boma best health care companion guide
TRANSCRIPT
The Voice of the Commercial Real Estate Industry in Canada
August 2014
BOMA BESt® Health Care
Companion Guide
BOMA BESt® Health Care Companion Guide (August 2014) Page | 2
The BOMA BESt® Health Care Companion Guide is primarily a technical guide to using the
BOMA BESt® certification tool, complete with building definitions, tips on question interpretation
and information about benchmarking. In addition to this, it also describes the benefits of certifying
to the BOMA BESt® Health Care standard and details about module development.
This Guide is complementary to the BOMA BESt® Version 2 Application Guide which provides
details about the certification process including verification, policies, pricing categories and
timelines for completing an application.
We hope you will find this BOMA BESt® Health Care Companion Guide helpful. Please send
feedback to [email protected] or by telephone at 416-214-1912.
BOMA BESt® Health Care Companion Guide (August 2014) Page | 3
Table of Contents
1. Introduction to BOMA BESt® Health Care .......................................................................................... 4
1.1 Welcome to BOMA BESt® Health Care......................................................................................... 5
1.2 About BOMA BESt® ...................................................................................................................... 6
1.3 Why BOMA BESt® Health Care? .................................................................................................. 7
1.4 Benefits of BOMA BESt® Health Care .......................................................................................... 8
2. BOMA BESt® Health Care Technical Guide ..................................................................................... 10
2.1 Building type definitions .............................................................................................................. 11
2.2 What is a “building”? ................................................................................................................... 13
2.3 How to complete the questionnaire if your building is part of a larger campus ............................ 14
2.4 Energy Benchmarking in BOMA BESt® ...................................................................................... 17
2.5 Water Benchmarking in BOMA BESt® ........................................................................................ 20
2.6 Global Capture Rate ................................................................................................................... 22
2.7 Alignment with Natural Resources Canada’s ENERGY STAR Portfolio Manager ....................... 23
2.8 Quick Tips .................................................................................................................................. 24
3. BOMA BESt® Health Care Module Development ............................................................................. 25
3.1 Technical Advisory Committee ................................................................................................... 26
3.2 Contributors ................................................................................................................................ 26
3.3 Pilot participants ......................................................................................................................... 27
3.4 Organizational support ............................................................................................................... 27
3.5 Additional Resources and References ........................................................................................ 28
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1. Introduction to BOMA
BESt® Health Care
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1.1 Welcome to BOMA BESt® Health Care
A unique tool for assessing your health care facility’s environmental
performance
The Canadian health care sector is committed to reducing its ecological impact while also providing
patients, staff and visitors with an environment that facilitates healing. BOMA Canada has built on
these efforts by offering managers and operators of health care facilities a BOMA BESt® module
specifically designed to fit their building’s unique energy and environmental profile.
Health care facilities are distinctive, each with their own organizational structure and culture. In
addition, health care facilities are composed of numerous departments and functional areas, some
medical, some non-medical, each operating independently and with different objectives and
challenges.
BOMA BESt® Health Care seeks to reconcile these differences by engaging all departments to work
towards a common goal: improving the environmental performance of the health care facility.
Specifically, the BOMA BESt® Health Care module:
Recognizes building definition complexity: The definition of a facility is sufficiently flexible to
allow for complex building structures to be assessed and certified.
Emphasizes collaboration and integrated management practices: The module recognizes the
role played by green teams for developing processes and communication networks that
facilitate the integration of all functional areas/departments.
Emphasizes continuous improvement: By establishing a baseline performance and setting
targets for future performance in energy, water and waste, facility managers and operators can
map out a framework for achieving these objectives.
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1.2 About BOMA BESt®
With over 3,600 buildings certified in Canada, the BOMA BESt® (Building Environmental Standards)
program is Canada’s largest environmental assessment and certification program for existing buildings.
It is a program developed for the industry, by the industry, and is therefore uniquely positioned to
understand the processes and standards used by owners and operators to manage their buildings
sustainably and optimally.
The BOMA BESt® assessment guides managers and operators through a holistic building performance
review. By emphasizing all six areas of environmental impact (Energy, Water, Waste Reduction and
Site Enhancement, Emissions and Effluents, Indoor Environment, and Environmental Management
Systems) the BOMA BESt® program encourages users to consider the building in its entirety,
facilitating the implementation of strategies leading to overall performance improvement.
The BOMA BESt® program is affordable, user-friendly, and available in both official languages. The
program and tools empower owners and managers to learn, act and create change, putting them on a
continuous path to achieve best sustainable practices.
For more details about the BOMA BESt® Program, please consult the BOMA BESt® Version 2
Application Guide.
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1.3 Why BOMA BESt® Health Care?
Health care facilities can have a tremendous impact on individual health as well as on the
environmental, social and economic health of a community.
Energy footprint: Hospitals operate 24 hours a day, 7 days a week, 365 days a year. Sixty-
three percent of hospital energy use is dedicated to heating, ventilation, air conditioning and
lighting. This represents a tremendous opportunity for improvement through commissioning and
retrofits. Implementing comprehensive measures can lead to a 30% reduction in energy
consumption, resulting in very large energy cost savings. 1
Waste diversion: Although the health care sector is responsible for some hazardous waste
(which may be pathogenic, chemical, explosive, toxic or radioactive), 80-90% of the waste
stream is non-hazardous. This represents a huge opportunity for improving waste diversion
practices and reducing the toxicity of the waste stream through sustainable purchasing
practices.2 In addition, as costs associated with landfills continue to increase, better diversion
rates will lead to cost savings for those with well-developed recycling and composting programs.
