Walgreens store, OConor says.
What’s more, many malls have excess space, says Wendy Liebmann, CEO of consulting firm WSL Strategic Retail. Retailers and shopping centers can attract and retain customers, who like the convenience of handling both their health care and shopping needs in one trip. For 100 Oaks Mall in Nashville, Tenn., bringing health care into its retail mix was key to its survival: The mall was struggling when Vanderbilt Health took over about half its 850,000 square feet, now used for both clinic and office space.
Using retail locations to provide health care also might help drive down costs. While Liebmann isn’t an expert on the cost of health care, she talks with many people who are. “They see community-based health care as one way health care costs can be contained,” she says.
Americans’ interest in health and wellness is another motivator. This includes both preventative care as well as the need to manage chronic conditions, many of which become more prevalent with an aging population. “This huge focus is one of the biggest consumer spending opportunities in decades,” Liebmann says. “It’s the ‘big business of well.’”
At the same time, many hospital systems are in “growth mode,” says Todd Caruso, senior managing director with a focus on retail at commercial real estate firm CBRE Group. Moreover, executives with many systems recognize the opportunities available in outpatient care, much of which can be handled in a retail setting.
Some newer doctors and dentists, especially those graduating with mountains of debt, might decide a position at a retailer with a nice salary is more feasible than trying to buy out a practice when a doctor retires. “It’s not for everyone, but some may feel under the gun, and pressed financially, to start generating income,” Caruso says.
The models
Retailers are taking somewhat different approaches in the ways they provide health care services. Through its physician-led primary care centers, Walgreens combines its core pharmacy expertise with care provided by organizations like Partners in Primary Care, Village Medical and Southwest Medical Associates. The result is “a neighborhood health destination around a modern pharmacy that brings affordable health care services to customers,” OConor says.
Walgreens combines its core pharmacy expertise with care provided by organizations including Partners in Primary Care.
While it might seem that the expansion of services to primary care would overshadow the need for pharmacies, that’s not necessarily so. As OConor notes, many older individuals have chronic conditions, and pharmacists often play a significant role in these patients’ efforts to manage their conditions.
Walgreens’ pharmacists have “specialized knowledge and training to help manage chronic diseases, provide medication therapy management support, administer life-saving immunizations and provide education and counseling to assist patients with their health care needs,” he says.
In addition to its primary care centers, Walgreens offers clinics across the country through partnerships with local health systems. These are run by nurse practitioners and provide acute care. By partnering with local health systems, patients are able to receive care at their local Walgreens while seeing a provider that may be within their larger health system network, OConor says, and with whom they have an existing relationship.
Walgreens also offers weight loss management and diagnostic lab testing, and select stores are trialing dental, optical and hearing services. In addition, UnitedHealthcare and Walgreens have opened a handful of UHC Medicare service centers, where Walgreens customers can learn more about Medicare plans, meet with service advocates to discuss their UnitedHealthcare benefits and enroll in plans.
For its foray into more extensive health care services, Walmart Care Clinic focuses on bringing accessibility, affordability and transparency to primary care. The clinic encompasses diagnosis and treatment of chronic and acute illnesses, as well as preventative services and additional screenings. Patients booking appointments receive estimates of the costs, and the website lists prices for common services. The transparency “is taking the guesswork and complexity out of getting care,” McInnis says.
Feedback from both medical providers and patients has been positive, she says. Clinicians say they appreciate the integrated care model and the ability to address the diverse health needs of the community, and patients like accessing health care conveniently and affordably.
Accessibility and quality underpin the approach to health care by M Health Fairview, says Jakup Tolar, dean of the University of Minnesota’s medical school. “Our general approach to health care is to meet patients where they are,” he says. “We seek to make it as easy as possible for patients to interface with their health care providers.”
The M Health clinic at the Mall of America offers physicals, vaccinations and other services, as well as help for travel-related issues.
