Cirrus Blog

The Dangers of the Demolition Clause in Your Veterinary Office Lease

Picture this – after a few years in your new veterinary clinic/hospital location, you have developed a solid culture with staff and patients that you truly enjoy. Your loans are slowly but surely being repaid and you are building up an enviable client roster in the process. Your home and your children’s school are all within a three-mile radius of your clinic. Life is good, and improving. Then, out of the blue, you receive a notice that your lease is being terminated due to a redevelopment of the property. Can the landlord do this? What happens now?
What is a “redevelopment” or “demolition” clause?

The “redevelopment” or “demolition” clause is an increasingly common feature of veterinary office lease agreements, particularly in high-density, metropolitan real estate markets. This clause gives your landlord the right to terminate your lease if they decide to demolish, renovate, or redevelop the building or center you are practicing in. Often the definitions of “redevelop”, “demolish”, or “renovate” in the lease are highly ambiguous.

The particulars of this redevelopment or demolition – the who, what, when, why and where – will invariably differ from lease to lease and from landlord to landlord.

For example, a given veterinary office lease might allow the landlord to terminate your tenancy if they decide to build a condominium building on the land. Another lease might permit the landlord to permanently relocate you to another part of the property, or to another property altogether, if renovations are to be carried out.

The struggle is particularly relevant to veterinarians, who invest heavily in leasehold improvements and can’t simply pick up and relocate without considerable expense. Sound familiar? That’s because the average veterinarian spends hundreds of thousands of dollars constructing an animal hospital/clinic. […]

The Dangers of the Redevelopment/Demolition Clause in Your Office Lease

Picture this – after a few years in your new dental office location, you have developed a solid practice culture with staff and patients that you truly enjoy. Your loans are slowly but surely being repaid and you are building up an enviable patient roster in the process. Your home, your children’s school are all within a three-mile radius of your practice. Life is good, and improving. Then, out of the blue, you receive a notice that your lease is being terminated due to a redevelopment of the property. Can the landlord do this? What happens now?
What is a “redevelopment” or “demolition” clause?

The “Redevelopment” or “Demolition” clause is an increasingly common feature of dental office lease agreements, particularly in high-density, metropolitan real estate markets. This clause gives your landlord the right to terminate your lease if they decide to demolish, renovate, or redevelop the building or center you are practicing in. Often, the definitions of “redevelop”, “demolish”, or “alter” in the lease are highly ambiguous.

The particulars of this redevelopment or demolition – the who, what, when, why and where – will invariably differ from lease to lease and from landlord to landlord.

For example, a given dental office lease might allow the landlord to terminate your tenancy if they decide to build a condominium building on the land. Another lease might permit the landlord to permanently relocate you to another part of the property, or to another property altogether, if renovations are to be carried out.

The struggle is particularly relevant to dentists, as they invest heavily in leasehold improvements and can’t simply pick up and relocate without considerable expense. Sound familiar? That’s because the average dentist spends $200,000 constructing a dental office. As such, the […]

New De-Roster Codes

The MOHLTC has recently announced that they have rolled out three new billing codes that will enable physicians to de-roster patients without having to submit the “Primary Care – Request to Remove a Patient” forms.
What are the De-Roster Codes Implemented?

Q401A – De-Roster – Member Deceased.
Q402A – De-Roster – Ended by Provider.
Q403A – De-Roster – Patient Left Province.

How do we bill the new De-Roster Q Codes?

Ensure the Service Date inputted when billing matches the effective De-roster Date you wish to remove the patient to.

The usual six-month stale dating rule that applies to all claim submissions applies to the De-Roster Q codes.

The De-Roster Q codes may be submitted with a service date of up to six months prior to February 1st, 2017 (therefore August 1st, 2016).
Physicians who have submitted de-roster forms with an end date after August 1st, 2016 and within the 6-month stale-dating period may submit the De-Roster Q codes or wait for their forms to be processed.

Ensure the service date when billing the Q code matches the de-roster date noted on the paper copy of the de-roster form.
Per the MOHLTC, should the de-roster date be greater than 6 months from the date the claims are being billed for submission, then you must contact your Claims Services Branch office and request approval to submit a stale dated claims file for these claims. Approval must be received prior to submitting the stale dated claims file.

Physicians who have submitted de-roster forms with an end date prior to August 1st, 2016 must wait to have their form processed.

Please note that the MOHLTC will continue processing paper de-roster forms until April 1st, 2017 only.

Further information on the MOHLTC changes […]

Customer Case Study: Dr. Gordon S., DVM | Woodstock, GA

Dr. Gordon S. is a late-career veterinarian running a successful animal hospital in Woodstock, GA.

