Maybe you’re just getting started with your nurse practitioner practice and need space for your new office. Or perhaps, you’ve been in your own practice for some time but now need to move because you’ve outgrown your current space.
No matter the reason, at one time or another every nurse practitioner practice owner jumps in the market to find the perfect clinic space.
While it sounds pretty simple, often it turns out to be challenging.
Finding the perfect match between what you need and what’s available is not always easy. As a matter of fact, the perfect match may an illusion…
So what is it that makes finding space so challenging?
While there are many different reasons why finding the right space can be difficult, there are three, in particular, that stand out.
- Location: medical vs. mixed.
- Optimal dimension: not too big or small.
- Lease Terms: unfavorable and confusing lease terms.
Choosing the Right Location
Whenever there’s a discussion about real estate, without fail, the words “location, location, location” come up.
And of course, all that means is when buying or selling real estate, the location of the property is of utmost importance.
Well, the same is true when renting or leasing office space. If the space you want to lease is in a prime location… well, it’ll cost you more.
The location of any real estate property determines and influences things like:
- Ease of access… how easy is it to get to your office?
- Who are the other tenants around you?
- Do the other tenants provide complimentary, medical services or are they operating in a different industry altogether?
- What are other services close by? Is there the potential for cross referrals and exposure via foot traffic?
- Your professional image… Are you next to a tattoo parlor or a dermatology clinic? Either one has the potential to reflect on you, your clinic, and perhaps your perceived level of competence.
Is Location Important for your Medical Office?
You bet it is!
While you may not be able to secure a “prime location” for your office, you want it to be in a good, reputable location.
It’s the age-old debate between pure medical or mixed use. Is it better to set up “shop” in a medical space or would it be alright to go with a mixed-use office location?
Traditionally, most medical offices have been surrounded by or have been close to other medical offices… in a medical building or a medical complex. Frequently, they’re also adjacent or close to a hospital.
While today you’ll find more clinics and medical offices in non-clinical environments (shopping centers, business centers, etc.), consumers still tend to judge an office based on location.
Clinics housed in pure medical facilities tend to have a “higher status,” because they have built-in social proof. The thinking goes something like: “They are right next to all these other doctors, they must know what they’re doing; I can trust them.”
So what if your clinic space is located somewhere else?
If your clinic is housed in a less traditional space or the non-medical environment, patients initially may be a bit more hesitant. As a result, you may have to do a bit more in your marketing to convey competence and build trust with prospective patients.
Overall, however, it seems that medical offices located in mixed-use spaces are becoming more and more accepted today.
The Dimension of The Space
If you’ve ever looked for space, you know what I’m talking about here, right? This is particularly true when working with a commercial leasing company to find space.
You’ll either come across space that could hold a small army or space that might house one tiny person, at best. Often it’s hard to find something in between that would be workable.
First, most don’t need all that square footage… certainly not when just starting out.
Second, most are not prepared for the huge build out that frequently needs to get done (at your expense!).
Often, the spaces you’re shown have been offices of some sort and need to be built out to suit medical use. And that’s expensive!
Even though you may be told that the landlord will pay for the build out, most often, the cost will be rolled back into the lease payment (at least to some degree).
Needless to say, it’s best if you can find space for your new clinic that’s relatively close to what you want and need. It’s certainly less expensive and less headache in the long run!
Once you found the right space, you need to negotiate leasing it… you need to sign a lease!
Typically, if you’ll be renting from an individual (residential landlord), the lease is relatively straight forward.
Most often you’ll be paying deposits, first and last month rent, and perhaps a portion of utilities if they’re not individually metered. The landlord will take care of most everything else.
However, if a commercial landlord owns the space you’re considering, things tend to be a bit more complex and confusing!
There is one particular lease that you may come across… the Triple Net Lease; also known as “Net Lease” or “NNN Lease.
If you sign a triple net lease, you’ll be paying certain expenses beyond your base rental rate.
What exactly you’ll be paying above your rent depends on the specifics of the lease… what’s been negotiated between you and your landlord.
Here are just some of the extra expenses you may have to pay:
- Taxes… you may have to pay a share of the property taxes.
- Maintenance… may be expected to pay for upkeep of structures inside and/or outside the building.
- Common areas… you may have to pay some of the upkeep of areas used by all tenants.
When you’re signing a lease, keep in mind, that everything (to some degree) is negotiable!
So don’t be shy asking for what you want. Of course, there is no guarantee that you’ll get what you’re asking for. However, it’s guaranteed that you won’t get it if you don’t ask!
Here are some general considerations and questions to ask when negotiating a lease, regardless if it’s residential or commercial.
Don’t be afraid to negotiate any and all items on the lease if you think it appropriate.
Always make sure you understand what’s at stake and what the long-term consequences for you and your clinic are.
- What is the length (term) of the lease?
- What are the start days?
- When does the lease start: at signing, move-in, or at some point in the future?
- When can you move in and open for business?
- What is the amount of rent? Is it fixed for the duration of the term of the lease, or is it set to increase as your revenue increases?
- What insurances are you required to carry and when must they start?
- What security deposits or assurances from your bank are required?
- Is the lease renewable, if so, at which rate?
- Who pays for needed improvements and alterations to space?
- Is the space ADA compliant?
- Who pays the property taxes?
- Who is responsible for maintenance, inside and outside of the building? Who pays for maintenance?
- What type of signage is allowed or will be provided?
- How many parking spaces are included (if any)?
- What about after-hours access and use?
- Are you free to bring in other providers without needing approval?
- Are you allowed to sublet space?
- What constitutes emergency entry on the part of the landlord or representative? Consider HIPPA here and put the appropriate contracts in place.
These are just some of the things to think about. Depending on the type of medical clinic and your specific needs, there may be a lot more to consider.
A good resource on the topic of leasing is available from Nolo; the title is “Negotiate the Best Lease for Your Business.”
That’s it for today!
As with anything else in life, success is in the details. Don’t get caught off guard; adequately prepare before entering any lease negotiation, so you’ll stand a chance getting what you want.
Leave us a comment and share your experiences searching for space… we’d love to know!
By Johanna Hofmann, MBA; regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”
Image credit: Malcolm Reid, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=12915382
Awesome topic. Thanks for tackling it so that we are well prepared to negotiate terms of lease or other things. Thanks Barbara.
You are welcome Naomi. Thanks for stopping by and commenting.
Topic on point. This is the stage where am in for now. Though a small county the price of offices where high or none at all. We were mostly seeing house to rebuild for medical offices.
Considering the time it will take for credentialing I opted to rent a one room office for now. Still searching. Thanks for the insight.
Smart move to get one room for now and expand from there. Credentialing definitely takes time and it makes no sense to pay for overhead before you need to. Best wishes!
Good read!! This has provided good insight on looking for the right space. I’m in this phase now. I’ve been doing house call with my practice for 2 years and would like to expand because I’m finding that I’m missing out on clients who call and want to schedule an appointment prefer a clinic visit vs house call, since I am now credentialed with the majority of insurance companies.
Good to hear you are growing!