The reception to the clinic has been positive, says Jill Renslow, senior vice president of business development with the Mall of America. It’s easily accessed by the approximately 13,000 employees working at the mall, as well as guests staying at the two hotels connected to the property. That’s in addition to customers shopping at the mall. To serve the diverse group, the clinic offers physicals, vaccinations and other services, as well as help for travel-related issues.
“We’re fully prepared to scale this,” Tolar says. “We’ll go to different malls and different places where people go. We’re making health care simpler without compromising care.”
Halifax Shopping Centre in Halifax, Nova Scotia, is home to a range of health service providers, including medical, dental and breast-screening clinics and opticians. “We are looking to be a destination for customers, from shopping to dining, as well as health and wellness,” says marketing director Stephanie Schnare. The mall, which is on a bus line, is connected to several office buildings and near six universities, which host more than 50,000 students, including a large percentage of international students. “They find it convenient to hop on the bus, come to the shopping center and visit the clinic and dentist,” Schnare says.
Challenges
While the move to combine health care and retail shows no sign of stopping, it’s also not without challenges. One is building trust. “How do you show people they can trust you to deliver quality services?” Liebmann says. The idea of a “doc in a box” providing care from a retail location has rarely inspired confidence in potential patients. Similarly, some health care providers may balk at providing care in a non-traditional setting.
Another key is ensuring the quality and transparency of the services. At times, it’s hard to tell if some store-based clinics are staffed or even open, Caruso says. Who is providing care — that is, an MD or another medical professional — also can be unclear. “That fosters some skepticism,” he says.
Incorporating health care services within a retail setting often changes the business model. It could require an investment in space and medical equipment, as well as a trained medical staff. The product mix in the store could change, with more space devoted to medicines and equipment like walkers. “That conversion is important and not inexpensive,” Liebmann says.
And, as always, location is key. “The easier to access, the better,” Tolar says. The M Health Clinic is near an entrance to the Mall of America, where it has reserved parking.
Clear wayfinding also is critical, especially for medical services provided within shopping centers. Patients entering a mall may be nervous and focused on their upcoming visit; a confusing trek to get to a medical provider only adds to their anxiety. To alleviate this, Schnare says Halifax Shopping Center recently launched a text concierge service to help with wayfinding.
While the challenges are real, the promise of offering health care in a retail setting is as well. Changing demographics — most notably, an aging society with a generally increasing need for health care — along with growing interest in health and wellness will drive continued interest in the mix of retail and health care. “I don’t think we’re in the ninth inning,” Caruso says.
Similarly, consumers have grown increasingly used to the idea that the products and services they need be as convenient to access as possible. Adding health care to a retail mix is one way to accommodate this.
Developers are counting on demand to be strong for co-living apartments in Wynwood, offering lower rents, shared common areas and amenities geared to promote face-to-face interactions among residents.
“There is a real vibe in these buildings,” said Swiss real estate developer Ralph Winter, whose company, W5 Group, is developing a Wynwood co-living project with the Related Group. “It is very comparable to student housing except here you have people coming from all over the world [as roommates]. They really like it.”
Winter joined Alberto Milo Jr., president of Related’s affordable housing division, and Greg West, CEO of ZOM Living, for a panel discussion on the latest trends in multifamily development at the Urban Land Institute’s Housing Opportunity Conference on Monday. Ron Terwilliger, chairman of Terwilliger Pappas Multifamily Properties, was the moderator.
Winter said his project with Related, called w28 and designed by Arquitectonica, will likely take two-and-a-half years to complete. As the lead equity partner, W5 Group is providing 80 percent of the capital to build w28. The project will have 200 co-living apartments and 3,600 square feet of ground-floor retail. The development is set to rise at 33, 45, and 51 Northwest 28th Street, three parcels Related bought for $6.5 million in June.
Apartments at w28 will be fully-furnished, have shared common areas and include streaming services such as Netflix — features that appeal to millennials, Winter said. He said kitchens are designed to encourage interactions between an apartment’s tenants, such as drinking beer on a dining counter.