Green procurement: The health care sector is a major purchaser of goods and services and
can therefore positively influence supply chains by favouring vendors who respect sustainability
principles such as using non-toxic ingredients and keeping packaging to a minimum. Health
care facilities can also support local food distributors who use environmentally sound
agricultural methods.
This sector is uniquely positioned to play a critical role in becoming environmental leaders, models for
greener health care practices, and also for actively contributing to the communities where these
facilities are located. The BOMA BESt® program can help health care facility managers and building
operators be part of the solution for a more healthy and healing environment.
1 Schneider Electric (2010). How Energy Efficiency Ensures Financial Health for Hospitals. Retrieved from http://static.schneider-
electric.us/assets/pdf/healthcare/whitepapers/How%20Energy%20Efficiency%20Ensures%20Financial%20Support%20WP.pdf 2 Chris Strashok, et al (2010). Greening Canadian Hospitals. Community Research Connections Discussion Paper Series, Number 7.
Retrieved from http://www.sustainabilitysolutions.ca/sites/default/files/Greening%20Canadian%20Hospitals.pdf
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1.4 Benefits of BOMA BESt® Health Care
Every dollar is valuable in health care institutions. The BOMA BESt® program will help building
managers and operators develop strategies and plans that will maximize investments and foster a
culture for continuous improvement of the building’s operations. The environmental impact of the facility
will be reduced leaving money to be invested where it matters most, towards patient care.
The BOMA BESt® program provides a roadmap for operational improvement
The BOMA BESt® program is a management tool that helps facility managers and operators examine
the health care organization’s activities and practices, set operational and strategic objectives and
identify actions and resources necessary for achieving success.
The BOMA BESt® program leads to real savings
It isn’t always necessary to invest in new equipment; the BOMA BESt® program encourages managers
and operators to focus on existing systems, which can result in identifying operational improvements
that will extend the life of your equipment. Such adjustments can lead to a 30% or more reduction in
energy consumption3, maximizing energy efficiency and patient comfort while resulting in significant
energy cost savings.
The BOMA BESt® program is for all buildings
The BOMA BESt® program attracts all types of buildings and performers. Not simply for high
performing buildings, the BOMA BESt® program provides a framework for all buildings, regardless of
where they are on their sustainability journey, to start benchmarking environmental performance and
work towards continuous environmental improvement.
The BOMA BESt® program builds capacity
The BOMA BESt® program is based on a hands-on approach that enables facility managers and
operators to develop a better understanding of the building’s operations, as well as a sense of
responsibility and pride over the building’s performance. Increased familiarity with the building’s
processes means staff can more easily identify areas for improvement. In turn, goals and targets
become more easily achievable.
In doing so, the BOMA BESt® program promotes strong leadership and the development of a culture of
sustainability and accountability. Building capacity will help foster a culture of continuous improvement
within the organization.
3 Schneider Electric (2010). How Energy Efficiency Ensures Financial Health for Hospitals. Retrieved from http://static.schneider-
electric.us/assets/pdf/healthcare/whitepapers/How%20Energy%20Efficiency%20Ensures%20Financial%20Support%20WP.pdf
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The BOMA BESt® program leads to continuous improvement
BOMA BESt® certified buildings are more likely to engage in activities linked with continuous
improvement and will therefore benefit from operational savings. Recertifying a building is strongly
associated with improved building performance.4 Buildings that recertified to the BOMA BESt® program
in 2013 achieved a 6% reduction in overall Energy Use Intensity – 26.8 ekWh/ft²/yr compared to 28.5
ekWh/ft²/yr at original certification.5
The BOMA BESt® program is a tool for engaging patients, staff and visitors
The BOMA BESt® program is more than a simple checklist of environmental action, it is a catalyst for
full communication between the building manager and operations team about what is important to
patients, staff and visitors.
The BOMA BESt® program provides a platform upon which to engage patients, staff and visitors to
build and contribute to the facility’s environmental achievements through enhanced inter-departmental
communication and knowledge-sharing.
The BOMA BESt® program publicly demonstrates your commitment to the environment
Health care facilities are important members of any community. Achieving BOMA BESt® certification
demonstrates leadership, accountability and the desire to be a responsible organization.
4 Light House (2014). British Columbia Building Performance Study. 2014. Retrieved from http://www.sustainablebuildingcentre.com/building-
performance/ 5 BOMA BESt Energy and Environment Report: The National Green Building Report 2014. Retrieved from http://www.bomabest.com/wp-
content/uploads/BBEER-2014-Full-Report.pdf
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2. BOMA BESt® Health
Care Technical Guide
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2.1 Building type definitions
A. Hospital
The Hospital designation applies to general
medical and surgical hospitals, critical access
hospitals, and children’s hospitals. These facilities
provide acute care services intended to treat
patients for short periods of time including
emergency medical care, physicians’ office
services, diagnostic care, ambulatory care, surgical
care, and limited specialty services such as
rehabilitation and cancer care.
To qualify as a Hospital, the following requirements
must be met:
More than 50% of the gross floor area of all
buildings must be used for general medical
and surgical services; AND
More than 50% of the licensed beds must provide acute care services; AND
These facilities must operate on a 24/7 basis.
