Yes it's a huge problem.You should fix this correctly now.Open the walls and put in proper sound reducing insulation.

Medical/dental office is very strong and will remain that way.

If they want to sell it and have emergency funds for medical bills, seller financing likely won't appeal to them. 

My unit is located by Rose Medical.

To avoid reducing your lifetime exemption, you could gift equity incrementally, but this requires proper legal structuring (e.g., fractional ownership transfers).

We’ve started talking about the potential for collaboration, particularly to reduce construction costs by building simultaneously.

As someone who did something very similar to this for the last 2 years - rented out my 2nd private bedroom and bathroom in my apartment (rental) furnished to traveling professionals and medical students - I think it's a great idea! 

Itemized breakdown has ridiculous amounts for damages, thefts of toolboxes, medical claim, loss of use etc.

A 1031 exchange doesn’t apply, but funding through a self-directed IRA can defer taxes, though profits from debt financing may trigger UBIT.To reduce taxes, consider forming an LLC for better expense deductions, offsetting gains with investment losses, or holding the property for 12+ months to qualify for lower long-term capital gains rates.This post does not create a CPA-Client relationship.

In some cases, federal tax credits like those for low-income housing or economic development might also apply if the project aligns with certain goals.Instead of buying the land outright, developers often lease it from the tribe, which can reduce upfront costs and sometimes come with favorable lease terms.