“This is more of a prime concept to bring people together,” Winter said. “We have seen in our research that the loneliness factor for a 25-year-old is much higher than for a 65-year-old. [Because of smartphones] they are not really connected in a face-to-face manner. That is what we try to do in these buildings.”
Winter said a co-living tenant can expect to pay 15 percent less than the average monthly rent for a studio. However, a room in a co-living apartment averages 140 square feet, he noted. Winter explained co-living apartments are attractive to young professionals who may not stay rooted in one city or often travel for long periods of time for their jobs.
“We have guys from Google and Apple who could easily pay $3,000 a month for an apartment,” Winter said. “You are paying to be part of a membership, an exclusive circle….They say, ‘Oh that is a cool place, and I want to be a part of it.”’
On the flip side of the demographic spectrum, demand for luxury apartment buildings geared to senior citizens is booming, according to ZOM Living’s West. His company is developing the Watermark at Merrick Park in Coral Gables and the Watermark at West Palm Beach, two mid-rise multifamily projects strictly for people near retirement age.
West said senior housing monthly rents can produce about an 8 percent yield compared to the typical 6 percent yield of regular apartment buildings.
“The exit [rate of return is] higher than conventional multifamily,” he said. “We’d sell apartments in the 4 [percent range]. In senior housing, you will sell at 6 [percent].”
However, multifamily owners have to employ more people to provide property management services. And achieving full occupancy takes longer in senior living buildings, West said.
The three-day ULI conference featured two days of panels on Monday and Tuesday. The event concludes Wednesday with site tours of various projects in Miami-Dade, including Related’s Liberty Square redevelopment project, the Link at Douglas transit-oriented development by The Adler Group and 13th Floor Investments, and condo buildings that allow short-term rentals.
There is 436,514 square feet under construction in the city with internationally known Aventura Mall and high-end condominium towers.
All will be Class A offices in a city where most of the existing inventory, nearly 799,000 square feet of a total of 1.13 million square feet, already is Class A, according to JLL data.
Aventura’s office market is focusing on high-end corporate towers like Inmobiliaria’s Optima complex and a medical district with offices for physicians and other health care and wellness providers.
Construction of the 12-story, 96,000-square-foot Forum Aventura at 19790 W. Dixie Highway just outside city limits wrapped up last year. The Optima complex at 21500 Biscayne Blvd. is to get its biggest building later this year when the 28-story, 300,000-square-foot Optima Onyx opens in Hallandale Beach, Broward County’s southernmost city bordering Aventura. On the Aventura side, the nine-story, 84,401-square-foot Optima White and four-story, 29,621-square-foot Optima Red were completed in 2013.
The budding medical district is growing following expansion of Aventura Hospital and Medical Center, which upgraded and added 22 rooms in a $75.6 million emergency room buildout. It then embarked on a 513-space garage and a three-story, 60-bed patient tower bringing the total number of hospital beds to nearly 500. The hospital owned by publicly traded HCA Healthcare Inc. three years ago obtained a Level Two trauma designation, one of two in Miami-Dade County.
North of the hospital, the 12-story Aventura Medical Tower was completed last year by The Faith Development Group, bringing 105,000 square feet of medical office condos. The tower at 2801 NE 213th St. is comprised of a seven-story, 472-space garage under five stories of offices.
On its heels to the east will be the medical office project Ivory 214 and 12 I 12 Aventura, 10-story buildings to be connected by a pedestrian bridge over 28th Court west of Biscayne Boulevard.
Healthcare providers are continually seeking cost-effective ways to deliver care. As construction costs rise, some are choosing to repurpose facilities instead of building new ones.
One example of this is the Texas Children’s Hospital, located in the Texas Medical Center in Houston. The hospital is repurposing seven floors of its West Tower, a 20-story hospital building that went through initial construction in 1991 and had additional floors added in 2001.
The seven floors being redone were vacated when Texas Children’s Hospital relocated some services to its new Legacy Tower in 2018. Two of the floors were inpatient nursing units. In planning the backfill of the seven vacated floors, those two floors were proposed for additional nursing units to address inpatient needs, and repurposed into “new” nursing units. The refresh of those two particular floors allowed the hospital to upgrade technology, repair aged fixtures and materials, implement updated signage and artwork, refresh the look and feel of the unit, and focus on medical specialties in need of beds.
