LEED for Healthcare Rating System Review

Posted on January 31, 2011


Late last year the much-anticipated LEED for Healthcare Rating System was released by the USGBC. It had a longer-than-expected journey to adoption, and you can read some of that here.

The short story is LEED 2009 for Healthcare New Construction and Major Renovations is a hybrid of what the USGBC thought was important for sustainable design and what the Green Guide for Healthcare (GGHC) thought was important. The Green Guide has an equivalent history to LEED, if not slightly older than LEED, but I cannot say for sure. I studied it quite a bit when sustainable design was getting started; it was a massive document, and appeared onerous to comply with.

If I had to summarize how the GGHC differed from the average USGBC Rating System, I would say the GGHC’s sustainability focus was primarily how a hospital executed its day-to-day operations. This is evident in LEED for Healthcare, which is good to see. In fact, the Rating System has some significant changes from LEED 2009 (V3), which was a major revision in itself.  Here are some of the differences compared to V3, which most new construction (NC) would register under today:

Sustainable Sites

  • One additional prerequisite (PR), Environmental Site Analysis.  I am not sure why this point was added.
  • One additional credit, Connection to the Natural World, worth a possible two points was added.  Research continues to confirm what was known on some level more than 50 years ago:  interaction with nature benefits the healing process.  This is a notion that has been used in the past in design for tuberculosis and psychiatric patients, and it has been adopted more by European designers.

Water Efficiency

  • One additional PR:  Minimize Potable Water Use for Medical Equipment Cooling.  No doubt resource use by hospitals is large, and especially by the equipment that generates heat, like imaging equipment.
  • Credit 4.1-4.3 are new, and deal with Water Use Reduction for equipment and systems.  Once again, this is fairly unique to hospitals, where massive systems are needed to handle the air conditioning for large facilities. In a nod to the GGHC, these three points target system design and make the owner and engineers question how green their operations can get.

Energy and Atmosphere

  • The only deviation from V3 is an additional credit for Community Contaminant Prevention – Airborne Releases. If you have ever been on a hospital roof, you know that you need to hold your breath until you figure out where the air is coming from that is being discharged from the grills, vents, traps, stacks and equipment that surround you. Health codes mandate certain design requirements for how contaminants are released, but no one has questioned their existence.  It seems this system does.

Materials and Methods

  • One additional PR was gained:  PBT Source Reduction – Mercury.  There are many subcategories of bad chemicals we do not want in our manufactured goods.  PBTs, or Persistent, Bioaccumulative or Toxic chemicals, either do not break down easily, are stored within our bodies or can be a hazard to human health.  Mercury is just one PBT, so I could see this category expanding in the future, but one that shows up in healthcare environments.
  • Credits 4, 5 and 6 are completely different from the MM credits of V3.  Gone are Materials Reuse, Recycled Content, Regional Materials, Rapidly Renewable Materials or Certified Wood—all V3 credits.
  • The replacement credits for those come in the form of:  c3 – Sustainably Sourced Materials and Products; c4.1 & 4.2 – PBT Source Reduction (various); c5 – Furniture and Medical Furnishings; and c6 – Resource Use:  Design for Flexibility.  Here we see less focus on raw materials like in V3.  I like the idea of addressing flexibility in the healthcare environment with credit 6.

Indoor Environmental Quality

  • Once again, another Prerequisite added:  Hazardous Material Removal or Encapsulation.  To me, this is a nod to major renovations and the idea that there will be many hospitals with asbestos being torn up, renovated and added onto.  If anyone has worked on a hospital or school with aesbestos (the most likely candidates these days), it is laborious and complicated to keep the contaminants contained and then vanquish it from the area, which is one reason many facilities like to ‘let it be’ until they are forced to deal with it.
  • You will also see Low Emitting Materials reduced to only one credit from four previously.
  • Also, a Thermal Comfort credit was eliminated.

Innovation in Design

  • A new prerequisite was added, Integrated Project Planning and Design, which seems to be a theme. I am curious to see how the USGBC defines these terms, and how they will be proven.
  • Interestingly, in this category another credit is allowed for the same subject, Integrated Planning.

There were no changes in the Regional Priority category.

Those are the highlights of the obvious differences between LEED 2009 (V3) and LEED 2009 for Healthcare.  The tiers for credit achievement:  40-49 (Certified), 50-59 (Silver), 60-79 (Gold) and 80-110 (Platinum), which are identical to V3. Go forth and design sustainably knowing you will see a lot more about LEED for Healthcare.