CREJ

July 2017 — Health Care Properties Quarterly —

Page 23

www.crej.com

monitoring and control. It is critical

to ensure new technology is both

efficient and scalable. By striving for

convergence in technology systems,

it will generate a lower total cost of

ownership for the technology invest-

ment. This ultimately will maximize

the return on that investment.

Organizations need to ensure that

construction managers have the proper

expertise on technology systems. Exten-

sive expertise and management will

better orchestrate this process. Consider

integrating all technology scopes under

one management source to ensure all

systems are being considered through-

out each subcontractor scopes of work

to eliminate silos.This integrated

approach will reduce challenges for

both organizations and project teams.

It also will provide a central point of

accountability for the entire technology

system.

Ultimately, this fourth utility isn’t just

a trend reserved for health care. In the

future, every device manageable from

doorbells to toasters will be connected

to the internet.The trend in technology

and integration is truly skyrocketing.

Howwell we plan for the integration

of these technology systems will setup

organizations from health care pro-

viders to construction managers for

success.

3) What is the estimated future value

profit compared to the factors consid-

ered in the first two questions?

If successfully analyzed, the rewards

gained from executing these transac-

tions are great, as described above,

as benefits. The ability for physicians

to reinvest into their core business

not only alleviates the challenges of

managing a property in tandem with

a health care practice but also enables

practice growth and positive future

planning.

Several successful sale-leaseback

transactions that have happened in

Colorado include a record-breaking

single-tenant, medical office, sale-

leaseback that occurred in 2015. A

56,349-square-foot MOB, the Urology

Center of Colorado, sold for $623.79

per sf. The elevated value was due to

many factors, including a strong ten-

ant, fantastic location, long-term lease

and high rents. Additionally, Engle-

wood-based health system Catholic

Health Initiatives sold 52 medical office

buildings, totaling more than 3.1 mil-

lion sf, to Physicians Realty Trust for

$725 million. At the time, the buildings

were nearly 95 percent leased with the

remaining lease term averaging 8.6

years.

Sale-leaseback transactions can be

complex and multifaceted commer-

cial real estate transactions. For this

reason, it is strongly recommended

that physicians hire a team that spe-

cializes in health care real estate. This

team should include a commercial real

estate broker, an attorney and a certi-

fied public accountant. Understand-

ing all risks and benefits associated

with the structure of both the sale and

leaseback allow both parties to careful-

ly determine if this is the right strategy

for their future.

hospital due to preventable condi-

tions. Rehab hospitals are full-time

care facilities with state-of-the-art

equipment in private rooms, rehabil-

itation spaces and even dining areas.

The most notable developments

of these newer facilities are taking

place in Denver, with the hopes that

more will find their way to Colorado

Springs.

The changing world of health care

real estate is complex for patients,

health care systems and commercial

real estate industry folks. Health

care systems and hospitals are ulti-

mately a needs-based industry; but

while they are caring for patients,

the incentive for efficient opera-

tions by consolidating locations is

impacting where patients are able to

receive care. The legislative agenda

before Congress will further impact

the medical office market and estab-

lish new financial considerations for

providers and patients alike. Stay

tuned.

Senior Housing & Care

ften in health care settings,

particularly long-term care

facilities such as indepen-

dent or assisted living and

nursing homes, mealtime

can be the highlight of the day: a

time when conversations and laugh-

ter fill the room, when friends and

families meet, and when staff can

connect with residents. It is an irre-

placeable and unique social hour

that stems from human nature of

community bonding over food.

Beyond just impacting the culture

and social climate that heavily affect

the minds of potential residents, it’s

also a necessary element for proper

sustenance and nutrition, which

can be critical when caring for the

elderly.

Recently, the attitudes to food

service in health care have shifted.

Strides are being made elevating

food offerings far above and beyond

the preconceived molds of infamous

plastic trays and green Jell-O. Today’s

senior societies feature fresh, local

ingredients from on-site gardens

served with a side of presentational

flair.

These changes are happening with

strong intent and purpose, as patient

care and nutrition are top priorities,

can become powerful marketing

tools for drawing in potential resi-

dents and even assist in employee

retention.

• High-quality food, local ingredi-

ents and executive chefs.

If you can’t

shake the Jell-O taste out of your

mouth, our first trend will revive

your taste buds. Our No. 1, most

influential trend in health care is

focusing on fresh and local food,

and made-to-order concepts. Imple-

mentation of this trend vastly varies

depending on the level of care pro-

vided, size and location of the facil-

ity, and many other factors, but the

goal remains the same – delicious-

tasting food with high nutritional

content.