“What we’re finding is, we’re doing this repurposing at half the cost of what new would be,” said Texas Children’s Hospital Vice President of Facilities Planning & Development and Real Estate Services Jill Pearsall, who was one of the panelists at Bisnow’s National Healthcare South event Feb. 13. “The other five floors are being planned for a variety of other uses, some for direct reuse, while others will receive significant demolition and renovation.”
New construction is expensive, and that cost is often passed onto consumers. Transwestern Executive Vice President of Health Advisory Services Justin Brasell said that only some end users can afford a new building, as rents have to reflect the returns required by new owners to take on the risk of building a new project. Brasell said he has seen many older buildings being repurposed, often in less urban areas with more green space. Those buildings tended to have a less efficient build-out, and part of the repurposing involved utilizing space that might otherwise be wasted, such as large atriums.
The challenge of reducing operational costs and construction costs while providing high-quality medical care has been an ongoing trend in healthcare for years, but has reached a new level of intensity, according to Baylor Scott & White Chief Innovation Officer LaVone Arthur.
“When we talk about the reduction of cost, from a provider side, we are every day trying to squeeze out every penny we can from our cost,” Arthur said. “We are just now taking control of trying to manage the cost to our consumers.”
The panelists also discussed other trends in the market, including the decentralization of healthcare. More health systems are redirecting patients to facilities located in neighborhoods to treat lower-acuity cases. Pearsall noted that an urgent care in a community setting does not have to be the same quality as a hospital. She said it is important to manage both internal and consumer expectations of how much investment should go into certain facilities.
“We are really working to develop the right facilities, in the right location at the right cost,” Pearsall said.
The trend of decentralizing care has moved further away from traditional hospitals, with technology developing to allow patients to access care in their own home, through methods such as telemedicine.
“Every health system out there is actively pursuing virtual options, because it’s a lower-cost option, and it also is providing access,” Arthur said.
The technology and infrastructure demands in hospitals and healthcare spaces have also changed over time. Everybody wants emergency power, as well as extensive redundancies built into a system to improve reliability.
“The demand for low-voltage infrastructure in new buildings is also significant,” McCarthy Building Cos. Vice President Preston Hodges said. “Nearly every hospital in the Texas Medical Center, and across Texas, is building or developing something right now. Just about every institution has a large initiative either underway in design or underway in construction.”
As a result, the demand for high-quality contractors and subcontractors has become fierce, with healthcare providers competing for labor earlier than ever before.
“These clients are going to secure teams earlier and earlier,” Hodges said.
With empty land in the Texas Medical Center at a minimum, and needs constantly evolving, Hodges believes demand for backfill and renovations will only grow.
When it comes to new design and new concepts, Arthur said she is most concerned with flexibility and creativity. Arthur points to the examples set by nontraditional players in the healthcare field, like Amazon and Google, and how the industry was closely watching what those technology leaders were doing in an attempt to keep pace.
“Healthcare is changing very quickly, and I think we are on an unprecedented path,” Arthur said. “If you’re building a traditional hospital today, something’s wrong.”
A recently completed office-apartment project in Miami’s booming Wynwood Arts District just secured $136 million in refinancing to pay off construction loans.
The Wynwood 25apartment building and adjacent Wynwood Annex office building opened last year.
Development team East End Capital, based in New York with a Miami office, and the Miami-based Related Group, founded and led by Jorge Perez, secured the loan from The Blackstone Group Inc.’s Blackstone Real Estate Debt Strategies.
The nine-story, 289-unit Wynwood 25 and the 60,000-square-foot Wynwood Annex sit on the northwest corner of Northwest Second Avenue and 24th Street.
