Marquee Background
Marquee Background

Offit Kurman Blogs

Healthcare

Doctor Not Paying Rent for Surgery

July 14, 2025

By Michael H. Cohen

A doctor not paying rent for a surgery space, equipment, or medical suite leads to consequences that extend beyond a typical lease default. In addition to potential eviction or legal action, the situation can raise serious regulatory and compliance risks. This happens if the lease wasn’t properly structured under laws like the Anti-Kickback Statute (AKS), Stark Law, or corporate practice of medicine (CPOM) restrictions

In healthcare, rent can be interpreted as a form of compensation or referral incentive if not properly documented. For landlords, clinics, MSOs (Management Services Organizations), and medical facility owners, a doctor’s failure to pay rent might raise red flags about how the lease was structured in the first place. If the agreement isn’t legally compliant, even well-meaning parties can face fines, investigations, or enforcement actions.

This blog explores what happens when a doctor fails to pay rent for surgery space and why it’s more than just a landlord-tenant issue. It also highlights the legal and compliance risks involved, especially under healthcare laws like the Anti-Kickback Statute, Stark Law, and corporate practice of medicine rules.

What Are the Rent Payment Obligations for Doctors?

Typically, doctors who rent surgery space or use specialized equipment within a medical office facility are bound by legally enforceable lease agreements. These contracts outline key rent payment obligations and often include provisions that account for the unique nature of medical practice, such as access to imaging centers, operating rooms, or radiology departments. A typical medical office lease agreement will specify the amount of rent, payment schedules (often monthly or quarterly), responsibilities for repairs and maintenance of equipment, and who is liable for shared services like janitorial staff, HVAC systems, or medical waste disposal.

For surgery centers in particular, lease agreements usually contain more detailed provisions due to the higher cost and sensitivity of the premises. These may include specialized rental terms, responsibilities related to the delivery of surgical services, clauses for early termination, and how space is shared among physicians, specialists, or hospital departments. In many cases, doctors are also responsible for a portion of the common area fees or building systems required to keep the facility operational and suitable for patient care.

Failure to meet these rent obligations can disrupt not only the landlord-tenant relationship but also the operations of other tenants in the facility. For example, when a physician stops paying rent or attempts to walk away from the agreement early, it can create legal and logistical challenges for landlords, patients, employees, and other practices connected to the space. In some circumstances, the landlord may refuse to allow continued use of the premises or may begin the process of finding a new tenant, which raises more questions about who is responsible for rent payments during the transition.

What Are the Consequences of a Doctor Not Paying Rent for Surgery?

The most immediate consequence is a breach of the lease agreement, which may lead the landlord to file a lawsuit for unpaid rent, early termination penalties, or damages related to loss of use. Depending on the provisions in the agreement, the clinic, imaging center, or hospital facility may also be entitled to recover costs associated with finding a new tenant or maintaining the premises during the vacancy.

From a business standpoint, non-payment can disrupt clinic operations, especially if other tenants or departments share the facility. Patients may lose access to vital services, employees might face instability, and the entire health ecosystem within the building could suffer. 

Physicians who default on lease payments also risk damaging their reputation among other professionals, hospital systems, and even patients. This potentially reduces future referrals or collaboration opportunities with specialists and contractors in their field.

In the worst-case scenario, the physician may lose access to critical equipment, be evicted, face a lawsuit that affects their credit or licensure status, and encounter difficulty securing rental space in another facility. Additionally, if improper arrangements around rent and services are flagged, there could be legal exposure under healthcare law, particularly regarding the Anti-Kickback Statute or fee-splitting violations. These consequences may extend to the MSO or business entity that employs or contracts with the physician, especially if the rental arrangement lacked proper legal review.

Can a Doctor Be Evicted for Not Paying Rent for Surgery?

Yes, a doctor can be legally evicted for not paying rent for surgery space, provided that the landlord follows the correct process under the lease agreement and applicable landlord-tenant law. Eviction in the healthcare industry is not taken lightly due to the sensitive nature of the services involved and the specialized needs of the premises. However, if rent goes unpaid and the facility owner decides the relationship cannot continue, they have the legal grounds to begin the eviction process.

The eviction process usually begins with a formal notice of non-payment, followed by a demand for payment within a set period. If the doctor fails to pay or negotiate new terms, the landlord may then file an unlawful detainer action in court. 

After receiving a judgment, the landlord can request that law enforcement remove the tenant from the premises. During this process, the physician may be denied access to equipment, patient records, and office systems, which can further disrupt clinic operations and negatively impact health services.

How to Stay Compliant With Surgery Space Lease Agreements

To stay compliant, begin by aligning your lease terms with federal statutes, such as the AKS and the Stark Law. This means ensuring rent payments are not based on the volume or value of referrals, and that any compensation or service exchange does not appear to be a disguised incentive. Fee-splitting is particularly risky and may be deemed illegal if not structured properly.

