Exchange now at 500k over basis into income property with lease back and put option for 300k more. 

Have you looked into property management options or run numbers factoring in potential vacancies and maintenance?

@Jackie LinThat’s a big decision, and with your experience in California rentals, you’re in a great position to weigh the options.

At the end of the day I'm ok with taking the slower path of saving up the cash for the down payments and buffer but if there's a quicker way that I'm not aware of I'm open to all options. 

Congratulations on the duplex -My investor clients have acquired several multi-family investment properties locally in the market I operate in Northwest Indiana - Figure out your personal investment objective for the next 4 years and align yourself with the next property that make sense in this current market environment-

Another option would be to connect with the hospital's administrative offices, as they may have partnerships with local landlords for these types of accommodations.Regarding utilities, in mid-term rental situations, it varies.

Note both of these options require paying the tenant to vacate for a no-fault eviction (terrible name as if lease is up it is not an eviction).Note terminating a lease agreement for the purpose of rehabbing the unit is under attack in some places in the county. 

Option A would allow me to keep it as a long term rental .

There are a few options.1.

My goal is to build a portfolio of single family and multi family properties.