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February 5, 2014
www.fgiguidelines.org
Sustainable Design Guidelines for Hospitals and Outpatient Facilities (February 5, 2014)
www.fgiguidelines.org
Sustainable Design Guidelines for Hospitals and Outpatient Facilities (February 5, 2014)
www.fgiguidelines.org
Contents
Introduction
1 Building Site
Mandatory Requirements
Performance Option
Prescriptive Option
2 Energy Use
Mandatory Requirements
Performance Option
Prescriptive Option
Mandatory Requirements
4 Water Supply
Mandatory Requirements
Performance Option
Prescriptive Option
Mandatory Requirements
Mandatory Requirements
Performance Option
Prescriptive Option
7 Waste
Mandatory Requirements
Sustainable Design Guidelines for Hospitals and Outpatient Facilities (February 5, 2014)
www.fgiguidelines.org
Sustainable Design Guidelines for Hospitals and Outpatient Facilities (February 5, 2014)
www.fgiguidelines.org
Sustainable Design Guidelines for Hospitals and Outpatient Facilities (February 5, 2014)
www.fgiguidelines.org
1 BUILDING SITE
In addition to the mandatory requirements, either the performance option (Section 1.2) or the prescriptive
option (Section 1.3) shall be implemented.
1.1 Mandatory Requirements
1.1.1 Erosion and sedimentation control plan. An erosion and sedimentation control (ESC) plan
shall be prepared for all construction activities associated with the project.
1.1.1.1 The ESC plan shall conform to the erosion and sedimentation requirements of the 2003
EPA Construction General Permit (CGP) or local erosion and sedimentation control
standards and codes, whichever are more stringent.
1.1.1.2 The plan shall describe the measures to be implemented to accomplish the following
objectives:
a. Prevent loss of soil during construction caused by storm water runoff and/or wind
erosion, including protecting topsoil by stockpiling for reuse.
b. Prevent sedimentation of storm sewer or receiving streams.
c. Prevent pollution of the air with dust and particulate matter.
The CGP shall outline the provisions necessary to comply with Phase I and Phase
II of the National Pollutant Discharge Elimination System (NPDES) program.
Although the CGP only applies to construction sites greater than one acre, the
requirements shall be applied to all projects.
Information about the EPA CGP (including a copy of the document) is available at
http://cfpub.epa.gov/npdes/stormwater/cgp.cfm.
1.1.2.2 Temporary construction facilities, designated staging areas, access roads, and
construction parking shall be planned within new building and paving footprints to
minimize site disturbance.
1.1.2.3 Measures shall be established to protect priority sensitive areas of the site, including
prohibiting staging, stockpiling and soil compaction.
1.1.2.4 Disturbance to protected wetlands and habitats of endangered species shall be prevented.
1.1.2.5 Storage shall be provided for fuels, and measures shall be established for handling fuels,
to prevent spills and discharge into waterways.
1.1.3 Brownfield remediation. If the site is a brownfield:
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2 ENERGY USE
In addition to the mandatory requirements, either the performance option (Section 2.2) or the prescriptive
option (Section 2.3) shall be implemented.
2.1 Mandatory Requirements
2.1.1 Measurement and verification plan
2.1.1.1 A measurement and verification (M&V) plan shall be developed and implemented
consistent with one of the following options in the International Performance
Measurement and Verification Protocol (IPMVP), Volume III: Applications, Part I:
Concepts and Options for Determining Energy Savings in New Construction:
a. Option D: Whole Building Calibrated Simulation
b. Option B: ECM (Energy Conservation Measure) Isolation
The January 2006 edition of IPMVP can be found at www.evo-world.org/
index.php?option=com_content&view=article&id=272&Itemid=504&lang=en.
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2.1.1.2 At minimum, metering that provides consistent and reliable data shall be provided for
the following electrical and mechanical systems (as applicable to the scope of the
project):
a. Gas
b. Electricity
Consumption (kWh) and demand (kW) for each source of electricity to the
building
Output from each automatic transfer switch
Energy consumption for pump and fan for each motor with a variable frequency
drive (VFD)
c. Thermal energy
All steam purchased from off-site sources, including recovered condensate
Steam produced by each steam boiler
Hot water produced by each hot water boiler
Chilled water output for each water chiller
d. Energy source (fuel oil, propane, etc.) for each device listed
Each steam or hot water boiler
Each generator not used for emergency purposes only
2.1.2 Interior lighting sensors and controls
2.1.2.1 Occupancy light sensor controls
a. The following spaces shall be equipped with occupant sensor(s) that automatically
turn lighting off within 30 minutes of all occupants leaving the space but allow
manual off control:
Offices 250 sq. ft. (25 m2) or smaller
Classrooms of any size
Lecture, training, or vocational rooms of less than 1,000 sq. ft. (100 m2)
Multipurpose rooms of less than 1,000 sq. ft. (100 m2)
Conference rooms and meeting rooms less than 1,000 sq. ft. (100 m2)
Meeting centers
Examination rooms (except those where patient may lie motionless for
observation for an extended period)
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Lighting that is in use for no more than 60 continuous days and is not reinstalled any sooner than 60 days after being uninstalled
Lighting for material handling, transportation areas, and associated storage
areas
Roadway lighting required by regulatory authorities
c. All permanently installed outdoor luminaires employing lamps rated over 100 watts
shall have a lamp efficacy of at least 60 lumens per watt.