Facilities that use more than 50% of the gross floor area for long-term care, skilled nursing, specialty
care, and/or ambulatory surgical centers OR that have less than 50% of their beds licensed for acute
care services are not considered eligible hospitals under this definition.
B. Medical Office Building
A Medical Office Building designation applies to buildings that meet the following requirements:
More than 50% of total
facility space is used
primarily to provide
diagnosis and treatment (no
major surgery) for medical,
dental, or psychiatric
outpatient care;
These facilities do not
operate on a 24/7 basis.
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C. Long Term Care Facility
Also called “acute inpatient health care facilities”, these facilities are certified as acute care hospitals
and provide patients with acute care for extended inpatient stays of an average of 25 days or more.
A Long Term Care facility designation applies to buildings that meet the following requirements:
More than 50% of the total facility space is used primarily for long term acute care, cancer care,
rehabilitation, and/or psychiatric care;
These facilities operate on a 24/7 basis.
Facilities where more than 50% of the space is
not dedicated to long term acute care, such as
retirement homes or assisted living facilities, are
not considered eligible under this definition.
These types of buildings can obtain a BOMA
BESt® certification by using the Multi-Unit
Residential Building module. For descriptions of
other BOMA BESt® modules please review the
Module Definitions and Performance
Benchmarks section of the BOMA BESt®
Version 2 Application Guide.
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2.2 What is a “building”?
The BOMA BESt® program is dedicated to assisting facility managers and operators improve their
building’s environmental performance. In order to do this, buildings must be assessed individually.
Each building must complete its own assessment questionnaire and will receive its own score.
However, assessing buildings in a health care setting presents additional challenges not present in
other modules since in many cases, a health care facility may in fact be a complex of buildings or be
part of a campus.
To be eligible for participation, a BOMA BESt® Health Care building (Hospital, Medical Office or Long
Term Care) must meet one of the following two definitions:
A. A free-standing building
A free-standing building is one that is not connected to other buildings except only superficially. It may
or may not be part of a larger campus of buildings and may share a common mechanical system with
other buildings.
B. A “health care building complex”
A “health care building complex” is an amalgamation of highly connected buildings that operate as a
single building. To be considered a single unit (a “health care building complex”) the buildings must
meet the following requirements:
Share a management/operations team; AND
Be physically connected to one another via corridors or walkways on at least 50% of all floors;
AND
Share common mechanical plant(s) to meet all energy end-uses; AND/OR
Common water distribution system.
In the case where a building does not meet the requirement for physical integration, but shares
management and a common mechanical plant or water distribution system, this building will be
considered a free-standing building requiring its own assessment questionnaire. Energy and water data
must be sub-metered for this building in order for the data to be considered valid.
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2.3 How to complete the questionnaire if your building is part of
a larger campus
BOMA BESt® Health Care assesses the performance of individual buildings. However, we recognize
that while some buildings may be free-standing others belong to a wider health care campus (with
multiple buildings), or constitute a “health care building complex”, where operations and management
policies are shared. Please see below to understand how questions should be interpreted depending
on a given building’s particular setting:
A. Buildings that are not part of a wider health care campus
1. Determining the building type: Identified based on Asset Class definitions provided in this guide.
2. Gross floor area (GFA): Must be measured based on the guidance provided in the questionnaire.
In the case of a “health care building complex”, the GFA must include all areas of the building
considered to be a part of the “health care building complex” and should be measured based on
the guidance provided in the questionnaire.
3. Energy and water benchmarking and reporting: When reporting on energy or water use, or when
reporting on efficiency features or equipment, report only on what is consumed or located within
the building itself. In the case of a “health care building complex”, this includes all data
representative of the GFA.
4. Services: Questions pertaining to a variety of services (laundry, laboratory) apply only to services
located – or processes performed – within the building itself (the same applies for a “health care
building complex”).
a) Questions pertaining to food services, specifically question 6.2.M.2, can also pertain to
food services that are contracted by a third-party delivering to the building being
assessed. In the case where food is contracted, but where these vendors have not been
engaged in developing a sustainable food procurement program, the applicant must
answer “No” (not N/A).
B. Buildings that are part of a wider health care campus
1. Determining the building type: Identified based on Asset Class definitions provided in this guide.
2. Gross floor area (GFA): Must be measured based on the guidance provided in the questionnaire.
In the case of a “health care building complex”, the GFA must include all areas of the building
considered to be a part of the “health care building complex” and should be measured based on
the guidance provided in the questionnaire.
3. Management programs and policies: In the case of a campus of buildings, these programs and
policies can be shared; however, it must be made evident to the verifier how they are being
implemented in the building in question.
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a) For example, the applicant must demonstrate how the building in question integrates the
corporate sustainable procurement policy into the operations of the building being
assessed.
