The Sanders Trust

What The Sanders Trust does

The Sanders Trust is a Birmingham, Alabama-based healthcare real estate investment and development company that develops, acquires, and asset-manages medical office buildings, inpatient rehabilitation hospitals, behavioral health hospitals, specialty hospitals, and ambulatory surgery centers across 30 U.S. states. The company traces its origin to 1989 when Bart Starr and Rance Sanders formed Starr Sanders Properties, reorganizing as The Sanders Trust, LLC in 1997. It operates as a private LLC domiciled in Alabama with a lean corporate team and two offices (Birmingham headquarters; Santa Rosa Beach, Florida). The company partners with healthcare systems and operators through joint ventures and direct ownership, providing strategic planning, construction management, financing arrangement, and ongoing asset management.

The Sanders Trust's core services are Healthcare Real Estate Development, Healthcare Property Acquisitions, and Asset Management, organized around four product categories: Inpatient Rehabilitation Hospitals, Behavioral Health Hospitals, Medical Office Buildings, and Specialty Hospitals. Its capital foundation rests on a long-running joint venture (HSRE-TST) with Harrison Street Real Estate Capital, formed in 2011 with a $250M initial commitment and grown through portfolio transactions including $230M (2017), $240M (2020), and $600M (2022) deals. The company invests $100 million to $200 million annually in projects ranging from $10 million to $200 million, with a portfolio exceeding $2 billion in cumulative value, and closes transactions within 60 days using dedicated development and legal teams.

Name

The Sanders Trust

Legal name

The Sanders Trust, LLC

Website

https://sanderstrust.com

Company type

Private

Founded year

1989

Operating status

Operating

Headcount range

1–10 employees

Short description

The Sanders Trust is a Birmingham-based healthcare real estate investment and development firm that develops, acquires, and asset-manages inpatient rehabilitation hospitals, behavioral health facilities, medical office buildings, and specialty hospitals across 30 U.S. states for healthcare systems and operators.

Ownership category

akta.pro rank

Product category

Healthcare Real Estate Investment and Development

NAICS

Funds, Trusts, and Other Financial Vehicles (525), Finance and Insurance (52)

SIC

Real Estate Investment Trusts (6798), Investors, Nec (6799)

akta.pro primary industry

Real Assets Fund of Funds (Real Estate / Infrastructure / Natural Resources FoF) (FSAHAKAG)

akta.pro secondary industries

Directed Trust & Trust Advisory Services (FSAAANAK), Corporate Trust Services (Trustee, Agent & Escrow Roles) (FSAEAKAB)

Keywords

• Healthcare real estate development
• Medical property investment
• Rehabilitation hospital development
• Healthcare asset management
• Behavioral health facilities

Headquarters

HQ city

Birmingham

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Operations, Personnel, Infrastructure, Marketing or Sales, Technology or R&D

Revenue model

1. Real Estate Development Fees: The Sanders Trust serves as developer for healthcare facilities, earning development fees for financing, constructing, and managing projects from concept to completion. They partner with healthcare systems and operators on new construction projects.
2. Property Acquisition and Value Appreciation: The company acquires healthcare properties and generates returns through appreciation, rental income, and eventual sale. They have acquired properties in 30 states with over $2 billion in value.
3. Joint Venture Equity Returns: The company forms joint ventures with equity partners like Harrison Street Real Estate Capital to acquire and develop healthcare properties, sharing in investment returns.
4. Asset Management: Ongoing asset management services for healthcare properties including property management, tenant relations, and portfolio optimization.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

The Sanders Trust is a healthcare real estate investment and development firm that develops, acquires, and asset-manages medical office buildings, inpatient rehabilitation hospitals, behavioral health hospitals, ambulatory surgery centers, and specialty hospitals. It invests $100 million to $200 million annually across 30 states, primarily through direct development partnerships and joint ventures (notably with Harrison Street Real Estate Capital), serving healthcare systems, hospital operators, and physician groups.

Product overview

The Sanders Trust is a healthcare real estate investment and development company that provides a comprehensive suite of services including property development, acquisitions, and asset management. The company operates across four main product categories: Inpatient Rehabilitation Hospitals (including ClearSky facilities, PAM Rehabilitation Hospitals, Mercy Health facilities, and Lifepoint-operated hospitals), Behavioral Health Hospitals (including Valley Springs, Serenity at Summit, and Baystate Behavioral Health), Medical Office Buildings, and Specialty Hospitals (including Bakersfield Heart Hospital, Fertility Centers of Illinois, and Eating Recovery Centers). The company also partners with Harrison Street Real Estate Capital for joint venture investments. Projects are typically operated by healthcare system partners including Lifepoint Health, Mercy Health, CommonSpirit, PAM Health, Dignity Health, and Kindred Healthcare. The company has developed or acquired medical properties in 30 states with a portfolio exceeding $2 billion in value.

