I have been in Milwaukee WI for quite a while as investing in my backyard in NY is cost prohibitive. good luck on your journey!!!! 

I prefer markets that experience mild winters to eliminate the added costs brutal winters can bring. 

The market between the 2 locations & resident class (Especially if you plan to self mange or find a PM company), Your future goals and the costs associated with moving and transferring to a new hospital. 

Our goal is to be able to use either some type of software or spreadsheets to continue to build off of and help dial in our costs as we begin to hire more contractors for our team.

My strategy incorporates asset protection measures like LLCs, specific trusts as well as professional property management to spread risk and ensure quality operations.As well as using tax codes to my benfiitSection 179, IRC Section 162, Cost Segregation and Bonus Depreciation and later 1031 them out for larger projects. 

I'll save you the details but...Per door cost: $63,300All in Cost: 700kTotal Revenue: 137k(ish) annuallyNOI: 65-73% (in the expenses we included: insurance, taxes, $75/month per door repair expense, management fee 8%, grass cutting, & a misc fund for random crap business license, etc.)Now...

Would you rather set it and forget it and not need to refi again or rather take advantage of low/no closing costs on this loan and plan to be more aggressive on your rate at the time of your refi?

I would guess an older home might be more cost to insure?

@Mike Levene cost to build per square foot is $200-$300 depending on finishes.So, you can start with that.

If you have a good FICO, a decent down payment and closing costs, go ahead an do the first one.