It’s equally important to document all lease communications, payment issues, or proposed changes in writing. Avoid making side arrangements outside of the official lease, and maintain records of all rent invoices, delivery of services, and any disputes that arise. If a physician becomes unable to afford rent or requests early termination, that conversation should be handled formally with clarity around liability, suitable replacement terms, and responsibilities during the transition period.

Furthermore, a lease review should not be a one-time task. Build it into your broader compliance plan and revisit the agreement regularly, especially as your business, tenants, or services evolve. Finally, always consult a qualified healthcare attorney before signing or breaking any lease connected to surgery space, imaging centers, or other regulated medical facilities. With the right legal guidance, you can protect your business, avoid costly regulatory action, and maintain healthy relationships with tenants, patients, and other healthcare providers.

What to Do If You’re Struggling to Pay Surgery Rent

If you’re a doctor or healthcare entity struggling to pay rent for a surgery center, imaging center, or shared clinic space, the first step is to notify your landlord in writing. This is not only a professional courtesy, but also to protect yourself legally under the lease agreement. 

You should also avoid making unilateral decisions such as subleasing to other tenants without consent or reducing rent payments without formal negotiation, as these actions can violate contract provisions and trigger liability. In many cases, financial strain may be temporary and negotiable, but landlords are less likely to cooperate if they’re blindsided. 

Legal consultation can help you determine if your current lease allows for flexibility in payment terms, early termination, or replacement with a new tenant. But attempting to modify or exit the agreement without understanding its legal structure can expose you to fees, lawsuits, or even impact your connection to hospital departments and referral partners.

Renegotiating your rental terms is possible, but it must be done with healthcare-specific legal oversight. These leases often involve shared use of equipment, employ multiple contractors, and touch on specialized services, which makes compliance with healthcare law a critical factor. By seeking proper legal advice, you’ll be better positioned to negotiate a fair and lawful arrangement that helps your practice stay open and your relationships with patients and employees intact.

How a Healthcare Lawyer Can Help Protect Your Practice

A healthcare lawyer can review your lease to ensure it aligns with state and federal law, particularly with respect to rent provisions that could violate the Anti-Kickback Statute, fee-splitting prohibitions, or the corporate practice of medicine doctrine. This is especially important when the space involves shared clinic access, radiology departments, hospital premises, or specialized delivery systems.

If you’re already in breach of your lease terms or the landlord refuses to renegotiate, a qualified attorney can help you file a legal response, defend your rights, or explore early termination options that minimize liability. Legal professionals also assist in structuring rent arrangements that reflect fair market value and don’t inadvertently tie payments to the volume or value of referrals, which is a common compliance misstep in medical business agreements.

Ready to Protect Your Medical Practice?

Lease agreements in the healthcare industry are legally binding arrangements that carry significant regulatory and financial consequences. By fully understanding your lease terms, negotiating in good faith, and maintaining open, written communication with landlords or facility owners, you can prevent disputes and preserve the integrity of your practice.

FAQs

Rent disputes involving surgery space can raise complex legal and compliance issues for doctors, especially when medical practice laws intersect with standard lease terms. Below are some quick answers to common questions healthcare providers face when dealing with lease challenges.

Can I Be Sued for Not Paying Rent on a Surgical Suite?

Yes, if you breach your lease agreement, your landlord can sue for unpaid rent, damages, or early termination fees.

Will Non-payment Affect My Medical License?

While non-payment alone may not directly affect your license, related legal issues or regulatory violations (like improper arrangements) could draw scrutiny from licensing boards.

What Happens if I Try to Sublease the Space to Another Provider?

Subleasing without landlord approval or proper legal structure may violate your lease terms and trigger liability or compliance issues under healthcare law.

Is a Verbal Lease Agreement Legally Valid?

In some jurisdictions, verbal agreements may be recognized, but they are risky and hard to enforce, especially for complex arrangements like surgical or imaging center rentals.

How Do I Know if My Lease Violates the Stark or AKS Laws?

If your rent is tied to referrals or not based on fair market value, it may violate the Stark Law or the Anti-Kickback Statute. A healthcare attorney should review your lease for compliance.

How Can Doctors Resolve Disputes With Landlords Over Rent for Their Surgery Space?

Start by reviewing the lease terms, documenting the issue in writing, and seeking legal counsel to negotiate or mediate a resolution.

Are There Any Options for Doctors to Renegotiate Their Rent Payment Terms for Their Surgery Space?

Yes, rent terms can often be renegotiated. But it should be done through formal legal channels to protect both parties and maintain regulatory compliance.