Differentiator

Problem solved

Functional benefit

Products and services

• Healthcare Real Estate Development Comprehensive development services for healthcare properties including medical office buildings, inpatient rehabilitation hospitals, behavioral health hospitals, and ambulatory surgery centers. Services include strategic planning, construction management, and project delivery.
• Healthcare Property Acquisitions Acquisition of healthcare properties including on and off-campus medical office buildings, post-acute care hospitals, inpatient rehabilitation facilities, and surgery centers. With over 35 years of expertise and ready access to capital.
• Asset Management High-touch asset management services for healthcare properties including customized experiences, tenant relations, operating expense management, and portfolio optimization.
• North Florida Rehabilitation Hospital 60,582 sq. ft. inpatient rehabilitation hospital in Jacksonville, Florida with 50 beds. Features 12-bed brain injury unit, multidisciplinary therapy gyms, and outdoor courtyards. Operated by Lifepoint Rehabilitation.
• Valley Springs Behavioral Health Hospital 123,230 sq. ft. behavioral health hospital in Holyoke, Massachusetts with 150 beds. Completed June 2023. Joint venture between Lifepoint Health and Baystate Health.
• Dignity Health East Valley Rehabilitation Hospital 54,316 sq. ft. inpatient rehabilitation hospital in Gilbert, Arizona with 40 beds. Completed December 2022. Joint venture between Dignity Health and Lifepoint Health.
• PAM Rehabilitation Hospital of Tulsa 60,932 sq. ft. inpatient rehabilitation hospital in Tulsa, Oklahoma. Originally acquired July 2018 for $24.5 million with 40 beds; expanded in June 2020 to 53 beds. Operated by Post Acute Medical (PAM).
• Bakersfield Heart Hospital 85,971 sq. ft. surgery center and specialty hospital in Bakersfield, California. Acquired May 2019. Features 47 private inpatient rooms, 3 operating rooms, 8-bed emergency department, and 4 cardiac catheterization labs.
• Eating Recovery Center 34,068 sq. ft. behavioral health hospital (eating disorder treatment) in Denver, Colorado. Acquired December 2018 for $17 million. Operated by Eating Recovery Center, LLC.

Quantifiable outcome

• Transactions typically close in 60 days or less
• +2 more outcomes

Named customers10 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Eleven partnerships are on record, tiered core, major and minor.

