I am beyond excited to introduce this edition of The Peoples Perspective. Last week I had the opportunity to interview Leah Hayes, a UNC Chapel Hill alumna and good friend. She has had an interesting path to end up working as a transaction coordinator at Realty Trust Group in Greensboro, where she focuses on the healthcare industry. I learned a ton from our conversation and am sure that you will as well.
Below are my questions followed by her answers, cleaned up slightly for easy reading but with minimal editing. This edition holds value for a solid chunk of those in the CRE field, but also for anyone looking to understand more about the intersection of healthcare and CRE strategy.
Role: Transaction Coordinator at Realty Trust Group : https://www.realtytrustgroup.com/
RTG Brief Overview: Realty Trust Group (RTG) is a national healthcare real estate advisory and services firm that helps hospitals, health systems, and physician groups make smarter decisions about their properties. Since 1998, they’ve guided organizations across the country in everything from site selection and development to portfolio strategy, compliance, day-to-day transaction management, and property management. In short, RTG sits at the crossroads of real estate and healthcare — turning complex facility needs into streamlined, strategic solutions that let providers stay focused on delivering care.
Career Journey & Background
Q: Can you walk me through your journey to becoming a transaction coordinator at Realty Trust Group?
“My dad started his commercial construction company after the 2008 crash. After high school, I was able to go work at his company part-time, while I did college online due to COVID. When I was going to Chapel Hill and trying to get into the business school, I was deciding what I wanted to focus on and I had worked for my dad during COVID while I was at home and knew I did not want to do construction.
But I knew that there was a lot of construction adjacent fields to enter, and he pushed me toward commercial real estate since he thought it fit my personality. So, I chose that, which was probably the best decision I could have made because studying commercial real estate at the Kenan-Flagler Business School gave me a great foundation that touched on everything from finance, planning, development, and consulting.
Coming out of school, I was working with Lynn Tocci (Associate Director, UNC Wood Center for Real Estate Studies) to find a job when my dad mentioned Linville Team Partners and their really good reputation. I reached out to their broker-in-charge and from there it snowballed. I ended up getting the job as an associate for LTP on their Xpand team, where we were doing business and development acquisitions. We mainly focused on retail, specifically the automotive aftermarket niche.
I spent two years there as an associate trying to identify acquisition opportunities, contact the decision-makers at those businesses and then create financial analyses for our clients to evaluate the business and decide on purchasing it.
It was a really good starting point for my career because I learned how to talk to people, what motivates them, and how people can see through to your intentions. These business owners care so much about the businesses they have grown that they can read when someone is not being genuine.
Which I enjoyed because I am not that person. I was able to build genuine connections with people about something they care about and help them either exit or deploy capital strategically to help them achieve their other dreams, which was really fun.
Then I started at Realty Trust Group in August (2025) as a transaction coordinator, where I am focusing a lot on portfolio management. I think portfolio management is a really natural way to get into the health care world because I am starting with what is existing and mapping that out. From understanding where we are, I am able to build on that toward a growth role, such as helping identify acquisitions, building new practices, and other strategies.”
Understanding the Role
Q: What is the scope of your responsibilities at RTG?
“RTG has offices in Tennessee, North Carolina, Texas, Florida, and Atlanta, but the Greensboro office is smaller, and our main client that we work with right now is a medium sized regional healthcare system. So that’s what is kind of anchoring us to Greensboro. The goal is to have relationships with multiple hospital systems throughout the Carolinas and broader RTG does, but for me, I'm working right now with one client. So that is a lot of lease management, because they own and lease a plethora of properties.
I've been doing this huge overhaul of every single lease within the portfolio. I have been abstracting them, so I go in there and read them top to bottom, and I’m pulling out whose responsibility is what. So, obviously that is a lot – like who is paying utilities: the tenant or the landlord, or the landlord at the tenants expense? So, it is very repetitive, but because of it, I am learning the portfolio. I am starting to know which tenant is where, and when a lease comes up for renewal or I get a call from the practice manager, I know a little bit about what is going on.
Reading through the leases is not fun, but it doesn't matter if I want to do it – it's the repetition. Okay, I’ve seen this address, name, practice, or doctor before, and I learn a little more about them each day, and this has been a good way to understand the portfolio.
Our client has buildings that they own and they're operating out of, but they are also leasing to and from third parties, so we manage all of that. We manage their internal leases and negotiate on their behalf where they are the tenant, and make sure everything gets renewed, everything is compliant, and everything's paid.
A lot of what I've been doing now is facilitating those conversations in terms of lease renewal: Have they outgrown their space? Does their space still meet their needs related to the way medicine is practiced today?
We have the ability and capacity to formulate transactions that will optimize their goals, revenue, and capital deployment that may be a bit out of the box and outside their traditional way of thinking.”
Q: What makes healthcare different from coordinating, say, retail or office transactions?