As a busy veterinarian, Dr. S. had not been keeping track of critical dates in his lease agreement such as the lease expiry date, which was vast approaching.

The doctor was invited to attend a CE webinar on the topic of “Negotiating or Renegotiating the Terms and Rent in the Veterinary Office Lease” hosted by Cirrus Consulting Group, the veterinary office lease negotiation experts. At the webinar, the doctor learned about the importance of beginning the lease renewal process 18-24 months in advance of the expiry date in order to bring the landlord to the table with enough leverage and time to secure the best deal. The doctor also learned about many of the inherent risks in lease agreements, and was shocked to learn that many of these pitfalls existed in his current lease.

With the negotiation clock ticking, the doctor retained Cirrus to review his current lease agreement, and negotiate the terms of his renewal.

The doctor communicated to Cirrus that as a late-career veterinarian, he was looking for lease terms that would appeal to future buyers, and enable him to transition profitably and smoothly without being indebted to the practice afterwards. In addition, the doctor believed that the new Property Management company that was hired to manage the shopping center was unfairly charging for rent and Common Area Maintenance (CAM) charges, so this was something he would also want addressed in the negotiations.

Dr. S. was looking for his new lease to provide him with the following:

Cirrus conducted a thorough practice needs analysis and reviewed the lease for critical dates and problematic language. Together they created a lease negotiation strategy and were […]

Customer Case Study: Dr. Emma M., DDS | Midlothian, VA

Dr. Emma M. is a general dentist in the later stages of her career practicing in Midlothian, VA. After being diagnosed with hand tremors, Dr. M. brought in dental associate Dr. Bill S., and has since begun treating patients for Sleep Apnea at the clinic.

Dr. M’s 28-year lease was rapidly approaching its renewal deadline. As a late career dentist, she was looking to renew her lease with terms that would support her eventual plans to transition out of dentistry. Naturally she considered Dr. S. as a potential buyer; however, she was unsure the timing was right as he was a fairly new associate.

Being cognizant of her eventual transition plans, she was looking to renew the lease agreement with terms that would spark the interest of potential buyers. She was looking for a shorter term, ideally 5 years, with options to renew to ensure the long-time viability for her successor.

After attending a dental office lease negotiation and commercial real estate seminar hosted by Cirrus Consulting Group, Dr. M. retained Cirrus for help with her upcoming lease renewal.

“I had no idea the ramifications that some of the clauses could have. I signed my old lease 28 years ago but was very young and not very bright when it came to lease agreements. Now that I am older and wiser, I felt it was necessary to hire Cirrus to re-write my lease and negotiate terms that I felt were fair and could live with.”

– Dr. Emma M., DDS, Midlothian, VA

She was looking for the following key wins in her renewed lease:

Cirrus Consulting Group guided Dr. M. through their strategic lease negotiation process and achieved the
following key wins:

Dr. M. now has peace-of-mind knowing her lease is set up for a […]

Henry Schein Dental Spotlight | Jeff Trachtenberg, FSC

“My relationship with Dr. Phadnis could not be stronger now and she has thanked me too many times to count! Ask your doctors for a copy of their lease agreement, and have Cirrus make you ‘SCHEIN’.”

– Jeff Trachtenberg, FSC | Henry Schein Wallingford, CT

Continued Learning

I have worked in the dental field for nearly 25 years, 17 of which was for Henry Schein Dental (HSD). I started my career at HSD as a Regional Manager and managed the CT region for 11 years. I transitioned to a Field Sales Consultant (FSC) over 6 years ago. Being a Regional Manager prior to becoming an FSC gave me the opportunity to work closely with some of the top-producing FSCs. I took so much away from them, and really engrossed myself in what made them successful.

Cirrus was Instrumental in Securing a Healthy Lease Agreement

I have been promoting Cirrus Consulting Group for the past couple of years. Cirrus has performed dozens of dental office lease reviews over the phone for my clients, and most recently I brought 6 doctors to one of their local CE seminars about “How to Negotiate the Terms and Rent in the Dental Office Lease”. I successfully referred two dental offices to Cirrus last year, with more to follow.

One particular case is Dr. Ukti Phadnis who opened a dental practice from scratch. She was extremely overwhelmed with the process because the landlord of the chosen location had provided her with a lease agreement she felt was very unfair to her. Of the many pitfalls/risks in the lease, she was being overcharged for the common area maintenance (CAM) fees with no explanation to what she was really being charged for, and, she had no […]

It’s Not JUST About the Rent: Shifting Veterinary Office Lease Negotiations

If I were to ask you which part of your veterinary office lease agreement is the most important, what comes to mind?

