ConstructionPro Week, Volume: Construction Advisor Today - Issue: 145 - 02/09/2012

Healthcare Facilities Survey Indicates Growing Concerns about ‘Green Washing’

By Steve Rizer


Concerns about “green washing” continue to impede the growth of more cost-efficient and sustainable healthcare facilities, according to a recent survey conducted by Corporate Realty, Design & Management Institute (CRD&MI) in partnership with IFMA (International Facility Management Association) Health Care Institute (HCI). The survey included a mix of architects, designers, engineers, hospital facilities managers, healthcare engineers, project managers, and contractors from 20 metropolitan areas across North America.


Of 1,251 professionals surveyed, about 85 percent of them believe that green washing by manufacturers and service is more prevalent now than two years ago. Less than 14 percent of respondents in any given surveyed city believe that green washing is less prevalent than two years ago. In no city did at least 36 percent of respondents express a belief that green washing is just as prevalent as it was two years ago.

Surveyed cities included Atlanta; Boston, Charlotte, N.C.; Chicago; Cincinnati; Cleveland; Dallas; Denver; Houston; Kansas City; Minneapolis; Philadelphia; Phoenix; Portland; San Francisco; Seattle; St. Louis; Tampa, Fla.; Toronto, Ont., Canada; and Washington, D.C.

Besides green washing, respondents also indicated that an apprehension about performance of new technology and buying decisions based on first cost also are creating bottlenecks in achieving more cost-efficient and efficient and sustainable healthcare facilities.

“It appears that these three issues are linked in the minds of buyers and specifiers, as eight of ten survey respondents share these opinions,” the report says. “A change in behavior and more education is needed to change these perceptions.”

When asked, “What concerns you most about installing or specifying new energy-saving technology,” 78 percent of survey participants responded that the technology “may not deliver projected performance.” Only 3 percent of respondents believe that the technology becoming outdated is the primary concern. About 18 percent of those surveyed reported that reliability is their main concern.

Other survey findings include the following:

  • Lowest first cost still dominates purchasing decisions, except in Cleveland.
  • Most survey respondents believe healthcare still lags behind other industries in implementing sustainable solutions, except in Midwest cities.
  • More than 90 percent of survey participants predicted that energy costs will rise at least four percent in the next year.
  • When asked, “To retool a hospital for sustainability, what do you think is the most important next step?” about 68 percent of respondents answered that a sustainability manager should be appointed. About 16 percent of those surveyed called for a sustainability committee, and 17 percent expressed a preference for Energy Star or Leadership in Energy and Environmental Design (LEED) certification.

The survey was conducted during 2010 and 2011 as part of the educational seminar series entitled “Economics, Efficiency, Energy & Environment: Making the 4Es Work Together in Healthcare.” HCI will co-host the seminar at Sinai Hospital in Baltimore March 29. Details about the event, including speakers, are available at

The IFMA Healthcare Council transitioned into HCI effective Jan. 1. HCI will focus on education and training as well as research for heath care professionals.

Fischer Provides Additional Information to GBI

In an email interview with Green Building Insider, CRD&MI Executive Vice President Glenn Fischer provided the following additional details:

GBI: Which survey results surprised you the most and why?

Fischer: Two things screamed out at us. First, when asked about what concerns them the most about installing or specifying energy saving technology, 78 percent answered, ‘May not deliver projected performance.’ Clearly, manufacturers need to work harder on proving the effectiveness of their products and delivering a credible message.

Second, because hospitals are owner-occupied buildings that consume massive amounts of energy, it’s shocking that 80 percent answered that lowest-first-cost was their product-selection method rather than life-cycle cost. Our analysis suggests that this low-bid thinking causes hospitals to leave $296 a square foot in excessive future energy costs on the table. That works out to be $85 a square foot in today’s dollars.

GBI: How may the results of this survey be used? Are the results being sent to state and federal lawmakers who potentially could introduce legislation to curtail green washing? Has IFMA issued a position paper or a set of recommendations on this topic?

Fischer: The survey was to gain a deeper understanding of the bottlenecks to high-performance buildings in healthcare and to uncover differences in green building and sustainability trends in 20 different geographic regions. Influencing potential legislation was not a goal of the survey. IFMA has not issued an official position. IFMA, however, encourages facilities operators to reduce energy and water consumption and eliminate waste. IFMA created a new professional designation, called the Sustainability Facility Professional (SFP) designation. Courses that lead to earning the SFP credential helps facilities managers increase their sustainability knowledge and develop the skills they need to implement significant sustainable solutions.

GBI: What statistics, if any, can you provide about the number of healthcare facilities currently in operation across the U.S., the number and/or percentage of such facilities certified as green, the number/percentage of new healthcare facilities that are expected to be green-certified in the future, etc.?