For those who

strive for a hospi-

tality or resortlike

model of health

care, a sit-down

restaurant style

of food delivery is

becoming increas-

ingly popular.

Leather-bound

menus, tablecloths

with flowers and

executive chefs

moving from

table to table are

not unheard of.

Further remov-

ing the monotony from scheduled

meal periods, these restaurants

are successful at creating unique

experiences throughout the day.

For example, breakfast can be more

informal with buffets and limited a

la carte options; for lunch, transition

into made-to-order items from the

grill; and dinner could be a more for-

mal atmosphere with chef’s tasting

courses and other specials.

If residents are more independent

and physically able, marketplace-

style serveries that dominate other

industries like corporate and higher

education are becoming increas-

ingly popular. A series of stations or

microrestaurants fight menu fatigue

by catering to all genres of food,

ranging from homemade falafel

and pita to wood-fired pizzas and

gourmet salads. Transforming the

dull dining hall into a lively place of

action benefits more than just the

food program. The smells, sights

and stimulation created have been

proven to engage seniors’ senses

and stimulate appetites.

To increase variety even further,

the platforms can be specifically

designed and outfitted with adapt-

able equipment, resulting in plat-

forms that have the potential to

serve pancakes and eggs in the

morning then change to a made-to-

order grill in the

afternoon. Steps

can be taken in

the design process

for future modifi-

cation, making it

easy to adapt new

trends and con-

cepts in the future.

If your make-your-

own sushi station

never catches on,

you could modify

it to become some-

thing more favored.

A simpler

approach that still

showcases farm-to-table creations

is adding a mobile food cart for chef

demonstrations and food tastings –

either during the meal periods or as

a separate event.

Other successful implementations

include on-site gardens from which

the produce is being harvested and

incorporated into meals. These gar-

dens can double in their purpose

and be used as a community out-

reach – sharing plots with neighbors

and inviting them into garden with

residents, as an example.

Some facilities are taking on larger

commitments by hosting on-site

beehives for harvesting honey, chick-

ens for farm-fresh eggs and even

goats for specialty cheeses. Again,

community outreach can be lever-

aged here for educational sessions

or selling the surplus as a unique

fund-raiser.

• Variety, variety, variety.

If we

haven’t mentioned it enough yet,

variety is key for these long-stay

establishments and the food ser-

vice programs should be designed

with that in mind. Another popular

avenue, especially for facilities with

multiple buildings, or on large cam-

puses, is a decentralization of food

service. Rather than one big main

dining area, multiple smaller outlets

are being introduced for around-the-

clock foodservice options and added

levels of customization. For example,

a café with light breakfast foods and

upscale coffee could be added as

supplementary outlet to your main

dining area, or an after-hours grab-

and-go option could be introduced.

In assisted and independent living

situations, small grocery items or

packaged grab-and-go options are

available for residences to purchase

and eat at their leisure. Often, offer-

ing selection and variety in food

choices can make the transition

easier for newcomers into long-term

care.

Inviting outside vendors in also

is becoming increasingly popular.

Some facilities are partnering with

local ice cream shops, cafés, bak-

eries and juice bars to lease out

space within their buildings. This

approach also is a great way to con-

nect with the local community and

offer an added perk to visitors.

• Double duty: Delighting residents

and staff.

Obviously, residents and

their families are top of mind when

considering food service options

for a new-build or renovation but

consider the impact on employees

as well. Your food program aids in

supporting healthy meals to your

residents and acts as a marketing

tool for outreach, but it could also

be shifted to be used as a recruit-

ment tool. Offering fully prepared,

healthy meals to eat on-site or to

take home to employees’ families is

a huge perk that can enhance ben-

efits packages to set you apart from

other facilities.

The modern and evolving land-

scape of health care food service

is opening windows of opportuni-

ties for senior care facilities to dif-

ferentiate themselves, showcase

specialty ingredients and promote

nutritional well-being – catering

not only to residents but also to

their families, employees and local

communities.

Thechangingatmosphereof food service for seniors

Al Moller, LEED

Principal, Ricca

Design Studios,

Greenwood Village

Lauren Bartos

Director of

marketing, Ricca

Design Studios,

Greenwood Village

Lynch

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Powell

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Boucher

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