“In a healthcare system, these are people's lives and getting care that improves their life really is important. I don't want to say we are like an intermediary, but we really are. Without that intermediary, it's chaotic because healthcare systems are there to provide healthcare services to the general public. That is what they are – they are not real estate companies.
Real estate follows strategy, not the other way around, where you have your real estate, you buy this, sell that, and then have to strategize around those decisions. It's better for systems and people to have a strategy, have a goal, and then work with us to form the real estate world that they have around that goal so we can help them meet their goals.
The hospital system itself is a monster of an organization. You have a hospital or multiple, and around those you have ambulatory centers, surgical centers, urgent cares, and specialists, etc. surrounding and referring in and out to each other. It is so complex that it's really difficult, nearly impossible for most systems to do it on their own unless they are absolutely monstrous and they have been around forever and had the time and money to build out their own real estate team.
I think the other important thing about having an outside party is that we are able to be unbiased and help in decision-making. Are you making this decision because of what's happening internally in your organization? Does it truly make the most sense? On paper, dollars-and-cents wise, does it make sense? Does it make sense for your strategy and for your goals?
It's good to have someone who can step out of the internal health system, who has no skin in the game, and tells you what I think you should do, and what you do with that information is up to you. At the end of the day, our goal is not to get a deal done. Our goals, and how we get paid, is through making them succeed, so our motivations are pure.”
Industry Trends
Q: Are there any trends you’re seeing in how medical providers approach real estate — maybe things that have changed since COVID?
“Post-COVID, a lot of what we are doing is changing and has had to change because of infection prevention. Prior to COVID, there were infection prevention standards, weren’t enforced or prioritized to the same degree, since we had not seen anything so highly contagious.
For example, if you walk into a doctor’s office and they have upholstered chairs, you can't do that – no exposed wood, no carpet, no wallpaper, no upholstered furniture. It is really strict and makes upfitting and building spaces more expensive, as they are more limited in what they can do based on regulations from infection prevention.
Which I think is cool. I didn't think about this until I started doing this, but if I am going to the doctor's office and I’m sick, I don't want to sit on a bunch of germs. Like carpet, which you can't have in a doctors office, but why would you want carpet in a doctors office anyways?”
Process & Day-to-Day Operations
Q: What does it actually look like to keep all the moving pieces of a medical deal on track?
“I think the biggest, most important part of it is making sure that everyone has a common goal and that everyone has all the information that they need. Because as soon as someone feels like they are not in the know or that they don't have a firm grasp on what's going on, then they are going to pump the brakes.
I think this is applicable to any deal. Obviously, everyone says this, but it really matters. Honesty, transparency, and good communication are the most important things in a deal. If I am talking about myself and I am buying a house or an investment property and I feel like you, as the seller, are trying to get one over on me or the broker is not telling me something, I am not doing it.
These are large amounts of money that are at stake, but not just that. These are people's lives, so being a good communicator and making sure that everyone is on the same page, working towards a common goal, is the biggest part and probably the biggest hurdle. Anytime that I’ve seen things stall or pause, it's because of a miscommunication or a lack of communication.
I think it is really interesting to see how our offices (RTG) have worked and continue to work together. We have cross-company Case Study Mondays. For example, we did this and saved a client some money this way, or added value in another way. So everyone in Greensboro, Atlanta, Tampa, etc., is getting to see how they did it and can call them to get more help.
I work in Greensboro – it's a small office – but I don't only work with the Greensboro team. We have such a big organization that it is almost necessary to share what we know. What are our experiences? What are we learning? What makes sense? And the only reason we’ve been able to do that is through amazing communication. And that is one thing I can say about RTG – we're great communicators.”
Reflections & Advice
Q: What do you enjoy most about being in the medical real estate niche — what keeps you excited about it?
“It's really easy for me to get up and go to work every day because I know it's probably insignificant, but some of what I do, even if it's the tiniest fraction, will positively impact someone's life. And it's a lot easier to care about something like that, you know?
I went to one of our client’s locations, and I got to walk through, and there's an urgent care, family doctor, radiation and imaging, and cancer radiation services. It is this beautiful building, and we helped them buy the land, assisted with pre-development work, and now manage it post operationalization. It’s a beautiful building, with a huge wall of windows where the people getting their cancer infusions can sit and look out into the woods. There are TVs, and it's just bright and beautiful.
I wasn't here when we did this, but I work for the company that helped make this happen, and that makes me happy – because these people are getting care in beautiful buildings where they are comfortable.
My sister's a nurse at Duke, so it makes me feel like, obviously, I'm not out here saving lives, but at least I'm in some way contributing to healthcare and the well-being of society, which I really like.
I also love the culture of working at RTG. They have created a great culture that prioritizes rest and a good balance between work and personal life. When I go home, I don't freak out about work, which I really appreciate.”
