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it jt Adventist Health System Contract Review Response Contracting Parties: FH Zephyrhills and Michael L. and Angela M. Caselnova Contract Tracking Number: AH04671 Corporate Legal Services Reviewed by: Shainoor Ladha - KarmaliReview Date: 1/30/09 Cleared Review n Reviewed with Comments Reviewed with Additional Requirements ❑ General Comments: This submission consists of an office space lease agreement furnished by the landlord in this case a physician practicing in the community also served by FHZ. Under this lease, FHZ would lease the space currently used for the physician's private practice since the physician is closing his private practice. FHZ will use this space initially as storage and later for general office space. Consequently, the question, does it make sense for the hospital to rent this space in a medical office building since medical office buildings generally have higher rental rates than a general office building? Accordingly, please provide juslifir do s r�finc this space over another location. Since the physician is a potential referral source, the lease is subject to Stark law and the Anti - kickback statute. The lease agreement would comply with the applicable laws, provided the payment terms are reflective of fair market value in arms - length transactions, are not based on the volume or value of referrals or business otherwise generated between the parties, are not adjusted for proximity or convenience to referral sources, and the hospital can show business reasons in support of selection of this space over another location and that this space is reasonably necessary for hospital's business purpose. Additional Requirements /Language Changes: (i) Add the following to Section I of the Lease Agreement: ili HEALTH SYSTEM Page 1 of 3