Thanks to COVID, for a couple of years, you can actually make enough money to be cash flow positive even if you hire a property manager AND have mortgage payments. 

Additionally, the price point is still cheap enough to find the 1% rule and positive cash flow and there's amazing appreciation potential.

Quote from @Chris Seveney: @Brian Burke I am also curious what the investor equity position is.

Am I in a bad position.

If you’re in the position to buy multiple deals because this nursing home may get properties frequently.

There is now some positive cash flow (not much considering the value of the asset, but a lot considering where the initial cash flow was).  

Private Lender Partnership: Partner with a private lender or investor willing to take a second lien position to get you to 85-90% cash out.

Those 7 years were cash positive, but we just weren't making enough cash flow to make it worth the trouble. 

Then the remaining profits get distributed at whatever split you both agree to...I often see it start at 25/75 (75 to the person in your position) and then maybe increase it to 40/60 or 50/50.It would really help if you could provide some numbers on your deal. 

This initial negative equity position consumes the initial cash flow.  2) the addition of the adu makes the property multi family and likely makes rent control apply.