Hospital Campus CAM Reconciliation Guide for Landlords

Typical CAM pools, billing errors, gross-up mechanics, and BOMA standards for hospital campus properties.

Benchmark CAM per SF

$6.00 – $14.00 / SF

Source: Revista / BOMA Medical Office 2024

Gross-Up Applicability

Complex — hospital campuses have a mix of fully-occupied hospital buildings and variably-occupied MOBs and retail spaces. Each building type may require separate gross-up treatment within a unified campus CAM framework.

Typical CAM Pools

  • Landscaping (campus-wide)
  • Security (24/7)
  • Parking (surface and structured)
  • Utilities (campus infrastructure)
  • Roads and pedestrian paths
  • Wayfinding/signage
  • Insurance
  • Property taxes
  • Management fees

Standard Exclusions

  • Clinical equipment
  • Patient care costs
  • Individual building capital
  • Hospital-specific regulatory compliance
  • Research facility costs

Common Lease Structures

Ground lease with campus CAM overlayModified gross with campus chargeFull-service with allocation formula

Common Billing Errors

  • Allocating campus security costs equally despite 24/7 hospital vs. daytime-only MOB usage
  • Including hospital-specific infrastructure (helipad, emergency power) in shared campus CAM
  • Misallocating structured parking between hospital visitors and MOB patients

Relevant BOMA Standards

  • ANSI/BOMA Z65.1-2024 (Office Buildings)
  • Campus measurement and allocation methods

Hospital Campus CAM Context

Hospital campus CAM is among the most complex property types because the campus serves multiple constituencies (hospital, outpatient clinics, MOBs, retail, research) with fundamentally different operating patterns and cost profiles.

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