2.1.3 Controls for outdoor lighting
2.1.3.1 Area lighting. All permanently installed outdoor lighting, including lighting of building
facades, parking lots, canopies, and pick-up/drop-off zones, shall be controlled by a
photo-control or astronomical time switch that automatically turns off the outdoor
lighting when daylight is available.
Exception: Lighting for steps or stairs that require illumination during daylight hours
Exception: Lighting for emergency department entrances and exits
2.1.3.2 Garage lighting. Two levels of lighting shall be provided in parking garages.
a. Thirty percent of the total fixtures shall be controlled by a daylight sensor.
b. The balance of the fixtures shall be controlled by a combination of daylight sensor
and occupancy sensor.
2.2 Performance Option
Buildings shall be designed to achieve an ENERGY STAR rating of at least 75, modeled in accordance
with Appendix G of ASHRAE 90.1-2010 as modified by the design assumptions in Appendix 1, using the
most current version of DOE-2 (www.doe2.com), EnergyPlus (www.energyplus.gov), eQuest
(www.doe2.com/equest) software, or other industry-accepted software.
Use EPA Target Finder to estimate energy use for a design project. Target Finder
calculates a rating based on a comparison of projected energy use with that of
facilities of similar size in the ENERGY STAR database. See
www.energystar.gov/index.cfm?c=evaluate_performance.bus_portfoliomanager.
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2.1.3.2 For buildings of 90,000 square feet or less, roofing shall be provided based on the
climate zone as recommended in the ASHRAE Advanced Energy Design Guide for
Small Hospitals and Healthcare Facilities. Components addressed in the
recommendations include insulation and the solar reflectance index (SRI).
2.3.2 Joints and other openings
2.3.2.1 Joints and other openings in the building envelope that are potential sources of air
leakage shall be caulked, gasketed, weather-stripped, or otherwise sealed to limit
infiltration and exfiltration.
2.3.2.2 Before the building is occupied, the building envelope shall be tested for thermal and
airflow leakage and any deficiencies discovered shall be corrected as part of the
envelope commissioning process.
2.3.3 Variable speed drives. Individual motors serving variable flow systems and having a motor
speed exceeding 3 horsepower shall have controls and/or devices (such as variable speed control) that
will result in pump motor demand of no more than 30 percent of design wattage at 50 percent of
design flow.
2.3.4 Hydronic variable flow systems. HVAC chilled and hot water pumping shall be designed for
variable fluid flow and shall be capable of reducing pump flow rates to no more than the larger of the
following:
2.3.4.1 50 percent or less of the design flow rate, or
2.3.4.2 The minimum flow required by the equipment manufacturer for the proper operation of
equipment served by the system.
2.3.5 Pipe insulation. Pipe insulation shall comply with the requirements of the latest edition of
ASHRAE 90.1.
2.3.6 Economizers. Systems shall have air-side or water-side economizers where required for the
facilitys climate zone in ASHRAE 90.1.
2.3.7 Heat recovery. Air-side heat recovery shall be provided in accordance with the ASHRAE
Advanced Energy Design Guide for Large Hospitals.
2.3.8 Building commissioning. Building commissioning shall be performed in accordance with the
American Society for Healthcare Engineering (ASHE) Health Facility Commissioning Guidelines.
2.3.9 Appliance efficiency. All equipment and appliances shall be Energy Star-labeled if Energy Star
is applicable to that equipment or appliance.
2.3.10 Equipment efficiency. Equipment shall comply with the provisions for cooling and heating
equipment efficiencies in the ASHRAE Advanced Energy Design Guide for Large Hospitals.
2.3.11Lighting power density. Lighting shall comply with the climate zone-specific targets for
lighting power density in the ASHRAE Advanced Energy Design Guide for Large Hospitals.
