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By Jeff Grandfield and Dale Willerton—The Lease Coach

Healthcare tenants should not be afraid to negotiate assertively on the rental rate. So why do healthcare tenants have such difficulty in this area?  Frequently, the answer is a simple unawareness of market rental rates (or the “going rate” in an area).

Let us explain. Suppose the leasing agent or landlord wants you to pay $25 per square foot on new lease space (or even on a lease renewal). However, you know that every other tenant in the building is paying rent ranging between $18 to $20 per square foot. Armed with this information, you would have no difficulty justifying your negotiations would you?

Healthcare tenants often mistakenly believe that the agent or landlord wouldn’t dare ask for more rent than the space is worth. Consider that the landlord is paying the leasing agent commission not just to lease the space, but to lease it for the highest rent possible – and to the best tenant available. Commercial landlords justifiably want to maximize the return on their real estate investments, which is entirely acceptable.

Here are eight strategies for lowering the rental rate on commercial leases: [Read more…]

By Jeff Grandfield and Dale Willerton

For many healthcare tenants, negotiating a good lease or lease renewal against an experienced agent or landlord can be a challenge. While a doctor focuses on proper patient care, savvy real estate agents and brokers are specialized sales people. Their job is to sell tenants on leasing their location at the highest possible rental rate.

As explained in our new book, Negotiating Commercial Leases & Renewals FOR DUMMIES, tenants may go through the leasing process only two or three times in their entire lifetime – yet they have to negotiate against seasoned professionals who negotiate leases every day for a living. Negotiating appropriate leasing terms is vital for a doctor as the amount of rent he pays will directly affect the practice’s financial bottom line.

Whether you are leasing a new location for the first time or negotiating a lease renewal for your practice, these are some money-saving tips for healthcare tenants: [Read more…]

$22 million project to be completed in late 2019

Today, Conemaugh Health System ceremoniously broke ground on a comprehensive outpatient center in Ebensburg, Pennsylvania. Community leaders, elected officials, health care providers and hospital supporters gathered to watch the first dig marking the beginning of construction for the facility, which is made possible by a $22 million investment from Duke LifePoint Healthcare.

“We are thrilled to break ground on this new outpatient center, which will provide high quality and patient-centered care close to home for those we serve in the Ebensburg community and surrounding areas,” said Bill Caldwell, Market President of Conemaugh Health System. “Today, we take another exciting step in advancing our mission of Making Communities Healthier, and we look forward to seeing this important project come to fruition.”

The new Conemaugh Ebensburg Outpatient Center will be a 40,000-square-foot facility featuring advanced diagnostic imaging services, including computerized tomography (CT) and magnetic resonance imaging (MRI); women’s health services; a primary care clinic; specialty care services; rehabilitation services; and MedWELL urgent care and corporate care services. It will also feature space for community education programs and events. [Read more…]

By Jeff Grandfield and Dale Willerton 

Readers of our new book, Negotiating Commercial Leases & Renewals FOR DUMMIES, will learn (in-part) that Common Area Maintenance (CAM / Operating Costs) charges for tenants come in two flavors: honest mistakes or dishonest calculations. In a building where the property is fully or close to fully occupied, the landlord may have less reason to try to profit from Common Area Maintenance charges but may still try to enhance the property with the tenant’s money.

When a commercial property has several vacancies, the landlord, typically, will be responsible for paying his proportionate share for the vacant units. Some landlords try to avoid paying for any of the CAM charges on the vacancies by adding language into the lease agreement that spreads out the obligations for the vacant spaces amongst the current tenants. In some situations, physician tenants can be carrying a very heavy financial burden if the property is not fully leased.

Ideally you are or were able to negotiate concise and reasonable CAM language in your initial lease with your landlord. That said, even the most detailed lease may result in issues with CAM so communicating with your landlord (both verbally and in writing) about any CAM concerns you may have is imperative. And don’t wait too long to ask your questions because your lease may stipulate a statute of limitations on adjustments. Sometimes the problem comes from the property manager; however, at other times, it originates from the owner or landlord taking advantage of tenants. [Read more…]

By Jeff Grandfield and Dale Willerton

Readers of our new book, Negotiating Commercial Leases & Renewals FOR DUMMIES, will learn (in part) that many lease renewal myths exist. Considering that the average physician tenant only negotiates a couple of leases in their lifetime (and sometimes with the same landlord), it’s easy to understand how leasing myths can persist. Occasionally, these myths are created and propagated by the landlord, but also by real estate professionals looking to serve their own interests.

