Leasing Premises for Medical Practice: Ministry of Health Requirements and Lease Agreement

Opening a medical office or an entire clinic may seem straightforward: find a space, sign a lease, and start working. Yet it is precisely at these two steps, choosing the premises and signing the lease, that future medical business owners most often run into trouble.

Why does this happen? Because in the medical field, the premises and the license are inseparable. You cannot first rent a “nice looking office” and then adjust the documentation to fit it.

A medical license is not just a standard set of papers. It is about spatial compliance. Every square meter matters, every technical detail can affect the outcome, and every clause in the lease agreement can either open the door to operations or completely block licensing.

Is the examination room too small? No restroom available? No permit for redevelopment? An incorrect lease term? What seemed like an ideal space can suddenly turn into a costly problem in terms of time, stress, and money.

That is why leasing premises for a medical practice is not simply about signing a contract. It is about avoiding the traps that can derail the launch of a medical facility or unexpectedly lead to a business shutdown. In this article, we explain why premises are the foundation of a medical business, what requirements the Ministry of Health sets, and how to sign a lease agreement that protects your investment.

You might also like: Medical Facility Inspections: Who Conducts Them and How to Prepare

Premises for a Medical License: Why They Are the Foundation of the Business

In the medical field, premises are not just a roof over your head. They are the foundation on which the entire future operation of a medical facility is built. A Ministry of Health license is not issued abstractly “based on intent.” It is granted for a specific location where medical practice will be carried out. This is what makes the premises a decisive element in the entire process.

Medical activity requires special conditions, including:

• sufficient floor space;
• proper zoning;
• compliant ventilation systems;
• separate sanitary facilities;
• accessibility for patients and compliance with building and sanitary standards.

If even one of these parameters does not meet regulatory requirements, the entire project may be at risk.

Very often, a space looks “ideal” at first glance. However, a modern renovation does not compensate for an inappropriate designated use, the inability to install a sterilization room, an improperly located restroom, or insufficient electrical capacity for medical equipment.

Moreover, the premises determine whether you can declare the full range of medical services you plan to provide. Certain types of medical activity require separate rooms, larger areas, or additional engineering systems.

That is why premises are not just one of many licensing factors. They are the starting point of the entire medical business. Their characteristics determine whether you obtain a medical license quickly and without obstacles, or whether you will need to correct mistakes, lose time, and search for a new location.

Key Sanitary and Licensing Requirements for Medical Premises

The requirements for premises used in medical practice are designed not merely to ensure a doctor’s comfort, but to create safe conditions for patients. The Ministry of Health, building regulations, sanitary standards, and accessibility requirements establish clear rules regarding floor space, zoning, technical equipment, and functional rooms. Ignoring even one of these parameters may render the premises unsuitable for medical activity.

Premises Size and Office Requirements

The size of medical premises depends on the physician’s specialty and the number of staff working there at the same time. Under building regulations and sanitary standards:

• A single physician’s office must meet the minimum floor area established for the specific medical specialty. For example, the requirements for a dental office differ from those for a general practitioner or pediatrician.
• An office shared by two physicians must be expanded by the норматив area required for a second workstation. Adding an extra chair or workstation without increasing the floor space is a common mistake that often leads to licensing refusals.

Requirements for Specialized Rooms

Certain medical specialties require not only a physician’s office, but also a full set of additional rooms:

• Dentistry: a sterilization room, an instrument storage area, and an X-ray room if required.
• Surgical specialties: an operating room, preoperative area, postoperative patient recovery room, and a sterilization room.
• Laboratories: rooms for sample collection and related functions.

Sanitary and Building Standards

The premises must comply with:

• State Building Regulations: requirements for ceiling height, lighting, ventilation, heating, and sound insulation.
• Ministry of Health sanitary standards: requirements for surface cleanliness, the ability to perform wet cleaning, and safe storage of instruments and materials.
• Zoning rules: clinical, auxiliary, and sanitary areas must be arranged logically, without the crossing of clean and contaminated flows.

Accessibility for People With Reduced Mobility

Under state building regulations, medical premises must be accessible to people with disabilities and other low mobility groups. This includes:

• the presence of a ramp or step-free entrance;
• sufficient door width;
• adequate maneuvering space in corridors;
• an accessible restroom where required;
• no changes in floor level.

Please note! Many landlords overlook these requirements, but for a medical facility they are critical. Lack of accessibility may become grounds for a licensing refusal or lead to claims from supervisory authorities.