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Minimum room volume, clear floor area, natural light, and window area to floor
area ratio of a private patient room as prescribed in the FGI Guidelines for
Design and Construction of Hospitals and Outpatient Facilities
Provision of outside air at a rate of 2.0 air changes per hour as prescribed in
Table 7-1 of ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities
b. Office furniture systems and seating installed prior to occupancy shall be tested in
accordance with, and shall not exceed the VOC limit requirements in Section 7.6.2
of ANSI/BIFMA e3: Furniture Sustainability Standard and Tools
(www.bifma.org/?page=e3standard).
c. Composite wood, wood structural panel, and agrifiber products shall not contain any
added urea-formaldehyde resins.
Composite wood and agrifiber products are defined as particleboard, mediumdensity fiberboard, wheatboard, strawboard, panel substrates, and door cores.
3.1.6 Lighting control. For requirements, see Section 2.1.2 (Lighting sensors and controls) under
Mandatory Requirements for Energy Use.
3.1.7 Acoustics. For acoustic planning and design requirements, see the FGI Guidelines for Design
and Construction of Hospitals and Outpatient Facilities, 2014 edition.
4 WATER USE
In addition to the mandatory requirements, either the performance option (5.2) or the prescriptive option
(5.3) shall be implemented.
4.1 Mandatory Requirements
4.1.1 Medical equipment. Potable water shall not be used for once-through cooling for any medical
equipment.
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4.1.2 Irrigation water. Irrigation systems shall be designed to use only captured rainwater, recycled
wastewater, recycled gray water, or water treated and conveyed by a public agency specifically for
non-potable uses for irrigation.
Exception: Use of irrigation systems to establish landscaping when first planted shall be permitted.
Use of xeriscaping should be considered to avoid the need for irrigation.
b. Urinal
c. Hand-washing station faucet 2.2 gpm at 60 psi (8.3 lpm at 415 kPa)
d. Showerhead
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ASME A112.19.14: Six-Liter Water Closets Equipped with a Dual Flushing Device
and the draft U.S. EPA WaterSense Specification for Flushometer Valve Toilets
shall be 1.28 gal (4.8 L).
4.3.1.2 Toiletstank type: Tank-type toilets shall comply with the performance criteria of the
U.S. EPA WaterSense Specification for Tank-Type Toilets.
4.3.1.3 Urinals: Maximum flush volume as determined in accordance with ASME A112.19.2
shall be 0.5 gal (1.9 L).
a. Non-water urinals shall comply with ASME A112.19.19: Vitreous China Nonwater
Urinals or IAPMO Z124.9: Plastic Urinal Fixtures as appropriate.
b. Equip all urinals (but not toilets or bedpan washers) with sensor operators.
4.3.1.4 Public sink faucets: Maximum flow rate shall be 0.5 gpm (1.9 L/min) when tested in
accordance with ASME A112.18.1/CSA B125.1: Plumbing Supply Fittings.
4.3.1.5 Public metering self-closing faucet: Maximum water use shall be 0.25 gal (1.0 L) per
metering cycle when tested in accordance with ASME A112.18.1/CSA B125.1.
4.3.1.6 Patient toilet room sink faucets: Maximum flow rate shall be 1.5 gpm (5.7 L/min) when
tested in accordance with ASME A112.18.1/CSA B125.1.
4.3.1.7 Patient toilet room and staff showerheads: Maximum flow rate shall be 2.0 gpm (7.6
L/min) when tested in accordance with ASME A112.18.1/CSA B125.1.
4.3.1.8 Hand-washing station sink faucets: Maximum flow rate shall be 2.2 gpm (8.3 L/min)
when tested in accordance with ASME A112.18.1/CSA B125.1
4.3.2 Vacuum pumps and air compressors. No potable water shall be used for vacuum pumps and
air compressors.
4.3.3 Sterilizers. Sterilizers shall be provided with water recovery provisions.
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5.1.4 Spill prevention. To minimize the risk of leakage and spills, above- and below ground
containment areas that comply with the following regulations shall be provided for storage of fuels
and chemicals:
5.1.4.1 U.S. EPA Spill Prevention, Control, and Countermeasures (SPCC) rule
(www.epa.gov/oem/content/spcc)
5.1.4.2 All applicable state and local administrative codes pertaining to storage tanks
5.1.5 Hazardous waste containment. All outdoor hazardous waste holding areas shall be designed in
accordance with 40 CFR Part 264: Standards for Owners and Operators of Hazardous Waste
Treatment, Storage, and Disposal Facilities (EPA Resource Conservation and Recovery Act).
