Healthcare and medical office have reputations as largely inflation-proof and good investments at almost any time. A number of events around the U.S. are showing that no property type is "safe," even hospitals that are in Massachusetts, a darling of the industry.

Healthcare in the state — home to massive care systems and teaching and research institutions — is facing some difficult times. The Department of Public Health increased the risk rating of hospitals in the greater Boston area and the region to the northeast of the city to so-called Tier 3 created during the height of the pandemic. It is the most serious level based on spikes in diseases, emergency department usage, and bed availability in hospitals.

"Tier 3 requires hospitals in the affected region to meet frequently to share bed availability, and may result in facilities implementing 'gradual and dynamic reductions in elective, non-urgent procedures and services,'" wrote the Massachusetts Health & Hospital Association (MHA). "Region 5 (Southeastern Mass. and the Cape and Islands) has been in Tier 3 since the beginning of 2023, following the fire at Signature Brockton Hospital on top of the prolonged closure of Norwood Hospital due to flooding."

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"On any given day in Massachusetts, more than 1,000 people who are awaiting discharge from hospitals are literally stuck in those facilities with no ability to transition to the next level of care," the organization wrote.

One reason for the jam-up is the lack post-acute care space. A previous MHA survey of how many hospital patients were waiting for discharge at the end of 2022 found 1,077 stuck in place in 42 hospitals surveyed. Of those, 570 needed space in a skilled nursing facility and 44% had been waiting for 30 days or longer.

And then, there are additional pressures coming from outside the state. Texas-based Steward Health Care, which owns nine hospitals in Massachusetts, is in a financial crisis.

"After falling $50 million behind on year-end rent to Medical Properties Trust, the largest hospital landlord in the U.S., the Dallas-based health system has also received backlash from state and federal lawmakers, Steward employees and concerned community members in response to the risk of hospital closures," Becker's Hospital Review reported.

"The Massachusetts healthcare system continues to face severe capacity challenges as we navigate through the winter months with record hospital occupancy levels, three prevalent viruses circulating, and significant workforce shortages," the Massachusetts Executive Office of Health and Human Services wrote in a January letter. "These issues exist across the system and require immediate, short-term action on all parts to release pressure in the system and support timely patient transitions to the most appropriate care setting."

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