As health care providers compete for patients, they seek locations convenient for patients. This phenomenon has driven clinics, urgent care facilities, and other health care providers into general office and store front retail space

Many medical tenants prefer to do their own janitorial work. If biomedical tenants do their own janitorial work, then, from the tenant’s perspective, the general janitorial expenses for the building should be backed out of the CAM Charges passed on to the biomedical tenant. Medical tenants use hazardous materials and generate biomedical waste. Medical tenants can use X-ray machines, CT scans, and other machines which may generate harmful radiation. To preserve the integrity of these machines, medical tenants also have specialized needs to avoid interference with these machines.

Medical uses usually violate the boilerplate use provisions in most retail and office leases. In addition to modifying the use provisions, landlords and tenants should consider the representations and warranties within the lease, together with the hours of operation. Patients are more likely than the general public to have special access needs. Buildings containing health care providers are more likely to receive ADA scrutiny.

Rent Commencement Date. Surprisingly, one of the points over which landlords and tenants argue most frequently is the date on which rent begins to be payable at the commencement of the lease term. Due primarily to poor draftsmanship, the question is often very gray and, unfortunately, the tenant often must begin to pay rent before he or she would have reasonably expected to be obligated to do so.

The underlying problem is fairly simple. In the typical medical office lease, the landlord undertakes the construction of certain improvements in the premises prior to turning the space over to the tenant for occupancy. As a new tenant, you expect to walk into your finished office, move in your furniture, and then begin paying rent on the day you open for business. All too often, however, the lease provides for a fixed date on which rent will commence to be payable and there is no provision for delaying that date if completion of the landlord’s work is delayed.

Yet health care providers need to limit the landlord’s access to examining rooms and other areas during certain hours of the day. Generally, medical tenants will seek to place limitations on the landlord’s reentry rights. This can be done through designating certain privacy areas on a diagram showing the finished lease premises

It is common for office leases to contain provisions requiring the tenant to consent to a substitute premises should the landlord decide that it is in the landlord’s best interest to move the tenant from one suite in the building to another. Because of the specialized build-out needs of the medical tenant, medical tenants are more likely to resist these provisions.

As health care providers seek to become increasingly convenient to their patients, they will continue to migrate to general office and storefront retail space. Both landlords and medical tenants need to work to ensure that their leases fit these special situations

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