I have read that you can contact  the nearest hospitals  and offer services, so how is this done successfully out if state and what are other means for the example staffing agencies. 

If I am understanding, you don’t (or can’t) refinance these properties for seed money for your next investments. 

Particularly if I make them mid-term rentals for traveling nurses and the like.Does anyone have experience with ADU's being added to 4-plex's.  

This will be my first investment property and I'm a little leery about this whole out of state buying process since I've never done this before.

This was a perfect set up as it had a walk out basement/separate unit with 2 beds/1 bath and a kitchenette.

Still talk to your CPA to understand the tax implications. 

Use the enemy method and see what they are doing.

@Andrew Freed is a good person to get in touch with about that as he is a MA multifamily investor who does a lot of meetups.STR is a tough way to start right now because in most markets the table stakes to be competitive are very high.

(I know this is tied to what seller has)Thank you!

Taking pictures with this youtube guru guy like he's a celeb...