Case Studies

Develop a comprehensive strategy for Ascension Health's medical office buildings.

Three service areas including Lillibridge Advisors, Capital and Property Management worked together on this project. The teams started by making an inventory of the system's medical office buildings and evaluating each of them. Strategic options were suggested for the future of the properties, and after assessing the options, many of the member systems chose to monetize a number of their buildings. Using a competitive bidding process managed by a third party, many of the member systems selected Lillibridge as the buyer of their buildings. Lillibridge then worked closely with the local systems and the tenants on their property management needs.

Construct and manage a showpiece medical office building.

Lillibridge met the client's very specific requirements. The new medical building constructed on a former parking lot was designed to include enough parking to replace the spaces lost as well as handle parking for new tenants and patients. In order to satisfy Banner Desert's desire that the patients "feel like they are in the hospital", features like a light-filled atrium were added to the building to create a seamless Southwestern look. Working closely with the new medical center, Lillibridge leased space to physician practices that focus on pediatrics; surgery, oncology, urology and gastroenterology.

Help Carondelet Health overcome growing competition from healthcare providers in neighboring state Kansas, where medical insurance costs are half of those in the state of Missouri.

Through a competitive bidding process, Lillibridge purchased and began managing Carondelet Health's three medical office buildings. It continued to invest in the properties, modernizing mechanical systems and redecorating the public spaces. A major addition to one property was also constructed to accommodate key growth areas including cardiology, orthopedics and internal medicine.

Assist Celebration Health achieve its next phase of growth by developing and managing a four story medical office building.

As part of the hospital's land-use agreement with Disney Corporation, which built the nearby planned community of Celebration, the 78,000 square foot building was designed working with outside architect Robert Stern to ensure that the facade of the new MOB met Disney's exacting standards. Because Celebration Hospital is not located near many residential areas, it asked Lillibridge to make the new office space especially inviting. Lillibridge also syndicated ownership of the building among the lessors, which was an added attraction for participating doctors.

To assess Centegra's portfolio and make strategic real estate recommendations.

Lillibridge examined Centegra's core network goals, and performed a portfolio assessment to gather market, property, and operations knowledge. It recommended centralizing data, identified areas of potential operating improvements and proposed specific measures to bring property management to "best practices" standards. After developing a level of trust with Centegra, Lillibridge was asked to identify and analyze portfolio monetization alternatives. The relationship between the two companies ultimately extended beyond the services of Lillibridge Advisors, and into an outsourcing of property management, where Lillibridge was able to make operating improvements, extend lease terms and reduce overall vacancy rates.

Free up capital and help reinvigorate CHRISTUS Santa Rosa's physician recruitment efforts.

Lillibridge purchased four of CHRISTUS Santa Rosa's medical office buildings and upgraded and renovated the facilities. It then developed and executed a strategy for retaining physicians, attracting new practices and expanding hospital services in the buildings. Because orthopedics is a major focus for the hospital, Lillibridge persuaded a number of physicians in the South Texas Medical Center, to move to different floors to allow a large orthopedic practice to occupy the entire first floor.

Raising capital for Cleveland Clinic Health System's facility and market expansion.

Lillibridge performed an examination of monetization alternatives across a 12 property portfolio. It closely examined all aspects of the portfolio including floor plans, rent rolls, sample leases and operating statements. By determining an identified market value, the Lillibridge team offered Cleveland Clinic valuable insights that detailed the specific impact to their income statement, balance sheet and key financial ratios. Once it was presented with the thorough market and property operations analysis, Cleveland Clinic could exercise recommendations that would impact their bottom line.

Attract community physicians serving other health plans to an on-campus medical office building.

Lillibridge developed a four story, 68,000 square foot office facility for Exempla Good Samaritan that opened even before the neighboring hospital did, helping to drive physician recruitment. It then built out space to accommodate a physician-owned ambulatory surgery center and recruited tenants including cardiologists, obstetrics, and the largest neurosurgery practice in the county.

To create an outpatient zone in a suburban Denver campus using two existing medical office buildings and constructing a third.

