Why So Few LEED Certified Hospitals?

Posted on April 23, 2010


At my last count there were 24 LEED Certified primary healthcare facilities (“hospitals” or “medical centers” in United States Green Building Council terminology); this excludes MOBs and outpatient clinics. I am skeptical of the numbers thrown around in the media for LEED registered and certified buildings, so I rely on what I can access from the USGBC website itself. 

The numbers (it is unclear what time table or sample set this encompasses) illustrate the following:  4444 LEED certified facilities out of 19,118 registered with the USGBC = 23% yield (registered facilities that end up as LEED certified, any level).  From what I have read, this is probably historically consistent for the USGBC; although it is not preferred, it is expected that many owners will register their project, but not follow through to certification. 

For healthcare, I found 24 certified healthcare facilities out of 159 registered healthcare projects, a 15% yield. And of the 4444 LEED certified projects listed, only 24 are certified healthcare facilities, or a miniscule 0.5% yield. These totals seem low given the longevity of the USGBC. Why?

Typical responses for ‘why not’ continue with the LEED project certification process after initial registration, include cost premium (per square foot), administrative burden (lots of paperwork), design team pushback (ignorance of one or more team units), and questionable payback (tough sell on lifecycle savings vs. capital outlay of new construction). And hospitals are just a different animal—big, expensive, complex projects.

However, changes are on the way.  Depending on who you talk to, cost premiums are significant to non-existent these days, with new products entering the market every day to deflate any lingering premiums on green products.  The USGBC created the GBCI to administer the certification process, and with the easy-to-use templates and web-based information exchange, things are mightily simplified. Design teams now recognize sustainability is not a fad and should have at least one LEED AP in their organization, so the learning curve has flattened. And the paybeck issue is still significant; but prudent managers are learning to think long term and understand the multiplying effect of incremental savings on reduced energy bills and maintenance.

Plus, the USGBC is close to rolling out its LEED for Healthcare Rating System, which is co-developed with the Green Guide for Health Care (GGHC).  This will make it more attractive to hospitals to attempt LEED because it will be tailored to their industry and measurable and marketable across the industry.  More importantly, it will have the gravitas of the GGHC, the first sustainability rating system on the healthcare scene, and the visibility of the USGBC behind it. 

As the initial press release for the joint venture announcement on Dec. 4, 2007 noted, “green hospital buildings are healthier for thepatients, doctors and nurses; use less energy and water; and have less of an impact on the environment.”  Rick Fedrizzi, President, CEO & Founding Chair, U.S. Green Building Council followed with the statement that “patients in green hospitals have greater emotional well-being, require less pain medication and other drugs, and have shorter hospital stays,” which reflects much of the evidence-based design on green design concepts in hospitals. 

Look for green healthcare projects to really take off once LEED for HC is introduced.