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Dallas: Medical District

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vman
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Re: Dallas: Medical District

Postby vman » 15 Jan 2019 12:27

tamtagon wrote:Apparently, "the community" see the hospital as a necessity along the lines of a fire department, police department, sanitation department, parks, street lights.... whatever


People tend to gripe about paying taxes for services they don't use (especially services for people less fortunate). Just a few months after I moved to Dallas, I developed a horrible case of strep throat. I could not afford insurance at the time. I was admitted overnight and and actually received very good care at Parkland. I don't know what I would have done if Parkland wasn't there.
That said...I own a home and don't have children. Why am I paying taxes for all of these shiny new schools!!! Pay for your own **@! kids!! :lol:

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tamtagon
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Re: Dallas: Medical District

Postby tamtagon » 15 Jan 2019 12:29

Hannibal Lecter wrote:^ Yet only two counties in NE Texas have public hospitals. All the other counties seem to do just fine without them. That doesn't appear to support them being a "necessity".


Well, then, trigger a referendum and put it to a vote. :D

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muncien
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Re: Dallas: Medical District

Postby muncien » 15 Jan 2019 13:11

I don't think anybody thinks poor people shouldn't have access to healthcare. That's just a silly argument people use to silence opponents when trying to defend excessive government waste. It's about the manner in how it's done that offends many taxpayers.
We live in a 'you get what you pay for' society (as we should). If someone wishes to splurge and take the Texpress lanes, they are welcome to. If someone wants to spend top $ on fancy healthcare facilities, go for it. But when that top dollar is spent by people who aren't benefited, that's when you run into problems.
I too pay for this one line item on my tax bill... But, I am a cheap SOB, and when I severed several tendons in my finger, I opted to go to a cheap clinic on Oconner in Irving instead of paying fancy hospital prices. I paid strictly from my HSA account with my money and didn't even use insurance. That seemed good enough for me... yet here I am paying for someone else's fancy hospital bill because enough people saw shiny buildings renderings and decided to vote to fund it.
The absolute worst place for your economic dollar is in the hands of the government. Anybody who has spent significant time working for the government either directly (such as myself), or as a contractor is well aware of this. So many more people could have been helped with this money if so much of it weren't spent on this Taj Mahal. But hey, at least it looks pretty...
Sorry... Sensitive topic for me. lol
"He doesn't know how to use the three seashells..."

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Matt777
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Re: Dallas: Medical District

Postby Matt777 » 15 Jan 2019 13:53

It would be nice to see these tree initiatives spread into other parts of the city too. Downtown would be less hot in the summer, and overall more attractive if the streets were lined with tall, skinny at the base trees that provide a high canopy. I'm not a tree expert, but looking at Richmond VA on google street maps shows a type of tree they use downtown that is similar to what I'm thinking.

I45Tex
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Re: Dallas: Medical District

Postby I45Tex » 15 Jan 2019 17:50

In downtown Richmond I read it's mostly willow oaks, Matt777.

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Hannibal Lecter
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Re: Dallas: Medical District

Postby Hannibal Lecter » 15 Jan 2019 20:31

tamtagon wrote:Well, then, trigger a referendum and put it to a vote. :D


Probably not possible. I know the county doesn't have the ability to petition for a referendum, and I would be shocked if the hospital district did.

Of course even if you could it would fail. It's like the DISD -- so many people have their hand in the till (teachers, administrators, consultants, contractors, construction companies) that any tax increase or bond election is guaranteed to win.

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Hannibal Lecter
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Re: Dallas: Medical District

Postby Hannibal Lecter » 15 Jan 2019 20:43

vman wrote:I don't know what I would have done if Parkland wasn't there.


Every other hospital in the county has an Emergency Room. Federal law requires them to stabilize you before transferring or releasing you.

A lot of people seem to think that if we didn't have Parkland we wouldn't have indigent care. The Texas Constitution requires counties to provide for that, and they do. But the vast majority of them do so through private providers instead of public facilities. Collin, Denton, Rockwall, Kaufman, Grayson and Johnson counties all take care of indigent care at a fraction of the cost without building their own Taj Mahals.

