Cox Castle’s Healthcare Real Estate Group has built a reputation as one of the foremost legal teams in healthcare real estate and seniors housing nationwide, having advised on more than $4 billion worth of transactions in the past few years alone. Our attorneys represent some of the largest healthcare REITs in the nation, as well as myriad other participants in the healthcare and seniors housing sectors, ranging from institutional investors, developers and hospitals to private owner/operators, physician groups and traditional investors. 

Our team stands out due to its full-service approach in advising on all facets of healthcare real estate and seniors housing transactions, from acquisitions and dispositions to financing, entitlement and development, construction, leasing and property management, joint venture, risk management and insurance. Our attorneys have worked on all types of healthcare assets, including medical office buildings, standalone hospitals, hospital campuses, ambulatory surgery centers, seniors housing projects (such as age-restricted housing, assisted living, memory care, independent living and skilled nursing) and other healthcare-related facilities.

Cox Castle’s Healthcare Real Estate Group has a breadth of experience and expertise in the industry-specific nuances of the healthcare and seniors housing sectors and understand current market conditions and trends, allowing us to help strategically and proactively meet our clients’ business objectives. Our attorneys have also taken a leading role in advising clients in integrating renewable energy systems into their medical office projects to meet new California solar and energy mandates, a recently emerging trend from local and state regulators.

Acquisitions and Dispositions

We represent buyers and sellers of healthcare and seniors housing assets throughout the United States. These operation-intensive industries present myriad unique considerations that affect the negotiation of various real estate transactional agreements. Cox Castle’s knowledge of the intricacies of these industries allows us to provide valuable advice and insights when advising these clients on purchase and sale documents, joint venture agreements, property management agreements and loan documents.


We represent developers, hospitals and investors in the development of a wide variety of healthcare and seniors housing related real estate assets. We have substantial expertise in all stages of the construction and development process, including negotiating development management agreements, architect agreements and construction contracts, as well as implementing customized insurance programs.

Joint Ventures

We represent both investors (including REITs and public pension funds) and operators (including operators of seniors housing communities and other healthcare facilities) in establishing their joint venture relationships in connection with the acquisition, ownership and operation of healthcare related real estate projects and portfolios.

Property Management

We represent owners and operators in the negotiation of property management agreements with a particular emphasis and expertise in negotiating seniors housing property management agreements. Our deep industry knowledge allows us to provide effective guidance to clients’ navigating the unique operational issues that must be addressed in these documents.


We assist healthcare and seniors housing clients in obtaining all types of financing from various sources, including traditional balance sheet lenders and agency lenders such as Fannie Mae, Freddie Mac and HUD. Our expertise includes the negotiation and documentation of acquisition, permanent, bridge and construction loans, as well as ground lease, mezzanine and joint venture financing.


Our attorneys have in-depth experience with all aspects of land use approvals, including general and specific plans, zoning, conditional use permits, variances and related matters.


We have extensive experience in leasing all types of medical office products, from multi-tenant to single user buildings, as well as master leases with hospitals. We are familiar with issues raised by various federal laws regarding the health care industry, including the Stark Act and anti-referral statutes and HIPAA/patient privacy.

The depth and breadth of our real estate capabilities enable us to draw on the special expertise of other Cox Castle attorneys in areas such as litigation and dispute resolution, environmental matters, risk management and insurance coverage, public finance and construction law to deliver comprehensive legal services to our healthcare and seniors housing clients.




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