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NNN Fresenius Medical Care for Sale
Fresenius Medical Care is a publicly traded dialysis provider that operated 2,562 U.S. clinics at March 31, 2026 (Fresenius Q1 2026 report). Boulder lists an S&P rating of BBB-, the lowest investment-grade rating, and typical leases are double net with a 15-year term and 10% rent increases every five years (The Boulder Group, September 2026). Fresenius has also said it is exiting up to 100 U.S. clinics, so the clinic you are buying matters. Below we cover the tenant, current asking cap rates and the risks to weigh.
BBB-
S&P credit rating
2,562
U.S. clinics (March 31, 2026)
15 Years
Typical lease term
10%
Increase every 5 years
10,000 SF
Typical building size
Double Net
Typical lease type
Sources: The Boulder Group, Net Lease Tenant Profiles, September 2026, p. 37; Fresenius Medical Care Form 6-K for the quarter ended March 31, 2026 (U.S. clinic count).
Key Takeaways
Investment Grade, at the Low End
Fresenius Medical Care is a publicly traded dialysis provider. Boulder lists an S&P rating of BBB-, which is the lowest investment-grade rating and above DaVita’s BB (The Boulder Group, September 2026).
Typically Double Net Leases
Boulder reports typical Fresenius leases as double net, with a 15-year term and 10% rent increases every 5 years (The Boulder Group, September 2026). Confirm in each lease who is responsible for the roof and structure.
Cap Rates by Remaining Term
Fresenius properties currently show asking cap rates of 6.40% – 6.70% with 10 years remaining and 6.00% – 6.30% for a new 15-year lease, rising to 7.00% – 8.00% with 5 years left (The Boulder Group, September 2026).
The U.S. Clinic Footprint Is Shrinking
In the first quarter of 2026 Fresenius began exiting 64 of up to 100 selected U.S. clinics and said it expects to keep most of those patients in neighboring clinics (Fresenius, Q1 2026 results). Ask whether a specific clinic is affected.
Fresenius NNN Cap Rates and Lease Data
If you’re weighing a Fresenius clinic, three things shape what you’ll earn: who the tenant is, how the lease is structured, and what yield you’re paying for. Here’s how they fit together.
On the first two, the picture is mixed. Fresenius is rated BBB-, the lowest investment-grade rating, and a typical lease is double net with a 15-year term and a 10% rent increase every five years.1 That is scheduled income, but a double net lease can leave the roof and structure with you, so confirm who handles them. The increases work out to only about 2% a year, so most of your return comes from the yield you buy in at, not from rent growth.
That’s where cap rates come in. Boulder shows asking cap rates of 6.00% – 6.30% on a new 15-year lease, 6.40% – 6.70% with 10 years left, and 7.00% – 8.00% with 5 years left.2 As the remaining term gets shorter, the yield goes up, and the 5-year range is unusually wide. You’re being paid more to take on the question of whether Fresenius renews the clinic when the lease ends.
In dollars, Boulder puts the average sale price at about $4.0 million with average rent of about $250,000 a year. On a typical 10,000 SF clinic, that works out to roughly $400 per square foot.3
1. The Boulder Group, Net Lease Tenant Profiles, September 2026, p. 37. Credit rating is S&P, as reported by Boulder; lease terms are typical, as reported by Boulder. The 2% a year figure is our calculation (10% over five years). ↩
2. The Boulder Group, Net Lease Tenant Profiles, September 2026, p. 37. Asking cap rates as of September 2026. ↩
3. The Boulder Group, Net Lease Tenant Profiles, September 2026, p. 37. Average sale price and average rent as reported by Boulder; the per-square-foot figure is our calculation ($4,000,000 across a typical 10,000 SF clinic). ↩
Fresenius as a Tenant
How Fresenius operates
Fresenius Medical Care operated 2,562 dialysis clinics in the U.S. at March 31, 2026 (Fresenius Form 6-K, Q1 2026). Boulder lists a typical clinic at 10,000 SF and 4,153 locations, a higher count than the company’s U.S. figure, so use the company number when sizing U.S. exposure.