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Dunner
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Re: Dallas: Medical District

Postby Dunner » 16 Jan 2019 10:32

Hannibal Lecter wrote:
vman wrote:I don't know what I would have done if Parkland wasn't there.


Every other hospital in the county has an Emergency Room. Federal law requires them to stabilize you before transferring or releasing you.

A lot of people seem to think that if we didn't have Parkland we wouldn't have indigent care. The Texas Constitution requires counties to provide for that, and they do. But the vast majority of them do so through private providers instead of public facilities. Collin, Denton, Rockwall, Kaufman, Grayson and Johnson counties all take care of indigent care at a fraction of the cost without building their own Taj Mahals.


If we didn't have Parkland, we would NOT have indigent care. We would have, as you say, ERs filled to the brim with uninsured or medicaid patients whom the ER will "stabilize" to be sent somewhere else who will take them. And who will take these patients, you ask? Do you think Presby or Methodist will admit a patient who can't pay for their stay? No, in all likelihood, these hospitals would punt these patients to the nearest hospital who will take patients without a guarentee of payment, and that is probably JPS in Fort Worth. Although the volume would be astronomical (17th highest ER volume in the country, https://www.beckershospitalreview.com/l ... -2016.html) so some of these hospitals that only take private insurance would have to absorb the costs - or better yet - shift the costs to insured patients like you.

So, don't let the Taj Mahal look fool you - there would be a healthcare disaster in North Texas if Parkland closed down. But in the end, it ends up being - are you willing to pay the ~50 dollars a year asked of all Dallas county residents to keep the most vulnerable from being tossed around like unwanted trash.

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tamtagon
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Re: Dallas: Medical District

Postby tamtagon » 16 Jan 2019 10:57

I'll try to remember to move this tangent to the Parkland Hospital thread over the weekend(ish).

Yes, the whole Taj Mahal extravaganza tugging is a collection of empty reasons to be angry about paying taxes. Public hospitals are an investment, like public education, that is very difficult to show meaningful return on investment on the kind of simple spreadsheet used to back up the empty outrage. I get, sure, but I also get that a society needs to provide these sort of services for its spiritual well being --- not having anything to do with physical healthfulness.

It may not be easily quantified, but it is certainly a requirement of a healthy society. If you want to express outrage that tax dollars are being wasted, look no further than the competition between municipal entities handing out tax breaks and incentives to win the prize of a workplace expansion.

Also -- I remember years ago being surprised that the dollar amount of services provided by Parkland written off toward indigent care is much lower than I thought, and not much more than other health service providers. Tucy - is that something you've tracked in the past? Seems like it's been discussed of the forum, but maybe not.

Something about how the Federal Govt covers indigent care for the public as well as private health care providers, it's just that companies like Tennant turn that into a dividend for stock holders while entities like Parkland turn it into a new building for expanded services....

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muncien
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Re: Dallas: Medical District

Postby muncien » 16 Jan 2019 11:06

Dunner wrote:
Hannibal Lecter wrote:
vman wrote:I don't know what I would have done if Parkland wasn't there.


Every other hospital in the county has an Emergency Room. Federal law requires them to stabilize you before transferring or releasing you.

A lot of people seem to think that if we didn't have Parkland we wouldn't have indigent care. The Texas Constitution requires counties to provide for that, and they do. But the vast majority of them do so through private providers instead of public facilities. Collin, Denton, Rockwall, Kaufman, Grayson and Johnson counties all take care of indigent care at a fraction of the cost without building their own Taj Mahals.


If we didn't have Parkland, we would NOT have indigent care. We would have, as you say, ERs filled to the brim with uninsured or medicaid patients whom the ER will "stabilize" to be sent somewhere else who will take them. And who will take these patients, you ask? Do you think Presby or Methodist will admit a patient who can't pay for their stay? No, in all likelihood, these hospitals would punt these patients to the nearest hospital who will take patients without a guarentee of payment, and that is probably JPS in Fort Worth. Although the volume would be astronomical (17th highest ER volume in the country, https://www.beckershospitalreview.com/l ... -2016.html) so some of these hospitals that only take private insurance would have to absorb the costs - or better yet - shift the costs to insured patients like you.

