Before you agree to another lease term, ask your staff what they would change about the office. If someone says, “We need more room,” ask which appointments are difficult to accommodate and where the shortage occurs.
Bring those examples to the year-end budget discussion. Price the work the practice would need to stay, then compare it with the cost and disruption of moving.
Start with the renewal notice
A lease that expires late next year may have a renewal notice deadline much sooner. The signed lease and every amendment should go to counsel to confirm the notice window, required delivery method and recipient. Counsel should also check any conditions on the renewal right and how renewal rent will be set.
Give someone within the practice responsibility for those dates and for retaining proof of any required notice. Your real estate advisor and project team can then help estimate the time needed to evaluate alternatives. A renewal involving renovations needs to account for design work, any approvals and construction. A move also raises the question of how to transfer operations without losing more clinic time than the practice can afford.
How many rooms do you need
Use provider schedules from a few typical weeks to map room use during each clinic session. Include the number of rooms each provider needs, paying particular attention to sessions when several providers are working at once.
For rooms that sit empty during those sessions, ask staff what prevents them from using the space. A room may need equipment or have been taken over by supplies. Get an estimate for making it usable again before deciding how much additional space to lease.
Add any approved hires to the room schedule using their expected appointment hours. If you’re holding rooms for a position you haven’t approved yet, work out what that unused space costs each month and how long you’re willing to pay for it.
The trip from parking to checkout
The front desk hears the explanation when a patient arrives late. A wrong entrance, a difficult drop-off or a long search for parking each points to a different problem. Recording recurring complaints gives the practice something specific to investigate and discuss with the landlord.
As our medical office site-tour guide recommends, visit the parking lot during your busiest clinic sessions, including times when neighboring tenants are busy. A lot can have open spaces at the far end while patients with limited mobility struggle to find a usable space near the entrance.
Some problems, such as unclear signs or a maintenance issue, may be fixable at the current property. Accessibility concerns need assessment by qualified professionals. Before a renewal, the practice should know which problems the landlord has agreed to address and which would remain.
Where your patients are coming from
Aggregated patient ZIP code counts and referral volumes, compared with similar earlier periods, can help show whether the practice is drawing patients from different areas. Patient-level information should stay within the practice’s approved systems.
For example, a Brandon practice receiving more referrals from Riverview could examine travel times at appointment hours and what those patients report about getting to the office. A temporary change in a referring physician’s schedule could account for the increase. Before making plans around those referrals, check whether they continue across comparable periods. A second location would need its own case for patient demand and staffing.
What expansion would require
Ask your project team to show how the new provider or service would fit in the suite. For an imaging service, they need to check whether the building can accommodate the equipment and any required shielding. Allow time and money for any required approvals before setting a construction budget and opening date.
If the neighboring suite is empty, ask whether it’s available and have the project team price the work needed to connect it to your office. Have counsel check any expansion rights in your lease.
Compare the cost of staying with the other workable options over the same lease term. That includes base rent and operating expenses with scheduled increases, plus improvements. A move adds relocation expenses, possible overlapping rent and disruption to patient visits. Any landlord contribution should be considered alongside the lease commitment required to obtain it.
Healthcare Realty Group works exclusively in healthcare real estate. To talk through a renewal or changes to your current space, contact us.