You might also like: Registration and Accounting of Medical Equipment in the ESOS

How to Choose Premises for a Clinic: Four Key Aspects

Choosing premises for a medical facility is a strategic decision. Spaces that look perfect at first glance often turn out to be legally unsuitable for medical use.

It is essential to assess a property more deeply. Can it accommodate all required rooms, does it meet regulatory standards, and will it avoid becoming a source of legal or technical issues in the future?

We have identified four aspects that should be reviewed before signing a lease agreement.

1. Legal status and layout
   
   First, you should confirm that the premises can be lawfully used for medical activities. An inappropriate designated use or existing usage restrictions often make a property unsuitable from the outset.
   
   It is also important to assess the layout. A medical facility must be able to allocate separate functional zones, ensure proper patient and staff flows, and provide sufficient space for one or more physicians, depending on the planned scope of services.
   
   
2. Technical parameters (engineering systems)
   
   The technical characteristics of premises are often decisive and most frequently become the reason for licensing refusals or extremely costly renovations. Engineering systems must be able to handle the load of medical equipment, ventilation must comply with sanitary requirements, and water supply and sewage systems must allow for the organization of sterilization or treatment areas.
   
   If the premises are located in an older building or subject to redevelopment restrictions, this can significantly limit the range of medical specialties that can be accommodated.
   
   
3. Inclusivity and accessibility (Requirement No.1)
   
   Today, it is impossible to obtain a medical license without an accessibility assessment report for people with reduced mobility. A medical facility must be comfortable for all patients, including those with limited mobility.
   
   A convenient entrance, the ability to install a ramp, sufficient door width, and easy movement inside the premises are essential both from a regulatory standpoint and for the clinic’s reputation.
   
   
4. Practical and commercial factors
   
   Finally, it is important to consider factors that are not explicitly set out in sanitary standards but directly affect day-to-day operations. These include patient logistics, parking availability, the possibility of installing signage, and proximity to noisy or problematic neighboring tenants. In some cases, these details determine whether a space is suitable for real-world medical practice, not just compliant on paper.

Legal tip: Do not sign a lease agreement for medical premises until a qualified specialist has conducted a compliance audit against licensing requirements. Correcting mistakes after renovation can lead to significant financial losses.

Lease Agreement for Premises for a Medical Facility

A lease agreement in the medical field is not a standard document that can be signed “like everyone else’s.” For a medical business, it is of strategic importance, as its terms determine whether you will be able to obtain a license without obstacles, carry out renovations, install equipment, and operate stably throughout the entire lease term.

A poorly drafted agreement can halt the launch of a clinic even when the premises fully meet all requirements. The specificity is simple: your license is tied to the address. If the landlord terminates the lease after six months, you lose not just the premises, but also the right to conduct business and the significant investments made in renovations.

The key points that must be clearly fixed in the agreement so you can operate with peace of mind.

Lease Term for Premises for a Medical Facility

For medical practice, it is crucial to have a sufficiently long period of use of the premises with strict limitations on the landlord’s right to early termination. If the property owner suddenly decides to terminate the lease (and such situations are not uncommon in practice), you will lose more than just a location. You will lose your license, your patient flow, and substantial funds invested in specialized renovations that cannot be taken with you.

That is why lawyers often insist on fixed guarantees of stability: limiting the grounds for termination, clearly defined notice periods, and compensation in the event of forced eviction.

Carte Blanche for Specialized Renovations

Medical facilities require special conditions: sterilization rooms, procedure areas, ventilation systems, additional water supply points, reinforced electrical networks, and more. If the lease agreement prohibits any interference with the premises or fails to define a clear approval procedure for works, any renovation may become a source of conflict with the landlord or even lead to a suspension of operations in the future.

Therefore, permission for renovations and technical works must be clearly and comprehensively set out in the agreement: alterations required to meet the licensing requirements of the Ministry of Health, including interference with load-bearing structures (if necessary), façade works, and similar modifications.

Please note! Particular attention should be paid to formally recording the technical condition of the premises. This is usually done through a handover (acceptance) report with photographs and a detailed description of engineering systems and the condition of finishes. This protects the tenant from unfounded claims after the lease ends and makes it possible to clearly document which changes were made to meet the needs of the medical facility.

Access for Regulatory Authorities

The lease agreement must also set out rules for granting access to regulatory authorities, as medical facilities are subject to regular inspections by the Ministry of Health, the State Service of Medicines, the State Labor Service, and the National Health Service. In practice, some conflict-prone landlords may block inspectors’ access in order to put pressure on the tenant. This can result in the revocation of the medical license.