So, don't let the Taj Mahal look fool you - there would be a healthcare disaster in North Texas if Parkland closed down. But in the end, it ends up being - are you willing to pay the ~50 dollars a year asked of all Dallas county residents to keep the most vulnerable from being tossed around like unwanted trash.


Weird... There must be a problem with my tax bill. Because it says I paid $583.57 last year for PARKLAND HOSPITAL. And my house was only valued at $261k.
No offense... but that is an ASTRONOMICAL number for every homeowner to pay for a county hospital. Surely you could have gotten a lot more service out of a lot less cash if it weren't for the Taj Mahal they created. There are a few Dallas County health clinics scattered around the county that cost far less and provide better accessibility. Those should have been the model of county driven healthcare if private institutions were not.
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I45Tex
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Re: Dallas: Medical District

Postby I45Tex » 16 Jan 2019 14:01

Muncien, while good for some things, health clinics are clearly no substitute for level one trauma centers, and there are a lot of ancillary services that it makes sense to concentrate around the expertise of a trauma center, so dispersing referrals around the county is not necessarily improving overall institutional efficiency in the county. Private entities are also the ones jockeying to develop much of the new graft in the public health system so going directly to them may do less to improve accountability than it does to improve their stranglehold on funding.

We're already seeing conservatives use Trump's shutdown to trot out articles that the TSA should obviously be privatized, once they "starve the beast" to make it underperform in the first place. It's like public schools on fast-forward. Once public sector alternatives are gone, profit margins can blame themselves on "the marketplace" and owner-donors can lobby to keep public alternatives from existing again.

261k is no extravagant home for sure, but if you have that plus $50k in other assets, your net worth is in the top quartile of Dallas County residents. I estimate this because the Federal Reserve's latest Survey of Consumer Finance says that a $361,000 net worth is above 71st percentile nationwide and, given Texas' poverty level, it's not a stretch to estimate 75th percentile here. Every homeowner doesn't pay as much as you because even at this modest level you've done a lot better than the majority have been able to.
Last edited by I45Tex on 16 Jan 2019 14:05, edited 1 time in total.

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Hannibal Lecter
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Re: Dallas: Medical District

Postby Hannibal Lecter » 16 Jan 2019 14:05

Dunner wrote:If we didn't have Parkland, we would NOT have indigent care.


Doesn't say much for your position when you have to resort to blatant falsehoods.

Collin County has indigent health care without a public hospital. So does every other county around Dallas except for Tarrant.

Something else to consider: Only a small percentage of Parkland's users are legally indigent. Most are not. They just don't want to pay.

Dunner wrote:But in the end, it ends up being - are you willing to pay the ~50 dollars a year asked of all Dallas county residents to keep the most vulnerable from being tossed around like unwanted trash.


$50 a year? I wish. Try about 10x that.

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Dunner
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Re: Dallas: Medical District

Postby Dunner » 16 Jan 2019 14:42

Hannibal Lecter wrote:Doesn't say much for your position when you have to resort to blatant falsehoods.

Collin County has indigent health care without a public hospital. So does every other county around Dallas except for Tarrant.

Something else to consider: Only a small percentage of Parkland's users are legally indigent. Most are not. They just don't want to pay.



I'm a physician employed by UTSW and working at Parkland hospital. I'm more than happy to compare notes about how Parkland operates.

Parkland doesn't admit patients that don't have a Dallas County address. They may take care of them in the ED due to EMTALA laws, but they can't admit them to an inpatient service. Furthermore, you want to compare the percentage of indigent or uninsured patients in Collin County to Dallas County? Really? In fact many of Collin County residents who are "indigent" come to Parkland instead - because guess what - they don't really provide much options. (https://www.dallasnews.com/news/dallas- ... -taxpayers)

Hannibal Lecter wrote: $50 a year? I wish. Try about 10x that.


Fine, you got me, that number is low. Parkland hospital exacts 0.28 cents per 100 dollars of property value - IF you're living in Dallas County. So it depends on how much your property is worth. Fun fact - you're paying 0.12 cents per 100 dollars to community colleges, and 1.4 cents per 100 dollars to Dallas ISD. These are public services that you pay for that you may not ever use, but should you need them you can. (http://www.dallascad.org/TaxRateCalculator.aspx)

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muncien
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Re: Dallas: Medical District

Postby muncien » 16 Jan 2019 15:46

Level 1 trauma center is great asset to have, but it's hardly a necessity at county expense. On top of that... Parkland was able to operate as Level 1 trauma out of a far less extravagant facility for years.
I'm glad you mentioned DISD and DCCCD... Can you image what those tax rates would be if their facilities were built with the same extravagance as the new Parkland?
Again... I'm not questioning whether the service should exist. But I am most certainly questioning the manner in which our tax dollars are being used to provide that service.

