BOMA BESt Health Care Companion Guide

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.

http://www.bomabest.com/tools-resources/

mailto:[email protected]


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


1. Introduction to BOMA

BESt® Health Care


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.


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.




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

http://static.schneider-electric.us/assets/pdf/healthcare/whitepapers/How%20Energy%20Efficiency%20Ensures%20Financial%20Support%20WP.pdf


http://www.sustainabilitysolutions.ca/sites/default/files/Greening%20Canadian%20Hospitals.pdf


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




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

http://www.bomabest.com/wp-content/uploads/BBEER-2014-Full-Report.pdf

http://www.bomabest.com/wp-content/uploads/BBEER-2014-Full-Report.pdf


2. BOMA BESt® Health

Care Technical Guide


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.


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.




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.


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.


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%).


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.


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.


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











Table 2: BOMA BESt® Energy Benchmarking – Medical Offices

Medical Offices – Energy Benchmarking Matrix












Table 3: BOMA BESt® Energy Benchmarking – Long Term Care

Long Term Care – Energy Benchmarking Matrix













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.


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







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


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.


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/


http://www.bomabest.com/network/


3. BOMA BESt® Health

Care Module Development


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


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


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

http://www.greenhealthcare.ca/component/content/article/251-ccr

http://www.nrcan.gc.ca/energy/efficiency/buildings/energy-benchmarking/15909

http://www.nrcan.gc.ca/energy/efficiency/buildings/energy-benchmarking/15909

http://www.trca.on.ca/the-living-city/programs-of-the-living-city/greening-health-care.dot

http://www.trca.on.ca/the-living-city/programs-of-the-living-city/greening-health-care.dot


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.

Documents

BOMA BESt Health Care Companion Guide