Fischer: There are 5,795 registered hospitals in U.S., according to American Hospital Association. As of Dec. 31, 2011, the U.S. Green Building Council (USGBC) reports there are 323 LEED-certified projects that list healthcare as their space type, totaling 36 million square feet. USGBC tracks healthcare as a space type rather than by hospital, medical office building, etc., so the numbers of certified projects are listing healthcare as their space type but not hospitals. There are medical office buildings and clinics in these totals. A number of our guest speakers and panelists at the 4Es seminars the past two years said projects at their hospitals met the standards to achieve LEED certification; however, they chose not to go through the LEED process. Most cited cost as the reason for not seeking LEED certification.

GBI: When may this survey on healthcare facilities be undertaken again? Will it be an annual survey?

Fischer: It’s undetermined if this exact survey will be taken again. Our next survey will have different questions as the marketplace is changing.

GBI: Have other IFMA surveys addressing green building issues at other types of facilities taken place recently or are planned? If so, what details can you provide?

Fischer: IFMA commissioned a sustainability survey of its members in early 2011. Respondents worked in a variety of building types. It was not a healthcare-facilities-specific survey. Survey findings can be downloaded at this link:

GBI: Other comments?

Fischer: Green washing continues to plague the industry. Over 85 percent of those survived say green washing is more prevalent today than two years ago. Only 4 percent think it is less than it was two years ago. This leads one to think the apprehension over the performance of new technology and green washing have become connected in the minds of healthcare buyers. Skepticism may well creep into play when manufacturers’ make their claims. ‘Will it perform as advertised?’ is the question everyone wants answered, and many manufacturers have effectively failed to answer.

Another issue is the tendency of healthcare-facility professionals to be risk averse, which is logical when patient safety is involved. However, healthcare defies the normal product-adoption curve. While there are the ‘innovators’ and ‘early adapters’ in the healthcare market, the ‘early majority’ phase has retreated into the ‘late majority’ and ‘laggard’ phases of the traditional product-adoption curve. This raises the question, ‘Why are so few willing to try something new or push for investments in new technology?’

Other IFMA News

In other news, IFMA earlier this month commended the U.S. House for passing the Civilian Property Realignment bill (H.R. 1734), which would require federal agencies to conduct a full life-cycle-cost analysis of any building design, construction, or operations-and-maintenance projects, thereby helping the federal government further reduce operating costs.

Introduced last year by Rep. Jeff Denham (R-Calif.), chairperson of the [House Transportation and Infrastructure Committee’s] Subcommittee on Economic Development, Public Buildings and Emergency Management, the bill addresses federal real estate holdings and seeks to maximize space utilization, create value in underperforming assets, reduce reliance on leasing, improve the overall management and controls related to federal properties, and maximize the return to the taxpayer. Thirty-one House members cosponsored the bill.

In addition to IFMA, the American Institute of Architects; the American Society of Heating, Refrigerating, and Air-Conditioning Engineers; International Association of Plumbing and Mechanical Officials; International Code Council; National Electrical Manufacturers Association; National Institute of Building Services; and U.S. Green Building Council also support the legislation, which next will undergo consideration in the Senate.

The White House Office of Management and Budget estimated that the benefit to taxpayers from passage of the proposed legislation will total at least $15 billion with the potential for even greater savings. The bill is self-funding, providing for a one-time appropriation of $88 million, after which proceeds from the sale of excess federal properties would be used to repay the treasury and give taxpayers a 60 percent windfall on any property sold.

On another front, the IFMA Foundation Feb. 6 announced the release of “U.S. Government Policy Impacts and Opportunities for Facility Management,” a free publication in the “Sustainability ‘How-to’ Guide Series” that the organization said offers “a comprehensive, practical approach to making sustainability improvements to public- and private-sector properties based on federal government guidelines.”

This guide was written for facility professionals who want to “stay ahead of the executive and legislative curve” and implement strategic sustainability performance plans for their facilities that use the best-in-class resources and benchmarking information developed by federal and state governments.


“U.S. Government Policy Impacts and Opportunities for Facility Management” will enable public- and private-sector facility professionals to do the following, according to the foundation:

  • Understand how recent legislative and executive initiatives have focused on reducing costs and increasing the efficiency of energy and water use in federal buildings.
  • Learn how to achieve greener buildings through site planning, building material selection, water efficiency, HVAC systems and ongoing building operations.
  • Improve energy management techniques through consideration of lighting, windows, energy demand, refrigeration systems, and efficient and Energy Star appliances.
  • Build a business case for sustainability initiatives and use effective measurement tools.
  • Learn more about waste stream management, including reusable dishes and flatware, composting, and recycling.
  • Procure sustainable foods through local purchasing and learn more about food safety and disposable products.
  • Take advantage of available grants, rebates, and incentives; encourage increased operational and capital investments; and identify resources supporting sustainability planning and execution.
  • Understand the current reporting requirements affecting both federal agencies and commercial entities.

Learn from case studies offering “real world” insight into effective sustainability approaches. 
The guide is primarily built around U.S. acts and executive orders pertaining to the built environment, including the National Environmental Policy Act of 1969, the Energy Policy Act of 2005, the Energy Independence and Security Act of 2007, Executive Order 13423, and Executive Order 13514.



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