A little background... My line of work is specifically tailored to improving process efficiency and reducing excessive waste. For the last 17 years, I have done this in the private Health Insurance, Pharmaceutical Distribution, and Pharmacy Benefit Administration operations. I have had direct family working at Parkland, and several professional acquaintances who have provided countless audits of Parkland operations.

The best way I can sum up what I have learned is that if Parkland were a private institution, not only would it have gone bankrupt, but it also would have had ANY government assistance and reimbursements withheld long ago due to countless infractions and mismanagement. But being the darling that it is, they get waiver after waiver from the government, and we reward their repeated failures with billions in unnecessary expansion, and new construction.
"He doesn't know how to use the three seashells..."

cowboyeagle05
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Re: Dallas: Medical District

Postby cowboyeagle05 » 16 Jan 2019 16:31

Hospitals good. Taxes Bad. Hospitals + Taxes = Ehh depends on who you ask. Got it.

willyk
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Re: Dallas: Medical District

Postby willyk » 16 Jan 2019 22:32

Hannibal Lecter wrote:^ Yet only two counties in NE Texas have public hospitals. All the other counties seem to do just fine without them. That doesn't appear to support them being a "necessity".


Other counties send all of their indigent patients to Parkland and Dallas County gets stuck with the costs. They need public hospitals too but they are free riding on Dallas.

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TNWE
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Re: Dallas: Medical District

Postby TNWE » 17 Jan 2019 11:11

I45Tex wrote:261k is no extravagant home for sure, but if you have that plus $50k in other assets, your net worth is in the top quartile of Dallas County residents. I estimate this because the Federal Reserve's latest Survey of Consumer Finance says that a $361,000 net worth is above 71st percentile nationwide and, given Texas' poverty level, it's not a stretch to estimate 75th percentile here. Every homeowner doesn't pay as much as you because even at this modest level you've done a lot better than the majority have been able to.


You misunderstand "net worth"- someone can own a $300k home, but if the mortgage balance is $250k, they're not in the highest percentiles of wealth.


The other oft-ignored point in discussing Property Taxes is that Everyone living in Dallas Country pays them- renters and homeowners alike - but only Homeowners actually see the tax bill. Apartment dwellers have that Property tax rolled into their monthly rent payment, and when rents go up (because property taxes go up), they conveniently blame the landlord, not the City/County/ISD/Hospital. I'd love to see a state law mandating that Landlords/Apartment complexes furnish an annual statement indicating each renter's share of a rental building's property tax assessment, preferably right before election day so renters are adequately informed when presented with a property tax ratification question on the ballot.

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Hannibal Lecter
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Re: Dallas: Medical District

Postby Hannibal Lecter » 17 Jan 2019 13:01

Dunner wrote:Fine, you got me, that number is low. Parkland hospital exacts 0.28 cents per 100 dollars of property value - IF you're living in Dallas County. So it depends on how much your property is worth.


Wrong again. Only this time you're not off by a factor of 10. You're off by a factor of 100. The hospital tax rate is 100 times that.

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Dunner
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Re: Dallas: Medical District

Postby Dunner » 17 Jan 2019 13:37

Hannibal Lecter wrote: Wrong again. Only this time you're not off by a factor of 10. You're off by a factor of 100. The hospital tax rate is 100 times that.


Come back when you have something useful to say. Nitpicking my mistakes just confirms that you have nothing of value to contribute to this conversation.

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Re: Dallas: Medical District

Postby I45Tex » 17 Jan 2019 14:17

TNWE wrote:You misunderstand "net worth"- someone can own a $300k home, but if the mortgage balance is $250k, they're not in the highest percentiles of wealth.


