Very often, the relocation of a medical office, and the subsequent negotiation and execution of a new lease, follows a well-defined pattern. After a certain amount of searching, one day a realtor shows you the perfect space, in the perfect location, and assures you that the lease will need to be signed as quickly as possible if you are not to lose the space to one of your competitors.

If you are acting without benefit of counsel, you will make sure that the business terms (rental rate, length of lease term, landlord allowances, and the like) match your discussions with the broker, and then you are apt to sign the lease, perhaps assuming that all of that “legal boilerplate” in the fine print is standard in every lease and basically not subject to negotiation in any case. All too often, the failure to carefully review and negotiate those boilerplate provisions may come back to haunt you down the road.

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.

Yet health care providers may seek specialists to finish the leased premises. The landlord may acquiesce to allow the tenant finish work to be done by contractors with whom the landlord has no prior relationship

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.

As a result, a tenant with a May 1 rent commencement date may find that, due to construction delays, the space is not ready for occupancy until May 5, but the landlord nonetheless bills the tenant for rent retroactively to May 1. Further, if the lease simply states that the rent commences on May 1, the landlord is legally entitled to collect rent from that date. It is therefore incumbent upon the tenant to make sure that the lease provides that rent will not commence until the landlord’s work has been completed and, ideally, the tenant has been afforded a day or two thereafter within which to take occupancy.

Operating Expenses and Taxes. While some leases simply provide for a monthly rent, others also require the tenant to reimburse to the landlord a share of the operating expenses and taxes for the property. While there are many subtle changes that can be made to these provisions by an experienced real estate lawyer (depending on the form that the landlord is using), at a minimum a tenant should expect to receive a photocopy of the real estate tax bill for the property (as opposed to simply receiving a statement from the landlord) each year, to verify that he or she is not being overcharged. Likewise, the landlord’s statement of operating expenses should be reasonably detailed and the tenant should be afforded an annual right to review and audit the landlord’s books and records relating to both operating expenses and taxes, in order to verify that charges have been correctly computed by the landlord.

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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