Emory Healthcare just told a mall in Tucker, Georgia that it wants more room. On July 1, the nonprofit Centurion Foundation closed on a deal to buy Northlake Mall, and Emory, which already leases 274,000 square feet inside the property, announced it will more than double that footprint under a new long term lease. The health system has been quietly building out primary care and administrative space inside the mall since 2019, and now it's set to become the property's main tenant.
This isn't an isolated deal. Malls and shopping centers across the country have been filling vacant anchor space with medical real estate for years now. According to research from commercial real estate firm Colliers, Duke University converted a former Macy's into an orthopedic clinic, Yale New Haven Health bought a two level building at a Connecticut mall to house an ambulatory care center, and the University of Rochester turned 350,000 square feet of a struggling mall into an orthopedic healthcare campus. If you manage a retail center, a mixed use property, or a medical office building, this trend is coming for your leasing pipeline, and it changes more than just your rent roll.
Let's start with what actually happened in Tucker. Northlake Mall had been losing traditional retail tenants for years, and in June several remaining stores were told to vacate within 30 days. Rather than watch the property go dark, the Centurion Foundation, a nonprofit that specializes in real estate deals for health systems, stepped in and bought the mall. Emory Healthcare's expansion announcement followed almost immediately.
Emory didn't show up overnight. The health system built a primary care center at Northlake in 2025 and a child care center in partnership with Primrose Schools in 2024, layering clinical and support services into space that used to hold apparel stores and a food court. The new lease will let Emory consolidate business functions and support future growth, according to the company's announcement. For a property that risked becoming another dead mall statistic, a single confident health system tenant just rewrote its future.
If you manage a property with a similar vacancy problem, this deal is worth studying closely. It shows how fast a struggling asset can find a new anchor once a health system decides it's ready to grow, and how little that decision has to do with the retail fundamentals you've been tracking.
Hospitals and health systems aren't picking malls because they miss food courts. They're picking them because retail real estate solves problems that traditional medical construction can't solve as quickly. Building a new medical office from the ground up takes years of permitting, site work, and financing. A vacant anchor box already has parking, loading access, and a shell that a contractor can build out in months instead of years.
Retail space also puts care closer to where patients already are. A primary care clinic or an outpatient imaging center inside a shopping center means shorter drives, familiar parking, and the kind of convenience that keeps patients coming back for follow up visits. That convenience matters more than it used to, since health systems increasingly compete on ease of access the same way retailers do.
For you as the property manager or owner, this means the tenant walking through your door with a letter of intent might not be a retailer at all. It might be a health system evaluating your vacant box as its next satellite location. Medical real estate has become one of the few segments of commercial real estate still growing its physical footprint while other categories pull back, and if your building has the bones for it, you're a candidate whether you planned for it or not.
A yoga studio and an urgent care clinic might occupy the same square footage, but they ask completely different things of your building. Medical tenants need dedicated exam room plumbing, backup power for refrigerated medications and diagnostic equipment, and HVAC systems that hold tighter humidity and temperature ranges than a typical retail buildout requires. If your engineering team hasn't priced out what those upgrades cost before the lease gets signed, you'll be negotiating tenant improvements blind.
Parking and hours change too. A dermatology practice or a physical therapy office generates steady midday traffic instead of the evening and weekend spikes retail tenants bring, and patients often need closer, more accessible parking than shoppers do. Your building operations team should walk the site with the incoming tenant's clinical needs in mind well before move in day, not after the first patient shows up and can't find a spot near the entrance.
Medical tenants are simply different from retail tenants, and that difference rewards a property team that asks the right questions during lease negotiation instead of discovering the gaps during buildout.
Medical buildouts bring more contractors, more specialized trades, and more insurance paperwork than a typical retail fit out. Every electrician, plumber, and medical equipment installer touching your property needs a current certificate of insurance on file before they start work, and healthcare contractors often carry policy requirements that standard COI templates don't capture. If your team is still tracking these documents in spreadsheets and email threads, a medical tenant's buildout will expose every gap in that system within the first month.
