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Applying LEED to healthcare projects

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What are the advantages of using LEED for healthcare facilities?

LEED‐certified healthcare facilities are the triple bottom line in action, benefiting people, planet, and profit. LEED certification leads to healthier, more productive places, reduced stress on the environment, impressive savings through reduced utility costs, and enhanced building value. They are designed and operated to consume less water, less energy, fewer natural resources, and are ultimately aimed to reduce the overall impact of the development on the local, regional, and global environment. Facilities across the world are using LEED to ensure a more efficient, equitable, and sustainable future across all project types from hospitals to long-term care facilities to offices located in the hospital campus. LEED is helping the healthcare industry achieve lofty sustainability goals while also helping building-level projects generate significant savings on operating costs.

What issues are unique to healthcare projects?

Healthcare projects often have different energy and water needs, unique ventilation requirements, high equipment loads, 24/7 operations, and programmatic relationships with other buildings that make pursuing strong efficiency measures challenging. Recognizing the unique challenges that exist for healthcare projects, USGBC developed a healthcare rating system with LEED credits that are designed to reflect the needs of the healthcare sector.

How many healthcare projects are registered and certified under LEED?

As of September 2024, there are 3,995 LEED‐certified and registered healthcare projects across the globe. This represents approximately 931 million square feet or 86 million square meters.

How do we certify healthcare facilities under LEED?

Healthcare facilities can be certified under different LEED rating systems at different stages of the building’s lifecycle.

  • LEED Building Design and Construction (BD+C): Healthcare is often the most appropriate rating system for healthcare projects that are new construction or major renovation. Hospitals that operate 24 hours a day, seven days a week and provide inpatient medical treatment, including acute and long-term care are required to use this rating system.  At least 60% of the project’s gross floor area must be complete by the time of certification and the project must include the entire building’s gross floor area. For healthcare spaces, this may include areas dedicated to both administrative and support-related functions.
  • LEED for Operations and Maintenance: Existing Buildings or Interiors can be applied to existing buildings or spaces that are fully operational and occupied for at least one year. The project may be undergoing improvement work or little to no construction and must also include the entire building’s gross floor area in the project. Unless otherwise noted in the credit‐specific requirements, this includes process‐related operations and performance metrics.

How does the latest version of LEED address the unique challenges of healthcare projects?

In developing LEEDv4 and LEEDv4.1, certain prerequisites and credits were adapted to support the unique needs of healthcare projects that incorporated feedback from our industry stakeholders. The LEED BD+C: Healthcare rating system incudes credits that specifically address this space type:

 

Additional credits that are not unique to Healthcare, but have Healthcare specific requirements: 

Relevant LEED Interpretations for healthcare can be found in the LEED Addenda database by entering the term “healthcare” in the main search bar.

How can multiple buildings and structures in a campus setting earn LEED certification?

Healthcare projects often operate on a large scale with multiple buildings spread across a single site. All the buildings, people, and processes are interconnected with each other. To address this, the LEED Campus Guidance was introduced for projects that are on a shared site under the control of a single entity. Its application to LEED projects in the healthcare setting represents the complexity and commonality of buildings and infrastructure on a site.

LEED Campus Guidance is a useful tool for healthcare situations with multiple buildings, common utilities, and site‐wide management policies. By utilizing LEED Campus Guidance, healthcare operators and project teams can benefit from an increase in streamlined review process, and reduced certification fees under the Master Site approach, leading to successful implementation of LEED projects.

How does the Arc platform relate to healthcare?

The LEED v4.1 O+M rating system offers a unique performance-based pathway to certify your existing buildings and interior spaces uses Arc, a state‐of‐the‐art platform designed to collect, manage and benchmark your building across five performance categories: energy, water, waste, transportation, and human experience.

And what does this mean for healthcare? LEED v4.1 can be used to compare healthcare projects to other similar facilities pursuing high-performance measures from around the world. Facility managers and owners can continuously monitor the data and make informed decisions to optimize the building performance based on real-time data and analytics. This performance pathway can then be used to certify and recertify the project every 3 years. Learn more.

What resources are available for healthcare facilities pursuing LEED?

There are resources available for healthcare projects pursuing LEED certification.

Technical Resources

LEED has published industry-specific guidance in the form of LEED Interpretations, Alternative Compliance Paths (ACPs), and pilot credits. The following may be of interest to healthcare projects. Many of them are designed to help projects with high process loads or high occupancy meet the intent of the credits.

  • Energy Jumpstart Pilot Credit available for O&M projects with very high process loads (at least 60%) and unable to meet the Minimum Energy Performance prerequisite in the LEED v4 O+M rating system 
  • Whole Project Water Use Reduction Pilot Credit allows LEED v4 BD+C projects to quantify water use with whole‐building water balance modeling, similar to the compliance path for whole‐building energy modeling. It also allows projects to include potentially significant water savings that previously went unrecognized, such as process water.
  • LEED v4 BD+C EApc107: Energy Performance Metering Path option allows project teams to work with the first 12 months of energy performance data to earn credit for Optimize Energy Performance credit and prerequisite.
  • LEED Interpretation 10493 allows LEEDv4 projects with more than 50% unregulated process load and whole building energy simulation to use the core and shell energy performance improvement thresholds in lieu of the new construction thresholds. How to document the input assumptions for receptacle and process loads when conducting an energy model is now included in the LEEDv4 BD+C Reference Guide. 
  • Additional LEED Interpretations for healthcare can be found in the Addenda database by entering the term “healthcare” in the main search bar.

Industry Articles:

Where can I find more owner profiles and case studies on healthcare?

View non-confidential LEED registered and certified projects in the USGBC Project Directory by entering key terms like ‘healthcare or hospital’ in the search bar. This will show projects with such terms in their project title. You can also filter by region and rating system type to get more specific results.

Does USGBC offer any education for project teams wanting to learn more about healthcare facilities pursuing green building measures?

Yes! Check out the following session in the USGBC online course catalog.

Who can I contact for more information about applying LEED in the healthcare market sector?

For more information, contact us.

Is there a document I can download and send to my team?

Yes! Click the link below.

 

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