The footprint is being trimmed. In the first quarter of 2026 Fresenius acquired 1, opened 3, and combined, closed or sold 64 U.S. dialysis clinics, and it said it was exiting 64 of up to 100 selected clinics as part of an optimization plan (Fresenius Form 6-K, Q1 2026; Q1 2026 results).
Fresenius is also replacing machines. Its 5008X CAREsystem was available in 227 U.S. clinics by the second quarter of 2026 (Fresenius, Q2 2026 results).
Financial strength and growth
In the second quarter of 2026, Fresenius reported revenue of EUR 4,861 million, up 1%, and operating income of EUR 466 million, up 10% (Fresenius, August 3, 2026). Review its current credit ratings from the major agencies as part of your due diligence.
U.S. same market treatment growth was -0.6% in the second quarter of 2026 (Fresenius, Q2 2026 results), so the U.S. business is not growing on volume right now.
The other large U.S. dialysis operator, DaVita, is rated BB by S&P, while Fresenius is rated BBB-. With 10 years remaining, Boulder’s asking range is 6.40% – 6.70% for Fresenius and 6.50% – 6.80% for DaVita (The Boulder Group, September 2026).
Why Investors Buy Fresenius Properties
Fresenius pairs an investment-grade rating with a long lease. Boulder reports an S&P rating of BBB-, a typical 15-year term and 10% rent increases every five years (The Boulder Group, September 2026).
The yield is also higher than many better-known net lease brands. With 10 years remaining, The Boulder Group’s September 2026 asking range of 6.40% – 6.70% compares with 5.40% – 5.70% for AutoZone and 4.50% – 4.80% for McDonald’s.
At the same 10-year mark, Boulder asks slightly less for Fresenius than for DaVita (6.40% – 6.70% versus 6.50% – 6.80%), which is consistent with Fresenius’s higher rating. In exchange for the higher yield versus most brands, you take on a double net lease and a tenant that is trimming its footprint.
Risks and Market Conditions
The most direct risk is clinic closures. Fresenius said it was exiting 64 of up to 100 selected U.S. clinics in the first quarter of 2026 (Fresenius, Q1 2026 results). A lease on a clinic in that group carries a very different risk than one on a clinic the company is investing in, so ask about the specific location.
Credit and the lease structure matter too. BBB- is the lowest investment-grade rating, and a double net lease can leave the roof and structure with the landlord. Look at the remaining term, the clinic’s own patient volume where it is available, and which Fresenius entity signs the lease, not just the corporate numbers.
Build a Diversified NNN Portfolio
Pairing a Fresenius clinic with other net-lease brands spreads risk across tenants, industries and markets. Compare other brands we help buyers acquire:
Fresenius NNN FAQs
Who backs Fresenius leases?
Boulder lists Fresenius Medical Care at S&P BBB- (The Boulder Group, September 2026). The rating belongs to the parent, so confirm which Fresenius entity signs each lease and whether the parent guarantees it, and check the lease itself rather than assuming a guarantee.
How long are Fresenius leases?
Boulder reports typical Fresenius leases as double net with a 15-year term and 10% rent increases every 5 years (The Boulder Group, September 2026). Individual leases vary, so check the remaining term and renewal options.
What cap rates do Fresenius dialysis centers offer?
Asking cap rates run 7.00% – 8.00% with 5 years remaining, 6.40% – 6.70% with 10 years remaining and 6.00% – 6.30% for a new 15-year lease (The Boulder Group, September 2026). Actual cap rates vary by location, remaining lease term, guarantor and rent history.
How can I reduce risk?
Do thorough due diligence and focus on clinics with a substantial remaining term. Ask whether the clinic is affected by the footprint optimization under which Fresenius said it was exiting up to 100 U.S. clinics (Fresenius, Q1 2026 results), and compare it with competitors such as DaVita.
Questions about Fresenius Medical Care NNN Properties for Sale?
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Market data, cap rates, and tenant statistics on this page come from third-party reports and company disclosures, cited in the footnotes. We believe these sources are reliable but do not guarantee their accuracy or completeness. Figures reflect the date of each source and change with market conditions, so verify current numbers before relying on them.