4. Energy and water benchmarking and reporting:
a) If a building shares a central mechanical plant with other buildings on campus (and
together do not constitute a “health care building complex”): Only sub-metered data can
be accepted. However, if there is no sub-metering, then the data cannot be reported and
points cannot be awarded. Estimated data cannot be accepted in lieu. Sub-meters must
be installed in order to correctly measure the energy or water attributable to a specific
building.
b) If the campus’ central mechanical plant is located inside the free-standing building: Data
must be specific to the free-standing building. If the central plant is sub-metered and it is
possible to isolate the energy consumed by the building itself for its regular operations,
only this data must be entered. However, if there is no sub-metering, then the data
cannot be reported and points cannot be awarded.
c) If the campus’ water distribution system is located inside the free-standing building: Data
must be specific to the free-standing building. If the water distribution system is sub-
metered and it is possible to isolate the water consumed by the building itself for its
regular operations, only this data must be entered. However, if there is no sub-metering,
then the data cannot be reported and points cannot be awarded.
d) If a building benefits from the services of a water or energy-intensive process (such as a
laundry or laboratory) that are located in another building on campus: It is not expected
that the applicant will identify the portion of water or energy used for these services
attributable to any given building. This data may be omitted. By extension, the building
housing these facilities (even if they serve a whole campus) must hold the burden of
reporting the energy and water consumption of those particular services if it is being
assessed by the BOMA BESt® program. Furthermore, and consistent with previous
statements, the user should only answer that there are laboratory or laundry facilities on-
site (questions 0.M.5 and 0.M.6) if these are actually located within the building itself.
5. Efficiency Features and Mechanical Equipment:
a) Reporting on equipment located in a central mechanical plant: The BOMA BESt® online
assessment asks many questions about equipment efficiency (for example, chillers,
boilers, and cooling towers). In the case where a building benefits from the operations of
equipment located in another building, questions about this equipment should be
answered as though they were located in the building itself. This means that many
buildings might report on the same equipment – this is acceptable and necessary to
understand the efficiency of the equipment serving an individual building.
For example, Q1.2.2.5.1 “What percentage (by capacity) of chillers in the
facility are high-efficiency?” If all chillers used by the free-standing building
are located in the central plant, assess how many of these are high-efficiency
and answer accordingly (e.g., 50%-100%).
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6. Transportation:
a) Assessing the building walkability index/access to public transportation: The most
frequently used entrance should be used to identify the building’s walkability index or
proximity to public transportation. This entrance may be located in another building
however may not be located more than 200 metres away from the most frequently used
entrance of the building being assessed.
b) Bike racks/changing facilities: Bike racks must be located within 100 metres of the
building’s most frequently used entrance. Changing facilities may be located in another
building on the campus (with same management company), but must be located within
400 metres of the building’s most frequently used entrance. These services (bike rack
and facilities) must be specific to the building, as opposed to being provided by the
municipality. This will ensure that delivery of these services depends on building
management, and not a third-party that may or may not reliably continue providing the
service (such as if the municipality removes bike racks due to construction).
7. Waste Performance and Monitoring:
a) Waste collection and storage: All buildings are expected to collect and store waste (at
least temporarily) on-site. As such, if the building does not participate in separating
waste from recycling, the applicant must answer “No”.
For example: Q 3.1.1.3 Are there clearly marked collection points for sorting
paper, glass, metal and plastic in the areas where waste is generated?
b) Availability of composting: It is acceptable for compost to be processed in another
building on the campus if the building being assessed is participating in a campus-wide
composting program (including collection).
c) Waste audits and diversion rate: Although it is preferable to obtain waste data based on
“point of generation” (since this will provide building managers with much more
meaningful information about where opportunities for improvement may exist), the
BOMA BESt® program recognizes the challenges associated with performing waste
audits at an individual building level. As such, waste data, diversion rates and capture
rates can be based on the numbers generated for the campus as a whole. This must
however be clearly expressed in question 3.1.M.11 “The waste data provided above is
representative of (…)”
8. Food Procurement Services:
a) Q.6.2.M.1 Purchase of sustainable foods for food prepared on-site (e.g. cafeteria, patient
meal catering): This question does not apply to food services offered elsewhere on
campus (for example a cafeteria in another building). However, this question does apply
to the building being assessed if meals prepared elsewhere are served within the
building (for example patient meals, catering) since the building occupants will benefit
from a sustainable food procurement initiative.
b) Q. 6.2.M.2 Engaging private retail food vendors on sustainable procurement: Same
rationale as above.
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2.4 Energy Benchmarking in BOMA BESt®
A. Benchmarking methodology
The BOMA BESt® Health Care score for energy consumption is based on a comparison of building
energy use intensity to the BOMA BESt® energy benchmarking scale.
Energy use intensity, reported in equivalent kilowatt hours per square foot per year (ekWh/ft²/yr), is
calculated in the following way:
All reported energy consumption from electricity and heating fuels is converted into a common
unit (ekWh/ft²/yr) using standard conversion factors.
Total reported energy consumption from electricity and heating fuels is divided by the total gross
floor area: Total Energy Consumption / GFA (Q. 0.12).
No normalization is applied to the data.
Complete data must be provided.
B. Total reported energy
Total reported energy represents all energy (electricity and heating fuel) used in the aggregate floor
area of the building, as well as all supporting functions such as (but not limited to):
Medical offices, exam rooms, operating rooms, and laboratories;
Lobbies, atria, and cafeterias;
Stairways and connecting corridors between buildings;
Storage areas and elevator shafts;
Exterior lighting and outdoor parking lighting (although the floor area associated with these
spaces should not be included in the building’s total gross floor area);
Heated parking facilities; and
Any space affiliated with emergency medical care or diagnostic care.
C. Total gross floor area
Total gross floor area includes all floor area measured to the outside of the exterior walls including the
aggregate floor area of the building, as well as all supporting functions such as: stairways, connecting
corridors between buildings, heated parking facilities, medical offices, exam rooms, laboratories,
lobbies, atria, cafeterias, storage areas, elevator shafts, and any space affiliated with emergency
medical care or diagnostic care. Note the following:
i. Existing atriums must only include the base floor area that they occupy (no virtual floors);
ii. Interstitial (plenum) space between floors must not be included in total;
iii. Gross floor area is not the same as leasable space. Leasable space is a subset of gross
floor area.
