Operator Risk Forensics for Healthcare Real Estate
Detecting operator deterioration before it impairs landlord enterprise value
The risk that doesn't show up in the financials
Most healthcare landlords don't lose money because an operator suddenly collapses. They lose money because the operator was deteriorating for 12 to 24 months before anyone recognized how serious the problem had become.
The warning signs exist. They simply don't appear first in the places landlords are looking. By the time deterioration surfaces in financial reporting or survey results, asset value is often already impaired and recovery options are limited.
The Operator Integrity Index
RDC Healthcare Advisory Group provides forensic operator risk assessment and ongoing surveillance for institutional landlords in healthcare real estate. Our methodology, the Operator, Integrity Index (OII), evaluates seven dimensions of operational sustainability through on-site forensics, leadership, interviews, financial engineering, analysis, and adversarial staged-readiness detection. The result is a structured operator risk rating with intervention recommendations mapped to defined collapse windows. Sophisticated landlords already retain specialized accounting and asset management advisors who do strong work on the financial side. OII addresses what those advisors structurally cannot see, the operational, cultural, and behavioral signals that only exist inside the building, in real time, in the eyes of someone who has run one.
Built from the operator's side of the table
RDC Healthcare Advisory Group was founded by Jack Smilovitz, who spent over 25 years operating long-term care facilities before moving to advisory work.
That operating experience built the eye for what's actually happening inside a building. The 12 years since, leading commercialization and market entry work across the US healthcare sector, added a second dimension: a continuously current read on how the US healthcare market pays, how reimbursement and referral dynamics shift, and how investors and acquirers actually evaluate operational risk. Operator risk forensics sits precisely at the intersection of those two perspectives, the inside view of how an operation runs, and the outside view of how capital judges it. The OII methodology is built on both.
Who we work with
- Healthcare REITs
- Private healthcare real estate owners
- Family offices with healthcare exposure
- Institutional lenders
Engagements range from single-operator assessments to enterprise portfolio surveillance with cross-operator benchmarking.
Start a conversation
If you own or finance healthcare real estate and want to understand the operational risk inside your portfolio before it reaches your financials, I'd welcome a conversation.
Jack Smilovitz, Principal
RDC Healthcare Advisory Group is a division of RDC Israel LLC. The Operator Integrity Index™ and OII™ are proprietary methodologies.
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