If you look at the SCF with this quick shortcut calculator you can either include or exclude home equity in the assets.

https://dqydj.com/net-worth-percentile- ... ed-states/

For all you know muncien could be underwater on his mortgage, but conjecturing an "if" scenario doesn't really affect what net worth is. Your posts are usually better than average but you can make your point about ownership vs equity without assuming that other people are ignorant.

Whether Parkland is terminally mismanaged or not, Lecter showing that only two Northeast Texas counties have public hospital districts so they're clearly optional is not that different an insight than pointing out that Chicago and New York have stock exchanges so they must not really be necessities. If Greenville, Tyler, and Texarkana had two million people in their counties like Tarrant and Dallas do, then Northeast Texas would have five counties with public hospital districts.

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jovan_gonzales
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Re: Dallas: Medical District

Postby jovan_gonzales » 17 Jan 2019 14:30

I45Tex wrote:
TNWE wrote:You misunderstand "net worth"- someone can own a $300k home, but if the mortgage balance is $250k, they're not in the highest percentiles of wealth.


If you look at the SCF with this quick shortcut calculator you can either include or exclude home equity in the assets.

https://dqydj.com/net-worth-percentile- ... ed-states/

For all you know muncien could be underwater on his mortgage, but conjecturing an "if" scenario doesn't really affect what net worth is. Your posts are usually better than average but you can make your point about ownership vs equity without assuming that other people are ignorant.

Whether Parkland is terminally mismanaged or not, Lecter showing that only two Northeast Texas counties have public hospital districts so they're clearly optional is not that different an insight than pointing out that Chicago and New York have stock exchanges so they must not really be necessities. If Greenville, Tyler, and Texarkana had two million people in their counties like Tarrant and Dallas do, then Northeast Texas would have five counties with public hospital districts.


Greenville / Hunt County does have a public hospital district.

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TNWE
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Re: Dallas: Medical District

Postby TNWE » 17 Jan 2019 16:32

I45Tex wrote:
TNWE wrote:You misunderstand "net worth"- someone can own a $300k home, but if the mortgage balance is $250k, they're not in the highest percentiles of wealth.


If you look at the SCF with this quick shortcut calculator you can either include or exclude home equity in the assets.

https://dqydj.com/net-worth-percentile- ... ed-states/

For all you know muncien could be underwater on his mortgage, but conjecturing an "if" scenario doesn't really affect what net worth is. Your posts are usually better than average but you can make your point about ownership vs equity without assuming that other people are ignorant.


My apologies if my posts come off as mean-spirited at times- trying to be better about that in 2019.

Even leaving out home equity when considering net worth calculations, Property tax assessments aren't based on home equity or net worth. Homeowners pay 100% of assessed property taxes, regardless of whether they paid cash for the house (100% equity) or just closed on a house with a near-zero down mortgage (0% equity). Assuming they both bought a $300k house, I'd argue that the cash buyer is more well-off, as they've been able to generate $300k in cash/assets to put toward buying a home, while the person who now has a mortgage liability against a house with a monthly payment that is mostly going towards interest, insurance, and tax escrow has a small net worth that isn't growing very quickly. These two hypothetical homeowners are going to fall in very different places along the net worth percentile curve, but still owe the same in property taxes.

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The_Overdog
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Re: Dallas: Medical District

Postby The_Overdog » 18 Jan 2019 10:45

"I'd argue that the cash buyer is more well-off, as they've been able to generate $300k in cash/assets to put toward buying a home, while the person who now has a mortgage liability against a house with a monthly payment that is mostly going towards interest, insurance, and tax escrow has a small net worth that isn't growing very quickly. "


Assuming that the two have roughly equal incomes (not net worths- ie: either could have chosen to put down 100% or 0%), and that both are going to live in the property (cash and renting out is clearly financially superior), and that both could get good interest rates, I'd argue that the one with the mortgage is in a better financial position, because the cash buyer just threw down $300k on a depreciating asset, and the only way to get that money back is through a sale (making them worse off than the other person) or through a cash-out loan, which puts them in the same position as the other person. Mortgages lock in inflation, which dulls the effect of the depreciating asset. And the other person has more cash to invest or improve their lifestyle. All you are saving if you pay cash is the interest, which at 3-5%, you can easily beat with normal risk investments.