• PAM Health (Post Acute Medical)coreStrategic or Co-development PartnerPAM Health operates the PAM Rehabilitation Hospital of Tulsa, a 53-bed inpatient rehabilitation facility. The Sanders Trust acquired the hospital in July 2018 and completed an expansion in June 2020, adding 13 beds. PAM has over 34 locations throughout the country as a national operator of specialty and rehabilitation hospitals.
• CommonSpirit HealthcoreStrategic or Co-development PartnerCommonSpirit Health has partnered with Lifepoint Rehabilitation and The Sanders Trust to develop the CommonSpirit - Memorial Rehabilitation Hospital in Ooltewah, Tennessee. The 40-bed, 56,000-square-foot facility broke ground in April 2026.
• UW Health and UnityPoint Health - MeritercoreStrategic or Co-development PartnerUW Health and UnityPoint Health - Meriter partnered with Lifepoint Rehabilitation and The Sanders Trust to develop a new inpatient rehabilitation hospital in Fitchburg, Wisconsin. The $45 million, 58,000-square-foot facility will have 40 all-private patient rooms and is expected to open in 2027.
• Lifepoint RehabilitationcoreStrategic or Co-development PartnerLifepoint Rehabilitation operates multiple rehabilitation hospitals developed by The Sanders Trust, including North Florida Rehabilitation Hospital in Jacksonville and the new facility in Fitchburg, Wisconsin. Lifepoint is a business unit of Lifepoint Health specializing in inpatient rehabilitation services.
• Dignity HealthcoreStrategic or Co-development PartnerDignity Health partnered with Lifepoint Health and The Sanders Trust to develop the Dignity Health East Valley Rehabilitation Hospital in Gilbert, Arizona. The $33 million, 40-bed facility opened in December 2022.
• Baystate HealthcoreStrategic or Co-development PartnerBaystate Health partnered with Lifepoint Health (Kindred Behavioral Health) and The Sanders Trust to develop Valley Spring Behavioral Health Hospital in Holyoke, Massachusetts. The $72 million, 150-bed facility opened in August 2023, increasing inpatient behavioral healthcare capacity by 50% in the area.
• Mercy HealthcoreStrategic or Co-development PartnerMercy Health has partnered with Kindred Healthcare and The Sanders Trust on multiple rehabilitation hospital developments, including Mercy Iowa City Rehabilitation Hospital in Coralville, Iowa ($23 million, 40 beds) and Mercy Health Youngstown Rehabilitation Hospital in Ohio ($66 million, 60 beds).
• ClearSky HealthmajorStrategic or Co-development PartnerClearSky Health operates ClearSky Rehabilitation Hospital of Lake City in Florida, a 36-bed, $31 million inpatient rehabilitation facility completed by The Sanders Trust. Also operates ClearSky Rehabilitation Hospital of Lecanto in Florida.
• Delphi Behavioral Health GroupmajorStrategic or Co-development PartnerDelphi Behavioral Health Group operates Serenity at Summit New England, an addiction treatment center acquired by The Sanders Trust in 2019. The property is operated by Summit Behavioral Health, a subsidiary of Delphi. The Sanders Trust completed a $6.5 million expansion adding 20 beds.
• Brown Gibbons Lang & CompanyminorImplementation/ SI/ Consulting PartnerBrown Gibbons Lang & Company served as advisor to Bakersfield Heart Hospital in the sale of the real estate to The Sanders Trust. Financing was provided by CIT Bank.
• CBRE Healthcare and Life Sciences Capital MarketsmajorImplementation/ SI/ Consulting PartnerCBRE's Healthcare and Life Sciences Capital Markets team, including Chris Bodnar and Lee Asher, Vice Chairmen, assisted The Sanders Trust and Harrison Street in the disposition of a $240 million medical real estate portfolio consisting of 11 properties.

Scale indicators7 records

Recent moves10 records

Expansion highlights5 records

Direct peers

• Anchor Health Properties: Private healthcare-focused real estate investment, development, and management firm specializing in medical office buildings and outpatient facilities. Closest private peer to TST in business model — developer/owner/manager of healthcare properties serving health systems and physicians.
• National Health Investors: Healthcare REIT with material exposure to senior housing, skilled nursing, and specialty hospitals including behavioral health. Closely comparable asset mix to TST's specialty hospital and behavioral health focus, though operated through a net-lease REIT structure rather than direct development.
• Healthcare Realty Trust: Pure-play healthcare REIT focused on outpatient medical office buildings and healthcare-related facilities. Closest publicly traded comparable to TST's medical office building and ambulatory acquisition strategy, though at materially larger scale.
• CareTrust REIT: Healthcare REIT concentrated in skilled nursing and seniors housing, with growing triple-net exposure to post-acute operators. Comparable to TST in its operator-tenant underwriting focus, particularly around rehabilitation and post-acute care operators.
• Sabra Health Care REIT: Mid-cap healthcare REIT focused on skilled nursing, senior housing, and behavioral health/specialty hospitals. Direct overlap with TST on behavioral health and specialty hospital tenants (including many of the same operators such as Kindred/Lifepoint-related entities).
• Global Medical REIT: Healthcare REIT that owns and acquires net-leased medical office buildings and outpatient facilities. Smaller and more focused than the mega-cap healthcare REITs, making it a close size- and strategy-comparable to TST's medical office and ambulatory surgery center activity.

Broad incumbents

• Ventas: One of the largest US healthcare REITs spanning senior housing, medical office, research/innovation, and specialty hospitals. Overlaps with TST on medical office and specialty hospital development, though at vastly greater scale and broader mandate.
• Healthpeak Properties: Large publicly traded healthcare REIT with significant outpatient medical office and life science exposure. Operates broadly in healthcare real estate with a much larger and more diversified portfolio than TST, but competes for many of the same health-system relationships and outpatient facility deals.
• Medical Properties Trust: Healthcare REIT specializing in acute care, rehabilitation, and behavioral health hospitals — directly overlapping TST's specialty hospital and behavioral health verticals. Notable as a peer because of its recent operator credit stress, illustrating the downside risk of concentrated inpatient/post-acute exposure.
• Welltower: Largest US healthcare REIT, focused on senior housing, outpatient medical, and post-acute care. Competes with TST for post-acute and rehabilitation operators and shares exposure to the same demographic and reimbursement drivers affecting inpatient rehab facilities.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/thesanderstrust

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about The Sanders Trust