Sila Realty Trust's Strategic Acquisition of High-Quality Healthcare Real Estate: A Blueprint for Durable Income in a Resilient Sector

The healthcare real estate sector has long been a bastion of stability, even in volatile economic climates. For income-focused investors, the appeal lies in its dual promise: consistent cash flow and the ability to adapt to evolving healthcare delivery models. Sila Realty Trust, Inc. (NYSE: SILA) has cemented its position as a leader in this space through strategic acquisitions of triple-net (NNN) leased medical outpatient buildings (MOBs) and inpatient rehabilitation facilities. These deals, completed in 2025, not only reinforce Sila's thesis of capitalizing on the shift toward outpatient care but also underscore the long-term income stability and growth potential of healthcare real estate as a recession-resistant asset class.

The Acquisition Thesis: Outpatient Care as a Growth Engine

Sila's recent $16.15 million acquisition of two MOBs in Southlake, Texas, exemplifies its disciplined approach. The portfolio includes a gastroenterology center leased to GI Alliance (a subsidiary of investment-grade-rated Cardinal Health) and an ambulatory surgery center (ASC) leased to a joint venture involving Baylor Scott & White Health and United Surgical Partners International (USPI). These properties benefit from operational synergies: they serve overlapping physician groups and patient populations, reducing tenant risk and enhancing utilization.

The shift from inpatient to outpatient care is a structural trend driven by cost efficiency and technological advancements. According to the Centers for Medicare & Medicaid Services (CMS), outpatient procedures grew by over 40% between 2010 and 2023. Sila's focus on ASCs and MOBs aligns perfectly with this trajectory. These facilities are inherently capital-light for operators, who prefer long-term NNN leases to avoid the costs of ownership. For Sila, this translates to predictable, inflation-linked income streams with minimal operational risk.

Institutional-Grade Tenants: A Pillar of Stability

The strength of Sila's portfolio lies in its tenant profiles. GI Alliance, for instance, is now part of Cardinal Health following a $2.8 billion acquisition in early 2025. This institutional backing ensures the tenant's financial resilience, even in downturns. Similarly, the ASC in Southlake is affiliated with Baylor Scott & White Health, the largest not-for-profit healthcare system in Texas, and USPI, the largest ambulatory surgery provider in the U.S. These partnerships provide a buffer against tenant default risk, a critical factor for income investors.

Sila's Dover, Delaware, acquisition—a $23.5 million inpatient rehabilitation facility—further illustrates this thesis. The 34-bed facility is fully leased to a joint venture between Bayhealth Medical Center and Post Acute Medical, LLC (PAM), both of which are investment-grade-rated. The property's regulatory protections (Delaware's Certificate of Public Review process) create a near-monopoly, ensuring high occupancy and stable cash flows.

Financial Fortitude: A Conservative Balance Sheet

Sila's recent capital structure adjustments reinforce its ability to execute its acquisition strategy. In early 2025, the company replaced its $500 million revolving credit facility with a $600 million unsecured facility maturing in 2029, extending liquidity and reducing refinancing risk. As of March 31, 2025, Sila had $598.5 million in liquidity and a net debt-to-EBITDAre ratio of 3.5x, well within conservative REIT thresholds.

The weighted average remaining lease term of 9.7 years, coupled with 2.2% annual contractual rent escalations, provides a durable revenue base. For context, Sila's portfolio has an EBITDARM coverage ratio of 5.3x for 73.3% of its assets, a metric that underscores the tenants' ability to service debt even during economic stress.

Market Positioning and Sun Belt Expansion

Sila's geographic diversification is another key strength. The Southlake (Texas) and Dover (Delaware) acquisitions add to its presence in the Sun Belt region, where demographic and economic trends favor healthcare demand. The Dallas-Fort Worth MSA, for example, has one of the fastest-growing populations in the U.S., with a median age of 36.6 years and a rising elderly cohort. Similarly, Dover's inpatient rehab facility benefits from a high proportion of Medicare-eligible residents.

The Investment Case: Income with Upside

For income-focused investors, Sila offers a compelling combination of yield, growth, and risk mitigation. Its current dividend yield of approximately 3.8% (as of August 2025) is supported by a robust cash flow profile. The company's disciplined capital allocation—targeting $150–250 million in 2025 acquisitions—suggests continued portfolio expansion without overleveraging.

However, the healthcare sector is not without risks. Regulatory changes, such as shifts in Medicare reimbursement rates, could impact tenant margins. That said, Sila's focus on necessity-driven assets (e.g., ASCs, inpatient rehab facilities) and long-term institutional tenants provides a buffer against such shocks.

Conclusion: A Recession-Resistant Play

Sila Realty Trust's recent acquisitions in Texas and Delaware are more than just real estate transactions—they are strategic bets on the future of healthcare. By targeting high-quality NNN-leased properties with institutional-grade tenants, Sila has created a portfolio that thrives in both bull and bear markets. For investors seeking durable, inflation-protected cash flows, Sila represents a rare combination of defensive qualities and growth potential. In an era of economic uncertainty, healthcare real estate is not just a safe haven—it's a high-conviction opportunity.