Health care rent is not like a commercial office rent. In addition to base rent, most commercial tenants pay some or all of the landlord’s operating expenses (”CAM Charges”). Yet medical tenants need to cope with the disposal of biomedical waste and have greater privacy concerns than many tenants.

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.

As health care providers move into space previously finished for general office or retail space, they typically need substantial remodeling. Landlords generally like to have tenant finish work done by contractors with whom the landlord has had a prior relationship. In many situations, the landlord controls the contractors who perform the tenant finish work

Though, as a practical matter, the tenant’s use may trigger the need for ADA compliance, the tenant will want to avoid lease language obligating the tenant to pay any of the costs that the landlord incurs to bring the building into compliance with ADA. While medical tenants generally bear the responsibility for finishing the lease premises consistently with the ADA, tenants will want to consider excluding the general building ADA compliance charges from the list of expenses passed through to the tenant.

Since many office leases contemplate that the landlord will hire the tenant finish contractors, the language in those leases often doesn’t address construction problems. A precise construction plan should be agreed to in advance.

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.

Services. It is a common mistake to assume that your new landlord will provide certain basic services to your space. Recognize that the landlord is not bound to provide services beyond those expressly stipulated in your lease. For this reason, you should carefully review the provisions of your lease that specify the services that the landlord will provide.