Here are a few myths to beware of:

Myth #1: You must exercise your renewal option to extend your lease. 98% of the successful lease-renewal deals that The Lease Coach completes for tenants don’t exercise the renewal-option clause. If they did, everything except the rental rate would have been off the table for negotiation. All of your negotiations on a renewal term should be done well in advance of your current lease expiring. If your landlord is unwilling to negotiate with you or you’re unable to achieve the terms you’re looking for, that’s when you consider your renewal option. If you play your lease-renewal cards in the right order, you may be able to negotiate for all kinds of inducements and changes that you were not aware of when you signed your first lease agreement. [Read more…]

By Jeff Grandfield and Dale Willerton 

Readers of our new book, Negotiating Commercial Leases & Renewals FOR DUMMIES, will learn (in-part) that they should be as equally cautious with their commercial lease renewals as they were with their new leases! Healthcare tenants (and established doctors) can be very attractive to commercial landlords and those doctors can use this fact to their advantage with their lease renewals. Without effective negotiation, physician tenants can miss out on valuable tenant inducements (paid by the landlord) and even lower rents.

As The Lease Coach, we frequently remind physicians of the following steps:

Do start the planning and site selection process well in-advance. Lease renewal negotiations should begin between nine – 12 months before the lease term expires. This will give you sufficient time to look at other sites and do your homework. If you can’t get a decent renewal rate, would you rather find out you need to move with three weeks or six months left on your lease term? 

Don’t settle for your same rental rate. Achieving a rent reduction on your lease renewal is a very real possibility. If your landlord is leasing space to new tenants at less than what you are currently paying, a rent reduction for you should be a given. If your current rental rate is artificially high because of your last tenant allowance, a rent reduction on your renewal term could also be in order. [Read more…]

By Tami Greene, AIA, NCARB

Now, more than ever, the quality of Healthcare Design is measured and rewarded on the basis of patient satisfaction. As a result of the Affordable Care Act, healthcare continues to evolve into a consumer commodity; where proactive patients require facilities that integrate with today’s culture of empowerment and choice around the services we choose.

Many healthcare providers may fall short in meeting that need without considering the use of technology throughout every stage of the care continuum.  Technology can greet patients at home even before their first face to face encounter with hospital staff and guide them seamlessly through their appointment or hospital stay.

In turn, investing in smart technology will not only improve the patient experience, but it also creates a more streamlined process for staff. As a healthcare designer, I often find myself asking, “why wouldn’t you?”

At Home

One rapidly growing trend that incorporates technology into the patient experience before and after visits is the use of patient portals. According to CDW’s ‘2017 Patient Engagement Perspective Study,’ there has been a 30% increase in patient signup for portals from 2016 to 2017 for a total of 74% of patients surveyed reporting that they were registered with a healthcare portal. 

The success of portals depends on the proactive measures taken by hospitals to ensure patient understanding of what a portal has to offer. First, patients must be educated as to what the portal is, how it benefits them, and how to sign up.  This education should start by the practice engaging the patient during an office visit; even offering a hands-on tutorial.

At that time, they can also ask the patient if they would like to enroll or schedule someone to contact them.  Second, the interface must be easy to use. Finally, the information available through the portal should be appropriate and relevant to the patient. [Read more…]

Facility is Centerpiece of Major Renovation Project Underway at AHN Flagship

Allegheny Health Network (AHN) and Highmark Health officials today celebrated the completion of a new facility at Allegheny General Hospital (AGH) that will provide cardiovascular patients with access to 48 private beds in a state-of-the-art setting, including 24 critical care beds and a 24-bed monitored step down unit.

Located on the 11th floor of AGH’s Snyder Pavilion, the $26 million project is part of a major initiative underway to improve and modernize the infrastructure of the hospital and further advance its capabilities as AHN’s flagship quaternary medical center.

The new cardiovascular unit at AGH is expected to begin admitting patients next week and will primarily be used by those who require intensive care and around-the-clock monitoring for conditions such as acute myocardial infarction, acute heart failure, and cardiac dysrhythmias.

“AGH and its exceptional clinicians have long been recognized for providing the highest quality of care for those with cardiovascular and other complex diseases,” said Michael Harlovic, Chief Executive Officer of AGH.  “Today is a great day for our hospital, our patients and the community, and we are extremely grateful to the leadership at AHN and Highmark for their investment in these critical resources and their commitment to excellence in everything we do.” [Read more…]