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D. Incomplete data
Health care buildings that do not have data for energy use representative of the ENTIRE facility’s gross
floor area cannot be scored for energy use intensity. If data is not complete, no data should be entered
in the consumption fields. This situation occurs in health care buildings where retail tenants are
metered and billed by the utility independently for their electricity and/or heating fuel use, and this data
is not provided to building management (not included in the “total reported energy”), or in cases where
a central mechanical plant is used for multiple buildings, and where sub-metering is not in place.
Estimated data cannot be accepted in lieu.
Since it does not represent the entire facility’s energy use, the total reported energy use is incomplete
and no points can be awarded based on the energy intensity scale.
E. Energy benchmarking tables for BOMA BESt® Health Care
Table 1: BOMA BESt® Energy Benchmarking – Hospitals
Hospitals – Energy Benchmarking Matrix
Zone 5 Zone 6 Zone 7 Zone 8 Points
< 80 ekWh/ft²/yr 80.2 ekWh/ft²/yr 80.4 ekWh/ft²/yr 80.6 ekWh/ft²/yr 7
< 76 ekWh/ft²/yr 76.2 ekWh/ft²/yr 76.4 ekWh/ft²/yr 76.6 ekWh/ft²/yr 14
< 72 ekWh/ft²/yr 72.2 ekWh/ft²/yr 72.4 ekWh/ft²/yr 72.6 ekWh/ft²/yr 21
< 68 ekWh/ft²/yr 68.2 ekWh/ft²/yr 68.4 ekWh/ft²/yr 68.6 ekWh/ft²/yr 28
< 64 ekWh/ft²/yr 64.2 ekWh/ft²/yr 64.4 ekWh/ft²/yr 64.6 ekWh/ft²/yr 35
< 60 ekWh/ft²/yr 60.2 ekWh/ft²/yr 60.4 ekWh/ft²/yr 60.6 ekWh/ft²/yr 42
< 56 ekWh/ft²/yr 56.2 ekWh/ft²/yr 56.4 ekWh/ft²/yr 56.6 ekWh/ft²/yr 49
< 52 ekWh/ft²/yr 52.2 ekWh/ft²/yr 52.4 ekWh/ft²/yr 52.6 ekWh/ft²/yr 56
< 48 ekWh/ft²/yr 48.2 ekWh/ft²/yr 48.4 ekWh/ft²/yr 48.6 ekWh/ft²/yr 63
< 44 ekWh/ft²/yr 44.2 ekWh/ft²/yr 44.4 ekWh/ft²/yr 44.6 ekWh/ft²/yr 70
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Table 2: BOMA BESt® Energy Benchmarking – Medical Offices
Medical Offices – Energy Benchmarking Matrix
Zone 5 Zone 6 Zone 7 Zone 8 Points
< 34 ekWh/ft²/yr 34.2 ekWh/ft²/yr 34.4 ekWh/ft²/yr 34.6 ekWh/ft²/yr 7
< 32 ekWh/ft²/yr 32.2 ekWh/ft²/yr 32.4 ekWh/ft²/yr 32.6 ekWh/ft²/yr 14
< 30 ekWh/ft²/yr 30.2 ekWh/ft²/yr 30.4 ekWh/ft²/yr 30.6 ekWh/ft²/yr 21
< 27 ekWh/ft²/yr 27.2 ekWh/ft²/yr 27.4 ekWh/ft²/yr 27.6 ekWh/ft²/yr 28
< 24 ekWh/ft²/yr 24.2 ekWh/ft²/yr 24.4 ekWh/ft²/yr 24.6 ekWh/ft²/yr 35
< 21 ekWh/ft²/yr 21.2 ekWh/ft²/yr 21.4 ekWh/ft²/yr 21.6 ekWh/ft²/yr 42
< 18 ekWh/ft²/yr 18.2 ekWh/ft²/yr 18.4 ekWh/ft²/yr 18.6 ekWh/ft²/yr 49
< 15 ekWh/ft²/yr 15.2 ekWh/ft²/yr 15.4 ekWh/ft²/yr 15.6 ekWh/ft²/yr 56
< 12 ekWh/ft²/yr 12.2 ekWh/ft²/yr 12.4 ekWh/ft²/yr 12.6 ekWh/ft²/yr 63
< 9 ekWh/ft²/yr 9.2 ekWh/ft²/yr 9.4 ekWh/ft²/yr 9.6 ekWh/ft²/yr 70
Table 3: BOMA BESt® Energy Benchmarking – Long Term Care
Long Term Care – Energy Benchmarking Matrix
Zone 5 Zone 6 Zone 7 Zone 8 Points
< 59 ekWh/ft²/yr 59.2 ekWh/ft²/yr 59.4 ekWh/ft²/yr 59.6 ekWh/ft²/yr 7
< 54 ekWh/ft²/yr 54.2 ekWh/ft²/yr 54.4 ekWh/ft²/yr 54.6 ekWh/ft²/yr 14
< 51 ekWh/ft²/yr 51.2 ekWh/ft²/yr 51.4 ekWh/ft²/yr 51.6 ekWh/ft²/yr 21
< 48 ekWh/ft²/yr 48.2 ekWh/ft²/yr 48.4 ekWh/ft²/yr 48.6 ekWh/ft²/yr 28
< 45 ekWh/ft²/yr 45.2 ekWh/ft²/yr 45.4 ekWh/ft²/yr 45.6 ekWh/ft²/yr 35
< 42 ekWh/ft²/yr 42.2 ekWh/ft²/yr 42.4 ekWh/ft²/yr 42.6 ekWh/ft²/yr 42
< 39 ekWh/ft²/yr 39.2 ekWh/ft²/yr 39.4 ekWh/ft²/yr 39.6 ekWh/ft²/yr 49
< 36 ekWh/ft²/yr 36.2 ekWh/ft²/yr 36.4 ekWh/ft²/yr 36.6 ekWh/ft²/yr 56
< 33 ekWh/ft²/yr 33.2 ekWh/ft²/yr 33.4 ekWh/ft²/yr 33.6 ekWh/ft²/yr 63
< 30 ekWh/ft²/yr 30.2 ekWh/ft²/yr 30.4 ekWh/ft²/yr 30.6 ekWh/ft²/yr 70
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2.5 Water Benchmarking in BOMA BESt®
A. Benchmarking methodology
The BOMA BESt® Health Care score for water consumption is based on a comparison of building water
use intensity to the BOMA BESt® water benchmarking scale.
