Art. R. 145-10
Single-use classification for clinics and care homes — exempts from standard market-value and capping rules
2009
T2A reform effective date — abolished per-diem pricing and ended the capacity-based rent method
Per m²
Metric method: rent assessed per m² of useful area per year HT HC — the only recognised post-T2A approach
GHS
Groupes Homogènes de Malades — pathology-based tariffs that replaced per-diem bed pricing under T2A

Single-Use Classification

Clinics and care homes are treated as single-use premises (locaux monovalents) under Article R. 145-10 of the Code de commerce. The classification is not automatic: courts must verify that the premises were built or fitted for a specific use and that conversion to another activity would require major and costly works. The burden of proof lies with the landlord asserting single-use status. Where that burden is not met, the standard market-value rules of Article L. 145-33 apply and the rent cannot be fixed under Art. R. 145-10 (CA Versailles, 7 March 2017).

The consequence of single-use classification is the same as for hotels: the rent at renewal is exempt from the five-criterion market-value assessment of Art. L. 145-33 and from the capping rule of Art. L. 145-34. It is determined according to the practices of the sector, or by the method the court finds most appropriate.

Before and After the T2A Reform: Two Different Methods

Pre-2009 method
Hotel-Style Capacity Approach
Before the T2A reform, clinic rents were determined by a method analogous to the hotel method, based on three parameters applied to theoretical bed revenue.
  • Posted daily rate (prix à la journée) × number of beds
  • Occupancy rate applied to theoretical revenue
  • Rent-to-revenue percentage (taux d'effort)
  • Supplementary elements: single-room premiums, consulting-room rents, ancillary income
  • Per-bed (prix au lit) cross-check also commonly used
  • Variable loyer binaire formula also available by agreement
Post-T2A — from 2009
Metric Method Only
The T2A reform abolished per-diem pricing, replacing it with GHS pathology-based tariffs. Courts rapidly recognised the metric method as the only coherent post-T2A approach.
  • Rent per m² of useful area per year HT HC
  • Confirmed by Court of Cassation (Cass. 3e civ., 11 Dec. 2012)
  • Four analytical steps: premises characteristics → lease clauses → surface breakdown → comparables
  • Per-diem theoretical revenue no longer calculable — variable GHS tariffs make it impossible
  • Ambulatory care expansion further reduced relevance of overnight bed numbers
  • Comparables rare and confidential — expert survey essential

Why the T2A Reform Ended the Capacity Method

The T2A reform (tarification à l'activité), effective 1 January 2009, replaced per-diem pricing in healthcare with a pathology-based payment model. Under T2A, tariffs are set by reference to Groupes Homogènes de Malades (GHS) — diagnostic groups with different procedures, durations, and costs. The per-diem bed rate that underpinned the old method was abolished.

With a different tariff for each GHS category, and the inherent variability of patient pathologies, it became impossible to construct a meaningful theoretical revenue figure from bed capacity alone. The concurrent expansion of ambulatory care services further reduced the relevance of overnight bed numbers as the primary revenue driver. Courts rapidly recognised this: both the Paris commercial rent court and the Court of Cassation confirmed that the metric method was the only coherent approach for post-T2A clinic valuations (TGI Paris, Loyers comm., 5 December 2011; CA Orléans, 26 May 2011; Cass. 3e civ., 11 December 2012, n° 11-21.910).

The Metric Method: Rent per m² of Useful Area

The metric method assesses the rental value of clinic premises on a per-m² basis, expressed in euros per m² of useful area per year, excluding tax and service charges (HT HC). The assessment follows four analytical steps.

Metric Method — Four Analytical Steps
1
Premises Characteristics and Condition
Examine location, state of maintenance, age of technical equipment, and how well the layout suits healthcare use. General building quality and any obsolescence of clinical infrastructure are assessed at this stage.
2
Lease Clause Analysis and Charge Abatements
Review the lease clauses and identify any exorbitant-of-common-law charges borne by the tenant — notably property tax, building insurance, and regulatory compliance works. These constitute grounds for downward adjustments to the metric rental value.
3
Surface Breakdown by Zone and Function
Distinguish surfaces by type: infrastructure (technical plant, circulation areas); superstructure (rooms, consultation areas, treatment areas); annexes (storage, car parks). Each level and zone is valued separately according to its utility coefficient.
4
Comparable Transactions per m²
Research comparable transactions at other clinic and care home premises, expressed per m² of useful area. Comparables are notoriously difficult to obtain given the confidential nature of healthcare property transactions — expert assessment typically relies on institutional databases, professional networks, and directly negotiated references obtained under professional secrecy.
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Practical Point — Scarcity of Comparables

The main difficulty with the metric method for clinics is the scarcity of publicly available comparable transactions. Healthcare premises rarely trade openly and renewal settlements are often confidential. Expert reports for clinic rent proceedings typically rely on a combination of directly negotiated references (obtained under professional secrecy), judicial decisions in other cases, and published institutional data. Parties should commission an independent expert survey well before the renewal date to avoid delays in proceedings.

Clinic and Care Home Leases: The Essentials
  • Single-use classification (Art. R. 145-10): exempts rent from the five-criterion market-value assessment (Art. L. 145-33) and the capping rule (Art. L. 145-34). Classification is not automatic — burden of proof lies with the landlord. Conversion to another activity must require major and costly works. If burden not met, standard rules apply (CA Versailles, 7 March 2017).
  • Pre-2009 method (hotel-style capacity approach): based on posted daily rate × beds × occupancy rate × taux d'effort. Supplementary elements added. Per-bed cross-check also used. Variable loyer binaire formula available by agreement.
  • T2A reform (effective 1 January 2009): replaced per-diem pricing with GHS pathology-based tariffs, making it impossible to calculate a meaningful theoretical revenue from bed capacity. The pre-2009 capacity method was rendered unworkable. Ambulatory care expansion further reduced the relevance of overnight bed numbers.
  • Metric method — confirmed post-T2A (Cass. 3e civ., 11 Dec. 2012, n° 11-21.910): rent per m² of useful area per year HT HC. Four steps: (1) premises characteristics and condition; (2) lease clause analysis and exorbitant-charge abatements; (3) surface breakdown by zone/function with utility coefficients; (4) comparable transactions per m².
  • Exorbitant charges: property tax, building insurance, and regulatory compliance works borne by the tenant under the lease give rise to downward adjustments to the metric rental value. These must be identified and documented before proceedings begin.
  • Comparables: scarce and largely confidential — healthcare premises rarely trade openly. Expert reports rely on institutional databases, professional networks, and confidentially negotiated references. Commission an independent expert survey well before the renewal date.
Advising on a Clinic or Care Home Lease Renewal?

The shift from the hotel method to the metric method changed the entire valuation framework for clinic premises, and comparables are difficult to source without specialist expertise. We advise landlords and healthcare operators on renewal strategy, method selection, and the preparation of evidence for judicial proceedings.

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This article is for general information and educational purposes only. It does not constitute legal advice and does not create a lawyer-client relationship. Laws and regulations may have changed since publication. Always seek qualified French legal advice on clinic or care home lease valuations in France.