Categories: Healthcare

Related People

Related Services

  • Posts
  • About
  • Subscribe

Firm Highlights

  • Events
    The 2026 Economic, Tax, and Accounting Updates
    We are looking forward to the Mid-Atlantic CFO Roundtable's next event on November 13, 2026. This is a program with topics built for Finance Executives. We are extremely fortunate to have three excellent speakers: Dr. Daraius Irani, Vice President of Business and Public Engagement at Towson University; Mike Stankus, Tax Office Managing Principal at BDO; and Daniel Wahlberg, Managing Partner of Acclare Solutions. The economy is rapidly changing with various factors driving it. The November 3rd midterm elections may also have an impact. Our three expert presenters will discuss the ramifications of the election, and the current year updates to GAAP financial reporting and Federal and State income taxes. Please join us for what will surely be an informative and timely discussion. Meet Our Speakers: Daraius Irani, Ph.D. • Towson University Vice President, Business & Public Engagement Dr. Daraius Irani serves as Vice President of Business and Public Engagement at Towson University as well as the chief economist for the Regional Economic Studies Institute (RESI) at Towson University, a policy group providing economic, fiscal impact, and policy analysis to public and private entities.  Dr. Irani is often called upon to provide economic presentations to organizations across Maryland. He has appeared on numerous television programs and in local and regional print media. Dr. Irani holds a Ph.D. in economics from University of California, Santa Barbara. Dan Wahlberg • Acclare Solutions Managing Partner With over 28 years of experience, Dan Wahlberg is a recognized leader in audit and assurance for the Mid-Atlantic’s middle market business community. As a licensed CPA in Maryland and Virginia, Dan has led assurance practices at top regional firms, including serving as Baltimore Audit Managing Partner and Assurance Practice Leader at BDO USA in Baltimore and as Partner and member of the Management Committee at Hertzbach & Company P.A which merged into BDO in 2020. His expertise centers on delivering clarity, strategic guidance, and proactive solutions to middle-market businesses across Baltimore and beyond. His entrepreneurial spirit has led him to begin a new CPA firm this year with four other CPAs serving the business community. Dan holds a Bachelor of Science in Accounting from Rutgers University and began his career at PWC in New York. He is also deeply engaged in the community, previously serving as President of ACG Maryland and current Board member and as Audit Committee Member for The Associated: Jewish Federation of Baltimore.  Mike Stankus • BDO USA LLP Tax Office Managing Principal Mike Stankus is the Tax Office Managing Principal for the firm’s Baltimore office. He has more than 16 years of experience providing tax planning and preparation and management advisory services for his clients. Mike focuses on advising privately held businesses and their owners on effective growth and tax strategies. He also performs various engagements for mergers and acquisitions and complex cost accounting projects and projections. In addition, he represents various government contracting clients before the DCAA and assists with FAR compliance. Mike’s areas of concentration include working with government contractors, professional service firms, construction companies, and homebuilders.
  • Events
    AIA Tri-State Conference
    Princeton will serve as the backdrop for three days of connection, learning, and design leadership. From keynotes to tours to the Tri-State Design Awards, this year’s conference is designed to go far beyond education sessions. Kick off the week with pre-conference intensives and individual state component Design Award celebrations, followed by three days of education, inspiration, networking, and design excellence at the 2026 AIA Tri-State Conference—featuring pre-conference intensives, three keynote speakers, 25 education sessions, curated tours, an expo, spec academies, and the AIA Tri-State Design Awards—bringing together architects and design professionals from New Jersey, New York, and Pennsylvania to connect, learn, and celebrate the best of the profession. G2. Designing Secure Practices: Cybersecurity, Data Privacy, Contractual Provisions, and Insurance Risks for Architects (4:00 PM - 5:30 PM) Architects and design professionals increasingly rely on cloud platforms, BIM software, and digital tools to manage sensitive data, creating cybersecurity and privacy risks. A single incident can trigger liability claims, regulatory obligations, reputational harm, and insurance challenges. Yet many firms underestimate how contracts, insurance, and internal practices intersect during a breach. This program offers legal and insurance perspectives on cyber risk in architecture, examining liability exposure, risky contract provisions, and mitigation strategies. A cyber insurance expert will explain policy responses, coverage gaps, coordination with professional liability, and best practices for aligning insurance with contractual risk and protecting firms from evolving cyber threats. Learning Objectives: Identify key cybersecurity and data privacy risks faced by architecture firms and explain how these risks can impact professional liability and project outcomes. Analyze common contractual provisions to determine which clauses may increase exposure to cyber incidents and propose strategies to mitigate these risks. Evaluate the scope and limitations of cyber insurance policies, including coordination with professional liability coverage, to determine how a policy would respond in a breach scenario. Develop actionable risk management strategies by integrating legal, contractual, and insurance considerations to protect sensitive client and project data.