Healthcare NNN Tenants by Credit Rating: Investment Grade, Speculative Grade and Unrated

How to Judge a Healthcare Tenant

• The lease obligor. A health system’s rating applies to the obligated group named in its bond documents; a clinic lease may be signed by a subsidiary or a physician group outside it. A parent company’s rating applies only if the parent signs or guarantees the lease.
• Reimbursement. Many providers depend on Medicare and Medicaid, so payment rate changes can affect margins.
• Specialized buildouts. Dialysis clinics, labs, and surgery centers can be costly to convert, which can make re-leasing harder or narrow the pool of replacement tenants.
• Leverage and ownership. Many dental, eye care, urgent care, and therapy platforms are owned by private equity and carry heavy debt.

Health Systems

Nonprofit health systems are among the highest-rated tenants in net lease, typically through their obligated groups.

Investment Grade Corporate Healthcare Tenants

Where the rated entity is a parent, confirm whether the parent or an operating subsidiary signs the lease. McKesson, Cencora, and Cardinal Health, the three large U.S. pharmaceutical distributors, are also rated investment grade and lease large distribution centers, though these are industrial rather than patient-facing properties.

Speculative Grade and Unrated Healthcare Tenants

Ratings in all tables update from our ratings database. NR means the agency does not rate the company; “no verified rating” means none is on file. A corporate rating applies to a lease only if the rated entity signs or guarantees it.

Live Asking Cap Rates for Healthcare Tenants

Median asking cap rates on active listings InvestmentGrade.com tracks, for healthcare tenants with at least five listings that publish a cap rate:

Active listings InvestmentGrade.com tracks with an asking cap rate (stated in the listing, or computed from its stated income and price when no rate is stated), listings last observed October 19, 2026. Asking cap rates are not closed-sale cap rates. The middle half is the range from the 25th to the 75th percentile of listings. The 10-year Treasury yield is 5.24% as of October 1, 2026 (FRED series DGS10). Ratings are the agency ratings in our ratings database for the entity shown, which may be a parent company; the rating type (for example issuer, senior unsecured debt, long-term debt or revenue bond ratings) varies by company and is shown on each tenant page. A rating applies to a lease only if the rated entity signs or guarantees it, so confirm the tenant and any guarantor in the lease. n/a means no verified rating is on file. Not shown because fewer than 5 active listings with a published cap rate were observed: Pacific Dental Services, Quest Diagnostics, Labcorp, Select Physical Therapy, Athletico, AFC Urgent Care, Banfield Pet Hospital, VCA Animal Hospitals, BioLife Plasma Services, CSL Plasma, Grifols, Encompass Health.

Asking cap rates vary widely within each tenant with lease term, rent, location, and building type, so use them as context rather than a price for a specific property.

Notes on Major Tenant Types

Dialysis

DaVita and Fresenius Medical Care operate most U.S. outpatient dialysis clinics. DaVita is rated BB by S&P and no verified rating by Moody’s, two notches below the BBB‑/Baa3 investment grade threshold. Fresenius Medical Care is rated investment grade (BBB- / Baa3). Fresenius Medical Care is independently governed: Fresenius SE ceased to control it on November 30, 2023 and owned 26.2% of its shares as of February 13, 2026, according to its annual report filed with the SEC. Dialysis is a recurring, life-sustaining treatment, but providers depend heavily on Medicare reimbursement, and growth in home dialysis could reduce demand for in-center clinics over time. Clinics need specialized plumbing and water treatment, which affects re-leasing.

Laboratories

Quest Diagnostics and Labcorp are both investment grade and operate thousands of patient service centers, often in retail centers and medical office buildings, plus large regional laboratories. Reimbursement pressure on lab tests is the main credit risk.

Hospitals and health systems

HCA Healthcare, the largest for-profit hospital operator, is rated BBB by S&P. Nonprofit systems such as those in the first table often carry higher ratings, but their outpatient leases may be signed by affiliates outside the rated obligated group, so check the lease.

Dental, eye care, urgent care, and therapy

These platforms are mostly owned by private equity and rated in the B or CCC categories, or not rated. Leases are often signed by a local practice entity, sometimes with a corporate guaranty. Underwrite the guarantor’s financial statements, the clinic’s performance, and the real estate.

Pharmacies

CVS Health is rated BBB by S&P. Walgreens lost its investment grade ratings in 2024 and was taken private by Sycamore Partners in August 2025; our ratings database shows no current public rating for it, and it has been closing stores. Rite Aid liquidated in 2025.

Investment Grade vs. Non-Investment Grade Healthcare Tenants

Investment grade tenants generally have lower assessed default risk, which tends to support lower cap rates and easier financing, but rent interruptions and property losses remain possible, for example if a tenant closes a location at lease expiration. Speculative-grade and unrated tenants usually ask higher cap rates to compensate for more credit risk. Whether that extra yield is worth it depends on the specific lease, guarantor, clinic performance, and how easily the building could be re-leased.

Frequently Asked Questions