Water use intensity, reported in cubic metres per square foot per year (m³/ft²/yr), is calculated in the
following way:
All reported water consumption is converted into a common unit (m³/ft²/yr) using standard
conversion factors.
Total reported water consumption is divided by the total gross floor area:
Total Water Consumption (Q.2.1.13.2) / Gross Floor Area (Q.0.12).
No normalization is applied to the data.
Complete data must be provided.
B. Total reported water
Total reported water represents all water used in the aggregate floor area of the building as well as all
supporting functions such as: medical offices, exam rooms, laboratories, lobbies, atria, cafeterias,
storage areas, and any space affiliated with emergency medical care or diagnostic care.
C. Total gross floor area
Total gross floor area includes all floor area measured to the outside of the exterior walls including the
aggregate floor area of the building as well as all supporting functions such as: stairways, connecting
corridors between buildings, heated parking facilities, medical offices, exam rooms, laboratories,
lobbies, atria, cafeterias, storage areas, elevator shafts, and any space affiliated with emergency
medical care or diagnostic care. Note the following:
i. Existing atriums must only include the base floor area that they occupy (no virtual floors);
ii. Interstitial (plenum) space between floors must not be included in total;
iii. Gross floor area is not the same as leasable space. Leasable space is a subset of gross
floor area.
D. Incomplete data
Health care buildings that do not have data for water use representative of the ENTIRE facility’s gross
floor area cannot be scored for water use intensity. If data is not complete, no data should be entered
in the consumption fields. This situation occurs in health care buildings where retail tenants are
metered and billed by the utility independently for their water, and this data is not provided to building
management (not included in the “total reported water”), or in cases where a central water distribution
system is used for multiple buildings, and where sub-metering is not in place. Estimated data cannot be
accepted in lieu. Since it does not represent the entire facility’s water use, the total reported water use
is incomplete and no points can be awarded based on the water intensity scale.
BOMA BESt® Health Care Companion Guide (August 2014) Page | 21
E. Water benchmarking tables for BOMA BESt® Health Care
Table 4: BOMA BESt® Water Benchmarking - All building types
Water Benchmarking Matrix – Health Care Facilities
Hospital Medical
Office
Long Term Care Points
< 0.28 m³/ft²/yr 0.15 m³/ft²/yr 0.18 m³/ft²/yr 5
< 0.24 m³/ft²/yr 0.13 m³/ft²/yr 0.16 m³/ft²/yr 10
< 0.20 m³/ft²/yr 0.11 m³/ft²/yr 0.12 m³/ft²/yr 15
< 0.16 m³/ft²/yr 0.09 m³/ft²/yr 0.10 m³/ft²/yr 20
< 0.12 m³/ft²/yr 0.07 m³/ft²/yr 0.08 m³/ft²/yr 25
< 0.08 m³/ft²/yr 0.05 m³/ft²/yr 0.06 m³/ft²/yr 30
BOMA BESt® Health Care Companion Guide (August 2014) Page | 22
2.6 Global Capture Rate
A. Methodology
A Global Capture Rate is a very useful method for analyzing a facility’s waste diversion practices since
it recognizes what can and can’t be diverted in a particular municipality.
To calculate your global capture rate (by percentage):
1. Add up all the materials currently being diverted from landfill. Express this total in metric tonnes or
kilograms (A in the table below).
2. Using your waste audit, add up all the materials found in the garbage during the waste audit that
could have been diverted through your existing diversion programs but slipped into the waste
stream. Express this total in metric tonnes or kilograms (B in the table below).
3. Perform Step 2 for each material included in your diversion program.
4. Using your totals, apply the following formula:
[A / (A+B)] * 100
B. Example
A waste audit has found that a building diverts 20.8 metric tonnes of paper, cardboard, recyclable
containers and organics from the waste stream. The waste audit reveals that an additional 5.9 tonnes
of these same materials were found in the garbage, destined for landfill. These materials were not
captured by the building’s diversion program. The table below shows how to easily calculate your
global capture rate.