Therefore, a lease agreement for premises used as a medical facility must include a clause imposing an unconditional obligation on the landlord to ensure access for representatives of licensing and regulatory authorities to the premises.

Capacity and Responsibility for Utilities

Another important section concerns the terms related to engineering systems and utilities. Lasers, sterilizers, and tomography equipment are sensitive to power fluctuations and the quality of infrastructure. Quite often, the lack of stable water supply, sufficient electrical capacity, or the ability to install proper ventilation systems makes a clinic’s operation impossible.

The lease agreement should clearly specify who is responsible for technical failures, who bears the cost and responsibility for upgrading engineering systems, and whether the installation of additional equipment is permitted.

Logistics and Marketing

A medical facility cannot function without proper visibility and accessibility. From the outset, the lease should secure the right to place a façade sign (otherwise patients simply will not find you) and clearly define parking arrangements. It is also important to ensure that the agreement does not impose restrictions on operating hours (for example, 24/7 access for inpatient facilities) or access control regimes that could discourage patients from visiting.

Why Clinics Close: 6 Fatal Mistakes When Leasing Premises for Medical Practice

Finding suitable premises accounts for only 10% of success. The remaining 90% depends on properly formalizing the relationship. Unfortunately, most clinic owners learn this the hard way, losing money on relocations and court disputes.

1. Leasing premises without legal and technical due diligence.
   
   Tenants often focus solely on the appearance of the premises or an attractive price, without checking ownership rights, possible encumbrances, ongoing litigation, or technical limitations of the building. Problems then emerge after the contract is signed, making the premises unsuitable for medical activities.
   
   
2. Signing a template agreement without analyzing its consequences.
   
   Many medical facility managers agree to standard contracts that do not take into account the specifics of medical practice. Vague grounds for termination, bans on renovations, or unclear access rules can result in losing the location or suspending operations.
   
   
3. Starting renovations and alterations without the landlord’s written consent.
   
   Installing ventilation, X-ray equipment, additional water points, or carrying out alterations without approval may lead to conflict or even termination of the lease. The landlord may demand restoration of the premises to their original condition or cessation of activities.
   
   
4. Ignoring accessibility requirements for people with limited mobility.
   
   Many tenants postpone installing ramps, expanding entrances, or adapting corridors “until later.” In the medical field, this is a critical mistake, as accessibility is mandatory, and its absence leads to violations noted during inspections.
   
   
5. Choosing premises without considering the clinic’s growth prospects.
   
   Tenants often select premises “for a single office,” without allowing for future expansion. When there is a need to add workstations or new medical specialties, the premises or lease terms may not permit it.
   
   
6. Lack of a detailed handover (acceptance) report for the premises.
   
   An undocumented technical condition is a common cause of disputes with landlords. Without photographic evidence and descriptions of engineering systems, the landlord may place responsibility on the tenant for damage the tenant did not cause.

You might also like: Mandatory SOPs for Medical Institutions: How to Develop and Implement Them Properly

Legal Due Diligence of Premises Before Signing a Lease Agreement

In the process of leasing premises for a medical facility, a lawyer effectively acts as a “filter,” screening out risky properties, problematic contracts, and hidden risks before they turn into real losses.

The specialist checks the legal status of the premises, identifies any restrictions, analyzes the ownership history, and immediately warns the client if the property may create problems with licensing or access in the future.

A lawyer also structures the lease agreement so that it genuinely works in favor of the medical business, securing the right to carry out renovations, providing long-term stability guarantees, ensuring approved alterations, and protecting against sudden eviction.

Why Medical Businesses Choose Us

We are not just lawyers. We are medical law experts with more than 10 years of hands-on experience who understand the specifics of your work. We know that you need not just a contract, but a fully functioning clinic with a license.

Our advantages:

1. Narrow specialization: We know building codes (DBN) and licensing requirements better than real estate agents. We determine in advance whether a premises is suitable for an X-ray room or surgical practice, before any documents are signed.
2. Audit before investment: We help save your money by preventing you from leasing problematic premises where obtaining a medical license is impossible.
3. Comprehensive approach: We support you from the initial inspection of the premises to obtaining a license with the Ministry of Health. You receive a legal partner throughout the entire process of launching a medical business.
4. Secure lease agreement: We draft lease terms in a way that protects you from rent increases, sudden eviction, or interference by the property owner in your operations.

As a result, your business receives not just premises, but a fully controlled, predictable, and legally protected start to medical practice, without the risk of license denial, unexpected eviction, or costly surprises after signing the lease.

Do not risk your start. Contact us and entrust the foundation of your business to professionals.