I doubt you would consider the assignment clause – the clause which governs your ability to purchase a clinic or transfer the lease alongside the sale of your veterinary clinic/hospital. You probably wouldn’t think about the surrender clause – the clause which outlines how you are meant to leave your space when your lease term ends. Almost certainly you wouldn’t think about the relocation or redevelopment/demolition clauses, which, if exercised by the landlord, could unexpectedly force you out of your space! No, I’m willing to bet you immediately thought the most important part of your lease is the rent. Well, I hate to be the bearer of bad news, but….it’s not just about the rent!

While rent is certainly one of the key components of any lease, I’m here to teach you that it should not be your number one concern.
It’s Not Just About the Rent
Who could blame you for believing otherwise? Rent is the most obvious cost that a veterinary tenant incurs. Sometimes the payment of that monthly cheque is the only contact a veterinarian has with their landlord all year. It is therefore no surprise when a veterinarian focuses entirely on achieving the lowest rental rates possible at negotiation time, completely ignoring the rest of the lease agreement. However, to be perfectly frank, this approach is just plain wrong. Rent may be an “obvious cost”, but there are numerous hidden yet important costs that you should be more concerned about.
Hidden Costs vs. Obvious Costs in Your Veterinary Office Lease Agreement
An Assignment Nightmare

One such hidden cost is often found lurking in the assignment […]

It’s Not JUST About the Dental Office Rent: Shifting Lease Negotiations

If I were to ask you which part of your dental office lease is the most important, what comes to mind? I doubt you would consider the assignment clause – the clause which governs your ability to purchase a practice or transfer the lease alongside the sale of your practice.

You probably wouldn’t think about the surrender clause – the clause which outlines how you are meant to leave your space when your lease term ends. Almost certainly you wouldn’t think about the relocation or redevelopment/demolition clauses, which, if exercised by the landlord, could unexpectedly force you out of your space!

No, I’m willing to bet you immediately thought the most important part of your lease is the rent. Well, I hate to be the bearer of bad news, but….it’s not just about the rent! While rent is certainly one of the key components of any lease, I’m here to teach you that it should not be your number one concern.
It’s Not Just About the Rent

Who could blame you for believing otherwise? Rent is the most obvious cost that a dental tenant incurs. Sometimes the payment of that monthly cheque is the only contact a dentist has with their landlord all year. It is therefore no surprise when a dentist focuses entirely on achieving the lowest rental rates possible at negotiation time, completely ignoring the rest of the lease agreement. However, to be perfectly frank, this approach is just plain wrong. Rent may be an “obvious cost”, but there are numerous hidden yet important costs that you should be more concerned about.
Hidden Costs vs. Obvious Costs in Your Dental Office Lease Agreement
An Assignment Nightmare

One such hidden cost is often found lurking in the assignment clause, and […]

Cirrus Special Premiums and Bonuses Update

A successful medical practice is built on a strong foundation and an understanding of the various revenue streams available to you.

Special Premiums & Bonuses are often overlooked when it comes to FHO revenue optimization. As part of the Cirrus mandate to ensure all potential revenue is captured for your practice by the end of the MOHLTC fiscal year, Cirrus will issue the Special Premiums and Bonuses Report prior to March 31st, 2017.

The report outlines your total premiums and bonuses attained year-to-date and compares your progress to your previous fiscal year performance to ensure you attain all bonus categories relevant to your medical practice.

Missed our latest informative webinar on capturing your Special Premiums? Access it at your convenience here.
If you have any questions about the above information, please fill in the form below and a Cirrus healthcare consultant will be in touch with you shortly.

The Do’s and Don’ts of Setting Up a Locum Physician and Billings

Are you considering hiring a Locum to cover your practice?
Hiring a Locum physician is recommended anytime a FHO physician will be away from their practice for a significant period of time and/or their FHO colleagues cannot provide sufficient coverage during their absence. When registered properly with the MOHLTC, the Locum Physician will be able to submit billings on FHO enrolled patients, without incurring Outside Use to the signatory physician and their FHO group.

Where do the payments from the Locum’s billings go to?
In a common scenario where the FHO is setup such that individual physician billings go to their solo accounts and group funds into the group account, the funds are distributed as follows:

If you or your colleagues have any questions with regards to hiring locums attached to your FHO practice, do not hesitate to contact one of our Cirrus Physician Support Specialists.
If you have any questions about the above information, please fill in the form below and a Cirrus healthcare consultant will be in touch with you shortly.