Wynwood 25, which was completed last June, is 90% leased. The market-rate building at 240 NW 25th St. offers units from 400-square-foot studios to three-bedroom apartments. Amenities include an electric car charging station, heated pool with sundeck, rooftop lounge and kitchen, library with coworking areas, gym, pet grooming area and 24/7 concierge.
Wynwood Annex was built with an eye toward tenants in the technology, advertising and marketing fields. Its first tenant is the California-based Live Nation entertainment company, which took a full floor. The building has loft-style offices with 18-foot ceilings and a rooftop terrace.
The office building has 4,429 square feet of ground-floor retail and the apartment building has 28,518 square feet of retail, including the Salt & Straw ice cream shop and the Uchi restaurant, which will open soon.
The financing is another project milestone officially marking its completion, Jonathon Yormak, founder and managing principal at East End, said in a news release.
About $110 million of the proceeds was used for Wynwood 25 and the balance for Wynwood Annex.
Tens of thousands of people passed through the turnstiles into Hard Rock Stadium for Super Bowl LIV, taking part in the spectacle and competition. And when it ended, nearly all of them bypassed the neighborhood entirely on their way out.
While the stadium’s privately-funded, $500 million renovation boasts an open-air canopy along with other impressive additions, the surrounding city of Miami Gardens stands in sharp contrast.
The city has so far failed to attract the wide-scale investment that some sports stadiums in other cities have brought, and has not seen a blossoming of new residential properties outside the stadium.
Hard Rock Stadium owner — and Related Companies’ founder and chairman — Stephen Ross began the massive renovations of the venue in 2015, which brought the Super Bowl back to South Florida after a decade of absence. In addition, the money that Ross invested in the stadium — he also owns the Miami Dolphins — led to the Miami Open tennis tournament there in April and potentially, a Formula 1 race.
Some real estate developers who have built or proposed projects in Miami Gardens believe the renovations may bring about new interest in the city as a whole. The city, incorporated in 2003, is a historic African-American community with a population of about 110,000. It largely consists of older residential properties and commercial and industrial properties. In 2017, the household median income was $41,000 — below the county’s average of $46,388.
“The stadium is starting to be an asset. It was just a football stadium, but now… you are seeing an active asset, you are drawing people,” said Barron Channer, the CEO of Woodwater Investments, a Miami-based real estate investment firm. He previously proposed building a mixed-use project near the stadium.
Some developments are already in the works.
Los Angeles-based Latigo Group recently broke ground on a 259-unit apartment project at 19279 Northwest 27th Avenue in Miami Gardens. Rents will range from $1,700 to $2,300 per month, and the project is one of the first new market rate apartment developments in the city. It’s part of a bigger mixed-use project that will include a 37,000-square-foot building on a 4.63-acre parcel that will be leased to 24 Hour Fitness.
Jonathan Roth of Miami-based 3650 REIT, which provided a $50 million construction loan for the project, said Miami Gardens could become an attractive place to build housing at reasonably priced rents, since land prices are cheaper.
“What is happening nationally, you have a lot of development, but it is all Class A going up. By going into Miami Gardens you are going to pay slightly less for the land,” Roth said.
Sitting right off the Florida Turnpike and I-95 and in between downtown Miami and Fort Lauderdale, Miami Gardens has become a hub for logistics and warehouses, the less sexy part of real estate.
In recent years, institutional industrial investors have been snapping up properties in the area. In October, private equity giant Blackstone acquired two industrial properties in Miami Gardens for $13.6 million at 5120 Northwest 165th Street. And in July, Longpoint Realty Partners bought an industrial park in Miami Gardens from Prologis for $25 million.
In the northeast Miami-Dade County submarket, which includes Miami Gardens, more than 197,000 square feet of industrial space was under construction at the end of 2019, according to a report from Avison Young. The net absorption was 1.1 million square feet, the most of any submarket in the county.
Yet, the question remains whether the city will pivot from attracting industrial development to more residential projects.
Some real estate experts are betting on it, in part due to the rising cost of land in other parts of South Florida, and a lack of developable land to build new projects. The city could also become an alternative for renters on a budget, who would otherwise move further south or west in Miami-Dade County.
