The “Creative Lease Financing Structures” panel discussion during the BOMA Medical Real Estate Conference April 30 included (from left to right): moderator Sean Maynard of Brown Gibbons Lang, Craig Fimple of NexCore Group, Ben Mingle of Centurion Foundation, Howard Vogel of The Walker Group, and Greg Fawcett of JLL Securities. (HREI™ photo)
BOMA panel discusses creative lease structures, shares case studies
By John B. Mugford
For health systems that would like to own certain outpatient facilities that they occupy, there has, for quite some time, seemingly been just a couple of methods to gain control of such assets.
Those have included owning the land underneath a facility and having a third-party owner enter a long-term ground lease, or to acquire a facility outright in a sale-leaseback transaction.
However, that last option has become increasingly difficult for health systems, as many of them are currently strapped for cash as they experience tighter operating margins, rising capital costs and decreasing reimbursements.
During one of the dozen or so panel sessions at the recent BOMA International 2026 Medical Real Estate Conference held from April 29 to May 1 at the Hilton Bayfront Hotel in San Diego, a group of panelists explained how they are providing health systems with what can be considered “more nuanced, system-led financing strategies” to help them own or occupy certain facilities at significantly lower occupancy costs.
The panel session, which was titled, “Creative Lease Financing Structures,” took a look at some of the alternative lease/financing structures available to health systems, including
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