Medical office building cleaning: who cleans what, the landlord or the tenant?

In a medical office building, the landlord usually cleans the shared spaces and the tenants answer for their own suites, either through a full-service lease or their own contract. Clinical equipment and regulated waste stay with each practice either way.

The lease covers the money and leaves out what matters at night: which doors the crew can open, who wipes the dental chairs, whether the lab refrigerator is ever touched. Here is a who-cleans-what map, how common lease types pay for cleaning, and how to write each tenant's rules into one scope.

Who cleans what: the usual split

Landlord for common areas, tenant for suites, practice staff for anything clinical. By area:

How the lease decides who pays

The lease decides who pays for cleaning and who hires the crew. Who touches what is a separate question.

Under a full-service or gross lease, the landlord commonly includes janitorial for tenant suites in the rent, often a set number of nights per week and a standard task list. Practices that want more, such as extra restroom checks or exam room work on weekends, pay the landlord or a contractor for the difference.

Under a net lease, tenants commonly pay a share of common area costs, including common area cleaning, and hire their own contractor for the suite. Many medical buildings lease this way, because practices have requirements the landlord does not want to manage.

Hospital-owned or health system buildings add a third pattern. The system's facilities team may set products and procedures for every suite, including tenants who are not part of the system. If you lease in one of these buildings, ask for the cleaning policy before you sign your own cleaning contract.

One contractor, many tenants: writing the rule sheets

The best-run medical office buildings use one contractor for common areas and for any suites whose tenants opt in, with a written rule sheet for each suite. That sheet is what keeps the weekly complaint email from starting.

A pediatric practice, a dental office, an imaging center, and a lab can share a floor, and each has items the crew must never touch. A generic scope cannot capture that. A one-page rule sheet per suite can.

Each tenant's rule sheet should cover:

1. Entry window. Earliest and latest time the crew may enter, and whether a staff member is ever present.
2. Alarm and doors. Suite alarm steps, doors that stay locked, and doors the crew must lock behind them.
3. Do-not-touch list. Sharps containers, regulated waste, specimen and medication refrigerators, sterile supply rooms, charts and screens, imaging equipment, and anything else the practice names.
4. Clinical surfaces. Which surfaces staff clean between patients and which the crew cleans on its visit, room by room.
5. Products. Whether the practice specifies a disinfectant, and where it is stored.
6. Restrooms. Whether suite restrooms get the same frequency as shared restrooms.
7. Contacts. Who to call at the practice when something is found: a leak, an unlocked door, a light left on in a procedure room.

The contractor's supervisor briefs the crew on each sheet before the first night in that suite, and the account manager updates it when a practice changes. When tenants turn over, the sheet is the first thing rewritten.

The nightly route and the floor calendar

Practices close at different times, so the crew's route follows the clinic schedule rather than the floor plan. A well-run night usually goes:

1. Common areas first where traffic has stopped: upper corridors, stairwells, and elevator lobbies on floors whose practices have closed.
2. Suites in closing order. The family practice that closes at 5 p.m. comes before the urgent care that closes at 9 p.m. Each suite's entry window on its rule sheet sets the order.
3. Shared restrooms cleaned after the floor's last practice closes, so they stay clean for the morning.
4. Lobby, entry, and elevator cabs last, so the first patients walk in on clean glass and floors.

The schedule should show this order with times. When a practice extends its hours, the route should change on paper before the crew finds a locked suite at 9 p.m.

Floors need their own calendar. Corridors and lobbies take wheelchairs, carts, and wet-weather traffic, so resilient floors there get regular scrub and recoat cycles, and waiting room carpet gets extraction tied to traffic. Plan it for the whole building at once: corridor work when the building is closed, often weekends, with suite floors the same nights if tenants agree and dates set around any Saturday clinic hours.

Daytime coverage for the shared spaces

Lobbies, elevators, and shared restrooms in medical buildings see heavy daytime traffic, from patients who may be unwell or using mobility aids. Night cleaning alone rarely holds through a full clinic day.

Day porter coverage on the landlord's side solves most of it: set rounds through the lobby, elevators, and shared restrooms, restocking and spot cleaning, and a quick response to spills. Porters also report leaks and broken fixtures to the account manager before tenants have to.

Tenants with busy waiting rooms sometimes buy their own porter hours inside the suite. With one contractor, the porter can split time between common areas and those suites on a written schedule.

Billing when tenants pay separately

When several tenants pay separately, one contractor running the nightly janitorial program for the whole building can still split the work and the invoices. Ask for separate pricing and invoices for common areas and for each tenant suite, all on the same service schedule. The landlord's statement then shows only common area costs, each practice pays only for its suite, and nobody argues about who paid for the corridor outside a busy suite.

Agree on shared items, such as paper in a corridor restroom used mostly by one large practice. The simplest answer keeps shared restrooms entirely in common area costs.

Questions for property managers and practice managers

Bring these to your next scope review or lease negotiation:

• Which areas are in the landlord's cleaning scope, and on what nights?
• Are tenant suites included in the rent, and to what standard?
• Does each suite have a written rule sheet, and who updates it?
• Who handles daytime restroom and lobby checks?
• How do tenants report a miss, and who responds?
• Can tenants buy added suite services from the building's contractor?
• How are keys, fobs, and suite alarm codes controlled across tenants?

For the room-by-room task list inside a practice, use our medical office cleaning checklist. For how this differs from hospital cleaning, see medical office janitorial vs hospital EVS.

One walkthrough for landlord and tenants

Property managers can walk the common areas with us along with any suites whose tenants want in, and practice managers can bring their do-not-touch lists to the same visit. You get a written quote for medical office cleaning, the shared spaces and porter hours, and you can ask for each tenant suite priced as its own line. Your dedicated account manager is the contact for the landlord and for every participating practice.

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