November 13, 2025 | Meghan Konigsberg, Education Manager, BOMA International
As regulatory scrutiny increases, accurate measurement and allocation of space, especially for shared areas between hospitals and adjoining medical office buildings, is essential for compliance and risk management. Under Stark Law, shared and time-based space use must be clearly defined to avoid financial penalties and compliance red flags by the OIG.
The allocation of circulation or connecting spaces between hospitals and adjoining MOBs depends on ownership boundaries and legal documentation. Similarly, time-shared spaces within a MOB, such as laboratories, imaging suites, or waiting areas, must be explicitly addressed in lease agreements. Proper documentation ensures compliance with regulatory standards, protects against financial disputes, and supports fair market value determinations.
For those seeking guidance, BOMA 2024 for Office Buildings (ANSI/BOMA Z65.1-2024) offers an important resource. While the standard doesn’t dictate where the ownership boundary must be drawn, it recommends using the legal demarcation point, such as a bridge or wall, as the defining line. If there’s no distinct physical demarcation separating ownership, these spaces can typically be allocated between properties. However, the key lies in documentation. Common areas can often be proportionally allocated to tenants unless a specific lease agreement dictates otherwise. Privately owned MOBs must ensure their legal agreements clearly define where ownership and maintenance responsibilities begin and end. Without that clarity, questions about who controls or benefits from shared corridors, lobbies, or passageways can become compliance or tax liabilities. When ownership is split between a hospital and an independent MOB, the parties must negotiate a commercially reasonable agreement to define how shared spaces are measured, maintained, and charged. The standard also allows a 2% variance in measurement, which can help accommodate minor discrepancies in space calculations.
You can learn more about BOMA 2024 for Office Buildings (ANSI/BOMA Z65.1-2024) here.