Lease Issues Unique to Medical Uses: A Trap For the Unwary (Part 2 of 2)*
This is the second posting on this topic (click here for part 1) which addresses the volatile combination: the aging population in America; the real estate industry looking for something to develop; and a lender community that is just now comprehending the value of understanding lease terms as a bedrock topic for the collateral.
The earlier posting addressed “problems” with standard lease boilerplate topics.
Here are some eccentric issues not found in standard office or retail leases:
- Building Name & Signage: The naming rights of buildings on hospital campuses, together with related building signage, can be a significant source of revenue for the hospital, especially to nonprofit hospitals. Hopefully all of this is addressed by the lease; and in fact conforms to the actual building names and signage. So, watch for these provisions; and then determine if they have been violated.
- Prohibited Uses: Medical office buildings affiliated with a particular hospital may prohibit uses that the hospital deems inappropriate given its particular mission. For example, many not-for-profit hospital systems are created by faith-based organizations carrying a faith-based mission. These hospitals may impose restrictions upon tenants relating to elective abortion services, stem cell harvesting from fetal tissue or other practices that violate their faith-based mission. Also, watch for this issue in any restrictive covenants, if the building is located in a project\campus established by such an organization. So, watch for these provisions, and then determine if they have been violated.
- Lease Restrictions Imposed by a Hospital: Because the goal of a hospital system for medical office buildings on its campus is for them to support and create synergies with the hospital, the hospital system may also want to limit the leasing of space in buildings on its campus to only those physicians and physician practices that have staff privileges at the hospital. This is a matter of convenience for both the hospital and the physician and additionally prevents competitors from occupying space in the hospital campus. Likewise, the hospital may require that any tenant of a building on the hospital campus be a medical-related tenant (Again, watch for this issue in any restrictive covenants if the building is located in a project\campus established by such an organization). So, watch for these provisions, and then determine if they have been violated.
- Lease Restrictions – Exclusive & Limited Uses: Similar to exclusive rights in retail leases, tenants under medical leases sometimes seek to be the exclusive physician in a medical office building providing their particular expertise to patients. Generally, landlords are also sensitive to the tenant mix on a hospital campus because their success in marketing the building to tenants will be enhanced if more specialties of medical practice are represented, which should enhance patient referrals among the tenants. So, watch for this provision, and then determine if it has been violated.
Again, once you understand these issues, then the inquiries become:
- Have these been implemented?
- Have they been violated?
- Are these “problems” that you’ll inherit once you take back the property?
Please share your comments, suggestions or questions on this topic.
* Confession: This entry comes from a piece written by my colleagues at Winstead PC, Andy Dow and Allan Katz. I thank them for bringing this good stuff to our attention. My contribution is “adding” the workout perspective to it.