Table 5: Global Capture Rate Example
Material
A
Amount Currently Diverted (kg)
B
Amount found in the garbage (kg)
C
Capture Rate (%)
Paper 12,400 1,023 92.4%
[12,400/(12,400+1,023)]*100
Mixed Containers (Cans, Glass, Plastics)
880 873 50.2%
[800/(880+873)]*100
Organics (Cafeteria) 7,590 4,092 65.0%
[7,590/(7,590+4,092)]*100
Global Capture Rate 20,870 kg
(12,400+800+7,590)
5,988 kg
(1,023+873+4,092)
77.7%
[20,870/(20,870+5,988)]*100
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2.7 Alignment with Natural Resources Canada’s ENERGY
STAR Portfolio Manager
BOMA Canada collaborated with Natural Resources Canada to ensure that the definitions and
language used throughout the BOMA BESt® Health Care module were closely aligned with ENERGY
STAR Portfolio Manager for Health Care.
As such, building definitions found in this guide match the requirements set by ENERGY STAR
Portfolio Manager (with the exception that BOMA BESt® Health Care does not exclude the participation
of Long Term Care facilities). In addition to this, many questions found in the “Basic Information”
section of the assessment have been included to capture information required by ENERGY STAR
Portfolio Manager. This is clearly indicated in the tip language. This has been done to facilitate eventual
data exchange capability between the two platforms.
BOMA BESt® Health Care Companion Guide (August 2014) Page | 24
2.8 Quick Tips
IMPORTANT TIPS: USING THE BOMA BESt® ONLINE PLATFORM
Consult the BOMA BESt® Version 2 Application Guide frequently for details about the
application process, verification process, the BESt Practices, fee schedules and BOMA
BESt® policies.
Use the “Verifier Report” for a quick glance at how you are performing as you move
through the questionnaire. This page can also be saved as a PDF (using your internet
Tools menu) as an easy reference guide to your answer selections.
The recommended web browser for the BOMA BESt® online assessment is Internet
Explorer. The pop-out functionality of the tips will not work in other browsers.
Click the “Update” button at the bottom of each assessment survey page to save your
information. If “Update” is not selected, your data will not be saved and will, therefore,
have to be re-entered.
If there is an error on the page (for example if a required field has not been correctly
completed), you will be notified with a message at the top of the page. You must correct
this error for your data to be saved. Information on the type of error will be provided.
Run-out time on web server: the BOMA BESt® platform is a highly secure website. There
is a 60 minute runtime limitation on the BOMA BESt® website; however, each company’s
web connection may have a stricter runtime limitation for security purposes. You will be
required to log in if no activity occurs (i.e. clicking “Update”) within a specified time,
dictated by your company’s web connection.
Always use the navigation menu and buttons within the application for all navigation (as
opposed to the browser’s “back” and “forward” options).
It is highly recommended that only one application be worked on at a time. Working on
two (in two different tabs) may lead to one questionnaire overwriting the other.
Use the “Report” for recommendations on how to improve your building before your next
certification.
Enjoy getting to know your building better!
Questions? Find your Local BOMA Association’s contact information here:
http://www.bomabest.com/network/
BOMA BESt® Health Care Companion Guide (August 2014) Page | 25
3. BOMA BESt® Health
Care Module Development
BOMA BESt® Health Care Companion Guide (August 2014) Page | 26
3.1 Technical Advisory Committee
BOMA Canada would like to thank this dedicated team of individuals who have provided continuous
input on the tool from the beginning of the process. Their contribution has been invaluable to the
development of BOMA BESt® Health Care:
André Chalifour, BOMA BESt® Certification Verifier, BOMA Quebec
Jérôme Ribesse, General Director, Synergie Santé Environnement
Edward Rubinstein, Manager, Energy and Environment, University Health Network
Serge Sevigny, Director of Technical Services, McGill University Health Centre
Hazel Sutton, Manager of Environmental Standards, BOMA Canada
3.2 Contributors
Throughout the development of BOMA BESt® Health Care, BOMA Canada has sought out feedback
from a variety of stakeholders. BOMA Canada would like to recognize all our contributors for their
knowledge and their time:
Lori Augustin, RPA, LEED AP O+M, Senior Associate, Stantec Consulting Ltd.
Berni Baier, National Sales Support Manager/S.E. Ontario Territory Manager, Camfil Canada
Inc.
Claude Charbonneau, Director of Technical Services, CSSS Jeanne-Mance
Pierre Chénier, P.Eng., DSA, Pierre Chénier – Solutions Inc.
Stefanie Dodaro, Director, Sustainability Services, CD SONTER – Environmental Consultants
Craig B.Doerksen, CFM, CEM, MFM, P.Eng, Divisional Director, Facility Management, Health
Sciences Centre Winnipeg
Meirav Even-Har, Program Manager, 3RCertified, Recycling Council of Ontario (RCO)
Jayme Last, Executive Assistant, McMurray Environmental Solutions Inc.
Yan Ferron, P.Eng., M.Env., Pageau Morel et associés inc.
Dusanka Filipovic, P. Eng., President and Vice Chair, Blue-Zone Technologies Ltd.
Michel Fournier, P.Eng., Ministère de l’Énergie et des Ressources naturelles
Julie Hamel, Executive Assistant – Facilities division, Technical Services Branch, CSSS
Bordeaux-Cartierville-St-Laurent
Scott Hammond, P.Eng, LEED AP BD+C, Partner, Mechanical Engineer, SMS Engineering Ltd.
