Also some people have no comprehension of the work and skill involved in executing a good value add and the compensation I expect for executing one.Be cautious in dealing with family.  

A degree is something not only to fall back on, but also gives you skills.

Do you have the skills to do the work yourself, or would you have to hire someone?

With that being said, most of the people in my immediate network who are in the construction business say the most valuable skill is just being able to run a team and a job efficiently and if they could start over they would go the GC route.

The CRASH is for sure coming....Here's how to protect yourself:1) Only buy good deals below current market value2) Prudently escrow the money it takes to get them into service (in service = making money)3) Don't over-extend on the amount of projects you can do at one time (project = time between purchase and "in service")4) Continually build your skills in getting deals (sales/networking/marketing), building a better depth chart of vendors, project management, and writing strategic scopes of work for the properties you buy. 5) Put money aside after every successful project.

Our current criteria are: no evictions, no bankruptcy, income 2.5x rent, max of 5 non-medical related collection items, and no collections related to unpaid rent or other past rental related obligations.

The medical industry is fueled by referrals, so you'll need to get out there and build relationships that will keep your facility full. 

Had to cancel my trip in the last minute as my wife is in a medical emergency.

Even though I have a business degree from a prestigious NYC University my skill set from owning my own business for 25 years did not transfer into my eventual W-2 job or the job market itself.

@Billie Young like I said, the 90% is NOT the norm... some of these owners are skilled marketers, agents, etc.