The concern with the DSCR loan is that I need to make the property present as though it's rented to individuals during appraisal (tough since it's a working rehab facility now) and must create another lease that shows the tenant as personal and not a company.

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. 

My company offers real estate syndications.

HOW TO SHARE UTILITIES 101You have a property with two or more units and the utility meters are shared.

Best of luck with your property management company!

Even with some people I believe are honest, I simply believe most do not properly analyze and manage risk, as is evident with nearly every syndication doing capital calls right now because they didnt properly plan for rising rates.Dave Van Horn however, along with his company PPR one of the few people I trust in the real estate space.

Also any tips for automating this as much as possible and how to protect the property financially and property management would be appreciated.I ALMOST understand the rental arbitrage strategy if building a company scaling with say 30 + units and looking for high short term cash flow.  

Quote from @Mel Rosario: HiDoes anyone know which companies that are willing to insure multiplexes in California, particularly coastal Oceanside, CA? 

In my case, I have residential rentals in one LLC, commercial properties in another, self-storage in a third, and my real estate company operates in a fourth.

And the cost of legal defense , even if successful, will drive the company out of business.