Property tax assessments aren't based on home equity or net worth.

No they are based on an assessment of land and structure value, which could be close to what was paid, or could be far away.

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kingpin
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Re: Dallas: Medical District

Postby kingpin » 12 Mar 2019 22:15

ImageUntitled by Around My City, on Flickr

ImageUntitled by Around My City, on Flickr

ImageUntitled by Around My City, on Flickr

ImageUntitled by Around My City, on Flickr

lakewoodhobo
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Re: Dallas: Medical District

Postby lakewoodhobo » 02 Jul 2019 10:19

New apartment community on the way at DART's Love Field station
https://www.dallasnews.com/business/rea ... ld-station


Oden Hughes filed two permits with the city of Dallas for more than 500 apartments in four and five-story buildings.

Several developers have looked at building a mixed-use retail and apartment project on the more than 4-acre property at Denton and Hundall drives just east of Maple Avenue.

The vacant shopping center previously housed Elliott's Hardware and the popular Herrera's Café.


This one has had so many false starts... I believe most recently it was supposed to include a grocery store, but with Kroger just down the road it was never really necessary.

cowboyeagle05
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Re: Dallas: Medical District

Postby cowboyeagle05 » 02 Jul 2019 12:05

Yeah the past renderings showed a Tom Thumb and it looks like Tom Thumb went with both the store they are building in Deep Ellum and the Uptown store instead.

itsjrd1964
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Re: Dallas: Medical District

Postby itsjrd1964 » 03 Jul 2019 00:06

Good to see that something is finally moving regarding this property. In the whole time since the earliest redevelopment speculation surfaced, there's been no move to demo the old shopping center. Would be nice to have seen some retail by the DART station, but at least the land is getting positively repurposed instead of sitting around adding dust bunnies.

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kingpin
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Re: Dallas: Medical District

Postby kingpin » 08 Nov 2019 16:02

ImageUntitled by rlopez2011, on FlickrImageUntitled by rlopez2011, on Flickr
ImageUntitled by rlopez2011, on Flickr
ImageUntitled by rlopez2011, on Flickr
ImageUntitled by rlopez2011, on Flickr

lakewoodhobo
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Re: Dallas: Medical District

Postby lakewoodhobo » 15 Nov 2019 11:22

Houston developer Hines buys business campus northwest of downtown Dallas
https://www.dallasnews.com/business/rea ... wn-dallas/

Screen Shot 2019-11-15 at 9.56.12 AM.jpg



Inwood is my primary crossing point to and from Oak Cliff, so I drive by this shopping center often. One thing I've noticed on the Oak Cliff side of this bridge where it turns into Hampton Rd is the very aggressive gentrification happening between Canada Dr. and Singleton.

Since these are clearly people buying homes for its proximity to Medical District and Oak Lawn (doubt they just want to be close to Trinity Groves) I wouldn't be surprised if this shopping center is being eyed for residential in the future, perhaps consolidating their top tenants like Crate & Barrel Outlet and Elliot's on one side in order to make room.
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muncien
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Re: Dallas: Medical District

Postby muncien » 15 Nov 2019 11:32

lakewoodhobo wrote:
Houston developer Hines buys business campus northwest of downtown Dallas
https://www.dallasnews.com/business/rea ... wn-dallas/

Screen Shot 2019-11-15 at 9.56.12 AM.jpg


Inwood is my primary crossing point to and from Oak Cliff, so I drive by this shopping center often. One thing I've noticed on the Oak Cliff side of this bridge where it turns into Hampton Rd is the very aggressive gentrification happening between Canada Dr. and Singleton. Since these are clearly people buying homes for its proximity to Medical District and Oak Lawn (doubt they just want to be close to Trinity Groves) I wouldn't be surprised if this shopping center is being eyed for residential or mixed-use in the future.


While it doesn't sound like they have anything planned for quite some time, it is very encouraging to see this type of speculation all the way up to Inwood. The future seems to hold a LOT of potential for this entire stretch along the Trinity.
"He doesn't know how to use the three seashells..."

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skeets
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Re: Dallas: Medical District

Postby skeets » 23 Nov 2019 12:35

In the West Love development on Mockingbird between Maple and Harry Hines. This is next to the Chipotle.

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