Colliers International South Florida’s Gerard Yetming and Mitash Kripalani are listing two parcels of land in Miami Gardens at 1255 Northwest 210th Street, totaling 82.5 acres, which allow for a maximum of 50 residential units per acre. Yetming said he is getting inquiries from developers who are looking to build workforce residential development, and that developer interest is growing in Miami Gardens.
“The level has increased over the past couple of years,” Yetming said. “A few years ago, developers were more interested in downtown and an urban type of environment.”
With new investment also comes the risk of gentrification and displacement of existing residents, something communities in places like Miami’s Little Haiti are trying to combat amid projects like the Magic City Innovation District.
“Miami Gardens is and has been heavily defined by the presence of black residents,” said Channer of Woodwater Investments. “If this is not reflected in who is courted to, and actually investing at all levels, then economic development efforts would have failed their ultimate test.”
Nicklaus Children’s Hospital plans to sell the failed Miami Medical Center, a specialty hospital that Nicklaus Children’s bought just over two years ago for $88 million, after deciding to focus its growth strategies on more outpatient clinics and its own Coral Terrace campus.
The decision to sell the building follows a year of financial instability, layoffs and administrative changes. At the time of the purchase, in December 2017, questions surrounded the financial underpinnings of the deal. That included questions about the nonprofit Nicklaus Children’s financial interests in the for-profit ventures associated with the Miami Medical Center. Miami Medical Center, located near Miami International Airport, closed in October 2017.
Matthew Love, who took over as chief executive officer on an interim basis in June last year, also announced this week that he will begin serving as the hospital’s permanent CEO. Love said he couldn’t answer questions about the relationship between the nonprofit hospital and the for-profit ventures because much of the arrangement predated his time with the hospital.
Before the bankruptcy filing, one of Miami Medical Center’s biggest investors was Nicklaus Children’s, which served as shareholder, lender and manager of the hospital through a venture called Miami Hospital Holdings. In March 2018, the company that operated Miami Medical Center filed for Chapter 11 reorganization, listing $21.4 million in assets and $67.3 million in liabilities.
Love said the hospital has retained an outside consulting firm to help with the sale, and that Nicklaus Children’s board signed off on the decision to sell. The CEO declined to list a specific price for the facility but said Nicklaus Children’s would sell the building for the “best price we can get.”
“The sale makes sense with Nicklaus Children’s growth strategy,” Love said. “When you talk about expansion and growth, it doesn’t always have to be brick and mortar. Miami Medical Center was right down the street. What I’m not really interested in is replicating high-end services — those are expensive.”
Sal Barbera, a former healthcare executive who now teaches healthcare administration at Florida Atlantic University, said he thinks the decision to sell the building goes beyond growth strategies and has more to do with the hospital’s current financial condition.
“They need to unload that asset, they need the cash,” Barbera said. “They didn’t buy it that long ago.”
In 2014, Nicklaus Children’s — when it was still an investor — signed on to guarantee up to $70 million of financial obligations related to Miami Medical Center. When the private hospital defaulted on its debts, Nicklaus Children’s paid a total of $14 million in 2017 and 2018, according to an analysis by Fitch Ratings.
During 2018, Nicklaus Children’s also funded $7 million of Miami Medical Center’s operating costs as part of its obligations. Miami Medical Center’s bankruptcy was finalized in January 2019.
The company that invested in Miami Medical Center was partly owned by a for-profit corporation whose officers were made up of Nicklaus Children’s board members and executives, including former CEO Narendra Kini, former CFO Timothy Birkenstock and April Andrews-Singh, a senior vice president and general counsel.
Love, the current CEO, said he is hopeful that the Florida Legislature’s deregulation of hospital building guidelines will make the facility attractive to out-of-state healthcare providers or providers from elsewhere in the state.
“What I’m interested in us doing is focusing on the fundamentals,” Love said. “We’re the best pediatric healthcare provider in Florida, and we need to focus on that. That’s who we are.”