Jessica Heiss, Coordinator, Sustainability and Building Integration, Engineering & Operations,
The Ottawa Hospital
J.J. Knott, CET, HMT, CEM, Director of Plant Operations, Norfolk General Hospital; Project
Lead, Health Care Energy Leaders Ontario
Manasi S.Koushik, MBA, EP(CEA), P.Eng., Project Manager, Compliance Services, Emissions
Reduction & Compliance, Pinchin Environmental Ltd
BOMA BESt® Health Care Companion Guide (August 2014) Page | 27
Bruce Lapointe, Coordinator of Emergency and Civil Protection, CSSS Jeanne-Mance
Jean-François Marquis, M.D., FRCPC, University of Ottawa Heart Institute
Angie McMurray, President/Waste Management Specialist, McMurray Environmental Solutions
Inc.
Dónal O'Connor, M.Eng.Sc., P.Eng., LEED AP BD+C, Energy Management Engineer, Stantec
Consulting Ltd.
Michael Pagel, Project Manager, Enerlife Consulting Inc
Marc Poudrier, Assistant Director of Technical Services, CSSS Pierre-Boucher
Paul Welsman, Manager, Business Development & Associations, Wasteco
Linda Varangu, M.Eng., Executive Director, Canadian Coalition for Green Health Care
Michael Zatz, Chief, Market Sectors Group, ENERGY STAR Commercial and Industrial Branch
Office of Air and Radiation, U.S. Environmental Protection Agency
The Regional Municipality of York
3.3 Pilot participants
BOMA Canada would like to thank the following institutions for participating in the pilot project and for
their invaluable feedback on the experience:
Montreal General Hospital, Montreal, QC
Centre d'hébergement Notre-Dame-de-la-Merci, Montreal, QC
PsycHealth Building, Health Sciences Centre, Winnipeg, MB
Children’s Hospital, Health Sciences Centre, Winnipeg, MB
Newmarket Health Center, Newmarket, ON
CLSC Simonne-Monet-Chartrand, Longeuil, QC
Hôpital Pierre-Boucher, Longeuil, QC
Centre d'hébergement Jean-De La Lande, Montreal, QC
Centre d'hébergement Ernest-Routhier, Montreal, QC
3.4 Organizational support
BOMA Canada would like to recognize the following organizations for generously sharing their
resources with BOMA Canada:
Natural Resources Canada
Toronto Region Conservation Authority & Enerlife Consulting Inc
Canadian Coalition for Green Health Care
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3.5 Additional Resources and References
Canadian Coalition for Green Health Care, Resiliency Toolkit:
The Canadian Coalition for Green Health Care, with research and technical support from Health
Canada, is pleased to announce the release of the Health Care Facility Climate Change Resiliency
Toolkit. The toolkit was co-developed for use by health care facilities to assess their resiliency to the
impacts of climate change.
Health care facilities in Canada are vulnerable to climate change. Climate-related hazards are
expected to create risks that can disrupt health care facility services and delivery. Extreme weather
events (e.g. storms, floods, wildfires, extreme temperature events) can create emergencies by
damaging infrastructure, compromising access to critical resources (e.g. food and water) and safety of
patients, visitors and staff. Climate change increases risks of some infectious diseases (vector-, water-
and food-borne, new and emerging) and worsens air quality. Climate-related hazards can have
significant implications for demand on health care facility services.
For more information, visit: http://www.greenhealthcare.ca/component/content/article/251-ccr
Natural Resources Canada, ENERGY STAR Portfolio Manager for Hospitals:
In a climate of increasing costs and decreased amounts of funding, hospital energy managers have to
look at new savings opportunities to cover the shortfall. Benchmarking your hospital’s energy
performance is the first step towards managing your energy. Continuous benchmarking helps you track
energy and water use over time to identify areas that need improvement and can help you measure the
impact of your actions.
Benchmarking can be a valuable tool in moving beyond national average performance to best in class
performance. In 2013, Natural Resources Canada introduced ENERGY STAR Portfolio Manager, a
free invaluable business planning tool, to Canada.
For more information, visit: http://www.nrcan.gc.ca/energy/efficiency/buildings/energy-
benchmarking/15909
Toronto Region Conservation Authority, Greening Health Care:
Hospitals can substantially reduce energy costs while maintaining or improving patient care. The
starting point is to know where you stand. Some facilities use three times more energy per square foot
than others, with high users typically able to save hundreds of thousands of dollars annually. Most
savings result from operational and maintenance improvements involving little capital expenditure, but
delivering remarkable results. Greening Health Care, available across Canada, provides the knowledge
and resources you need to maximize energy and operating cost savings and raise the environmental
performance for your hospital to be a leader in the community.
For more information, visit: http://www.trca.on.ca/the-living-city/programs-of-the-living-city/greening-
health-care.dot
BOMA BESt® Health Care Companion Guide (August 2014) Page | 29
Disclaimer: The BOMA BESt® Health Care Companion Guide is for informational purposes only
and is subject to change without notice. The BOMA BESt® Health Care Companion Guide is
protected by copyright pursuant to copyright laws and international conventions. Any
reproduction, modification, creation of derivative works from or redistribution or reproducing of
the policies or any portion thereof is prohibited without the express written consent of Building
Owners and Managers Association of Canada (BOMA Canada).
© 2014 by BOMA Canada. All rights reserved.