Lillibridge worked with Exempla Lutheran to rethink the location and configuration of its outpatient services, which were spread throughout the hospital and the physicians' office space. Lillibridge turned the cluster of medical office buildings into a unified subcampus. It built a two story, 63,000 square foot facility and renovated 81,000 square feet of existing properties. The buildings were connected with a covered walkway and a new healing garden. The project was so successful that it attracted an ambulatory surgery center, so Lillibridge constructed a two story wing addition to the newest building.

A hospital system with a 400-bed hospital in Chicago was challenged by a difficult core market with relatively poor demographics.

Lillibridge was asked for site selection alternatives that would provide the greatest potential to serve the community, while still attracting new providers and patients. 27 sites within a targeted area were identified by the initial search. Projected acquisition cost estimates and site planning analyses narrowed the array to two very desirable sites with excellent access, visibility and development potential. One site was selected, and Lillibridge began a swift yet careful assemblage of 11 parcels into one buildable site. Within one year, Ingalls secured control of a fully assembled and annexed site that was approved for development. Lillibridge's involvement continued post-acquisition with physician demand studies, economic analyses and project cost estimates.

Redirect capital for Mercy Hospital Miami to allow them to sharpen their focus on enhancing centers of excellence.

Lillibridge purchased two medical office buildings from Mercy Hospital Miami and collaborated with the hospital and physicians to accommodate practice expansion and the addition of new practices. Significant investments were made to upgrade the buildings, refurbishing common areas and modernizing the facilities. Lillibridge also helped the primary tenants find subtenants to lease in their suites, maximizing useful space. As a result, these two buildings are full with a total of 160 tenants, and they both have tenant waiting lists.

Design, build and manage the MountainView Regional Medical Center's medical office building in New Mexico.

Lillibridge broke new ground with its 110,000 square foot, four story development in Las Cruces. The facility was the first large medical office building in the area, and this one was upscale with top-flight amenities. The firm was the first to syndicate an MOB like this, which proved to be an attractive incentive for area physicians. So much so, that the building was 95 percent occupied when it opened.

Avoid excessive delays associated with traditional, non-profit hospital financing in developing a 164,000 square foot "big box" multidisciplinary outpatient facility.

Lillibridge was proud to have been selected to be the hospital's partner after an exhaustive search of 20 potential firms. Armed with substantial experience in the healthcare real estate capital markets, Lillibridge secured solid financing for both construction and permanent loans. Penn State's Board of Trustees leased 23 acres to Lillibridge for the new facility. Lillibridge is leasing the facility back to the Medical Center which has periodic purchase options throughout the 30-year lease term.

Confirm that twenty major outpatient assets are in line with ProMedica's System strategies. Provide physician alignment strategies through investment in existing and future real estate assets.

Lillibridge assessed the value of each property relative to the System's strategic plans. Financial operations assessments revealed performance improvement opportunities and potential expense reductions across the properties. It also recommended best practice processes and procedural improvements to streamline property management and maximize leasing opportunities. This provided for substantial revenue enhancement. Combined efforts of the Development team and Lillibridge Advisors, revealed successful physician investment models to be considered for future ProMedica developments.

Sherman needed to determine the physician demand for space in its 30,000 square foot integrated ambulatory care center.

Sherman contracted with Lillibridge Advisors to identify, contact, lease and relocate a desirable tenant mix. Lillibridge surveyed comparable medical and commercial buildings in the area to identify market-supportable lease terms and then reviewed and revised Sherman's existing "standard" lease form to prepare individual lease packages. It contacted all interested physicians and converted interest into actual leases. Shortly following construction completion, the physician space in the ambulatory care center was 100 percent leased and occupied by a desirable mix of physician tenants.

Allow St.Vincent Health to raise needed capital to finance its acquisitions of Saint John's Hospital.

Lillibridge worked with Ascension Health, the largest U.S. non-profit healthcare system; doing an inventory of their medical office buildings system-wide and evaluating the strategic options for the real estate. The assessment led St.Vincent management to sell some of its buildings, allowing the company to focus on its core mission. Through a competitive bidding process, Lillibridge acquired 11 buildings from St.Vincent, and developed a multi-year action plan for upgrades and improvements.