What would that entail cost wise?

Look at deals even if you don't intend to buy right now.

To do the cash out refi I want(leaving more cash in the deal than taking out) I would only have a $200 increase in the PITI.

BP has various tools to help you analyze your deals (rentals, flips, wholesale, etc). : https://www.biggerpockets.com/investment-calculators7.

I completed a 1031 exchange two years ago, but found the strict time limits made it difficult to find a good deal.

As long as you login to their app through the pro area it will recognize your membership and should give you the software at no cost.

Build a portfolio, get tax write offs, learn to buy "off market" and find great deals?

Nice facelift on your two deals!

You can use this as a lessons learned and get a better idea for how long something takes and how much it costs. 

They are dealing with more lease turnover caused by deaths of residents, high labor expenses for different levels of care (IL / AL / MC), as well as finding employees that want to do this work.