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Medical office ground lease

Ground lease financing for medical office.

Medical office buildings sit on land-heavy campuses with stable, creditworthy healthcare tenancy. Monetize the land to fund an acquisition or recap without dilution — and the leasehold stays agency- and CMBS-compatible. We buy the land; you keep the building and 100% of the upside.

Sticky healthcare tenancy on a land-heavy campus — the dirt is doing real work.
~30–40%
of basis is land you can monetize
·
3–4x
MOB income covers the ground rent
MOB campuses are land-heavy — low-rise footprints, structured and surface parking, and pads held for future phases all carry value in the land. Creditworthy, long-WALT healthcare tenancy makes the income unusually durable, so the ground rent — roughly a quarter of NOI — is covered several times over while the freed capital funds the acquisition or retires expensive money, all without giving up equity.
What it solves

What a medical-office ground lease funds.

With a Valor ground lease The usual path
Acquisition equity Land value funds the down payment — bid the dirt under the buyer and close the MOB on a thinner check. A larger LP equity raise or a more expensive bridge to win the asset.
Recap without dilution Permanent, non-amortizing capital recaps the deal as rent — no new equity partner, no surrendered promote. A cash-in refinance or fresh JV equity that dilutes your ownership and upside.
Agency / CMBS takeout Stays financeable — the leasehold refinances on the smaller basis; a properly structured ground lease is agency- and CMBS-compatible. Conventional debt on the full fee basis — more proceeds needed, more equity required.
Pref takeout Buy out the partner — land proceeds replace expensive preferred or LP equity, so you keep the promote. Carry a 9–15% pref, or surrender promote and control to a new equity partner.
Ownership Stay the owner — you keep the building, the leases, and the tenant relationships. A full sale or sale-leaseback can hand the asset to a new owner or REIT.
Your upside 100% kept — you own the building, the cash flow, and the appreciation. Shared with whatever pref or JV equity you brought in to fill the gap.

And: stabilized, leased MOB fits best — durable healthcare income covers the ground rent · the land comes out as permanent capital with no balloon and no maturity wall · one note: fee ownership has to be yours to sell — an MOB on a hospital-system-owned or public-authority parcel, where the institution holds title, can’t be ground-leased the same way.

Questions, answered

Medical-office ground lease — FAQ.

Why does a ground lease work for medical office?

MOB campuses are land-heavy: low-rise footprints, structured and surface parking, and pads held for future phases put a meaningful share of value in the dirt. Creditworthy, long-term healthcare tenancy makes the income durable, so the ground rent, roughly a quarter of NOI, is covered three to four times over. That lets you monetize the land without straining the asset.

Can I recap without giving up equity?

Yes. The land proceeds come out as permanent, non-amortizing rent, not as a new equity partner. You recap the deal, retire expensive or maturing capital, and keep the building, the promote, and 100% of the upside. There is no dilution, because we buy only the land and lease it back to you.

Is the leasehold still financeable by an agency or CMBS lender?

A properly structured, long-term ground lease with standard leasehold-mortgagee protections is agency- and CMBS-compatible, and the leasehold refinances on the smaller basis. We document the lease to the protections leasehold lenders expect, so your takeout path stays open.

Does it work if my land sits under a hospital or authority structure?

Often it does not. A ground lease requires that you actually own the fee, so it can be sold and leased back. Where a hospital system or public development authority holds title, the land is locked and a private ground lease generally cannot coexist. We check the recorded title and any bond or PILOT documents before quoting a land value.

Send us the deal

We move on real numbers.

Land-heavy, leased medical office — on-campus or off-campus MOB with creditworthy healthcare tenancy — especially where you’re funding an acquisition, recapping without dilution, or taking out a pref. Send the address, the as-complete stabilized NOI, and total project cost — we return an indicative land value in 48 hours, as principal or arranged capital.

Email us the deal