This is exactly where COI tracking software earns its keep. A property team managing a mix of retail and medical tenants needs a system that flags expired coverage automatically, matches vendor insurance requirements to the specific type of work being performed, and keeps a clean audit trail in case a health system's own compliance team comes asking questions, which they will. Health systems carry their own regulatory obligations, and they expect their landlords to meet a higher bar than the mall's previous nail salon tenant required.
Retail property management software that was built around lease abstracts and common area maintenance billing often wasn't designed with this level of vendor scrutiny in mind. If you're running a property that's shifting from a pure retail mix toward medical real estate, it's worth auditing whether your current commercial property management software can actually handle the compliance load a health system tenant brings, before that tenant signs.
Foot traffic patterns shift the moment a clinic opens its doors. Patients, caregivers, delivery drivers dropping off specimens, and medical equipment vendors all need a way into your building that a typical retail visitor never required. A property that's used to a simple retail check in now needs a visitor management process that can badge in a courier carrying lab samples just as easily as it badges in a shopper.
Health systems also care about who has access to clinical space after hours, since equipment, medications, and patient records all live behind those doors. Your access control setup should be able to restrict a medical suite separately from the rest of the property, log entries with enough detail to satisfy a hospital system's own security audit, and hand off cleanly between shifts. Property teams that treat this as an afterthought find out the hard way, usually when a health system's compliance officer asks for records the system was never built to produce.
The property managers who come out ahead on this trend ask questions before the letter of intent gets signed instead of after. Walk your vacant anchor space with a contractor who has done medical buildouts before, and get a real number on what plumbing, electrical, and HVAC upgrades will cost. That number belongs in your negotiation, not in a change order six months into construction.
Talk to your engineering team about backup power capacity, since a health system tenant will ask about it during due diligence even when a retail tenant never would have. Build your tenant experience plan around a mixed tenant population from day one, because shoppers and patients will share the same parking lot, the same common areas, and sometimes the same wait for an elevator. A unified operations platform that can flex between retail leasing workflows and medical compliance requirements will save your team from running two disconnected systems side by side. A system that can badge in a courier alongside a shopper without extra manual work saves your front desk team from juggling two separate processes.
Loop in leasing early too. If your broker is already fielding interest from health systems for a vacant box, your operations team should be part of that conversation from the start, not brought in after the ink dries. Which tenants your building attracts next depends on decisions you make today, and the properties winning this wave of medical real estate demand are the ones where leasing and operations already speak the same language.
Medical real estate refers to commercial property, including medical office buildings, outpatient clinics, and increasingly retail space, that's leased or built out for healthcare use. It covers everything from a single physician's suite inside a shopping center to a health system's satellite campus built inside a former mall anchor space, and demand for it has kept growing even as some other commercial sectors have slowed.
Health systems lease mall space because it's faster and often cheaper than ground up construction, and it puts care closer to where patients already shop and live. A vacant anchor box already has parking, loading access, and a usable shell, which can cut years off a typical medical facility timeline.
A medical tenant typically needs dedicated exam room plumbing, backup power for equipment and medications, and HVAC systems that hold tighter temperature and humidity ranges than standard retail space. Get a contractor's estimate on these upgrades before you sign the lease, so the cost shows up in your negotiation instead of a change order later.
A medical tenant brings more contractors, more insurance documentation, and different security needs than a typical retail tenant, even when the two occupy identical square footage. Property teams need COI tracking software and access control built to handle clinical space, not just standard retail leasing workflows, if they want to keep up with a health system's compliance expectations.
Yes, if your current system was built around retail lease abstracts and common area billing, it likely wasn't designed for the vendor insurance scrutiny and access control needs a health system brings. Audit your commercial property management software against a medical tenant's compliance requirements before the lease is signed, so you're not rebuilding your systems mid buildout.