5.1.5.1 Secondary containment systems shall be provided for all generators, whether otherwise
required or not, to prevent spills and migration of waste to soil and ground or surface
water.
5.1.5.2 Covered enclosures shall be provided to prevent precipitation from increasing the risk of
contaminated liquids migrating to the soil and ground or surface water.
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b. Each building structure and envelope alternative shall have a common design,
including building size and use; common construction requirements; and materials
appropriate for the locale.
c. The assemblies shall include all structural elements, insulation, and
sheathing/envelope, roof/ceiling, and intermediate floors (including interstitial space).
Examples of life cycle assessment tools suitable for completing building assembly
LCAs include the following:
Athena Impact Estimator for Buildings, Version 4.2 or later
(www.athenasmi.org/our-software-data/impact-estimator/)
GaBi (www.gabi-software.com/america/solutions/building-lca/)
SimaPro (www.simapro.co.uk/)
CMLCA (http://cml.leiden.edu/software/software-cmlca.html)
Building service life and maintenance should be considered when evaluating a
building assembly.
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construction works Environmental product declarations Core rules for the product
category of construction products); at minimum include cradle-to-gate scope; and
conform to the requirements for either industry-wide or product-specific EPDs:
Industry-wide (generic) EPD. Products specified for the building assembly
shall have third-party verified Type III EPDs, including external verification in
which the manufacturer is explicitly recognized as a participant by the program
operator.
Product-specific EPD. Products used for the building assembly shall have
publicly available product-specific, third-party verified Type III EPDs, including
external verification. Product-specific means manufacturer-specific for a
product family.
b. Third-party certifications. Products specified shall meet the requirements of
multiple-attribute standards developed by an approved standard development
organization using a consensus process. Examples of such standards include:
NSF Sustainability Assessment Standards
(http://www.nsf.org/business/sustainability_ncss/index.asp?program=Sustainabil
ityNcs)
UL Environment Standards
(http://www.ul.com/global/eng/pages/solutions/standards/accessstandards/sustai
nabilitystandards/)
Sustainable Forestry Initiative certifications (http://www.sfiprogram.org/gettingcertified/benefits-of-sfi-certification/)
c. Product life cycle
Products specified shall have a third-party certified life cycle product assessment
based on ISO 14040 and 14044 and minimally covers cradle-to-gate scope.
Compliance documentation shall include the life cycle assessment completed by a
manufacturer or third party with results verified and/or certified by a third party.
6.3.2 Interior fit-out (including interior finishes and furniture)
6.2.3.1 Based on the building application and specification of comparable products (based on
cost), 10 percent or more of the materials and products specified for the interior fit-out
assembly shall comply with one or more of the following:
a. Environmental Product Declarations. These shall be EPDs that use recognized
Product Category Rules; conform to ISO Standards 14040, 14044, 14025, and 21930
or EN 15804; at minimum include cradle-to-gate scope; and conform to the
requirements for industry-wide or product-specific EPD:
Industry-wide (generic) EPD. Products specified for the interior fit-out shall be
third-party, certified Type III Environmental Product Declarations (EPDs),
including external verification where the manufacturer is explicitly recognized
as a participant by the program operator.
Product-specific declaration. Products specified for the interior fit-out shall be
products with a publicly available product specific third-party, certified Type III
EPDs, including external verification.
Product-specific means manufacturer-specific for a product family.
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7 WASTE
Note: There is no prescriptive or performance option for this criterion.
7.1 Mandatory Requirements
7.1.1 Mercury reduction and waste. Building products that contain intentionally added mercury shall
not be specified. When there is no alternative, products that minimize mercury content shall be specified.
7.1.1.1 In facilities delivering dental care, amalgam separation devices shall be installed that
meet or exceed the requirements of ISO-11143: Dentistry Amalgam separators.
7.1.1.2 An area shall be provided for storing mercury-containing products (e.g., lamps) to be
recycled.
7.1.1.3 All illuminated exit signs shall be Energy Star-qualified, UL-certified LED lamps.
7.1.1.4 All fluorescent lamps shall be low-mercury lamps.
Fluorescent lamps other than compact fluorescent lamps (CFLs) should have
armor sleeves to reduce and contain breakage.
Maximum content
10 mg mercury
3.5 mg mercury
6 mg mercury
2.5 mg mercury
9 mg mercury
3.5 mg mercury
3.5 mg mercury, ENERGY
STAR-qualified
10 mg mercury
32 mg mercury
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7.1.2 Construction waste management. A construction waste management plan shall be developed
and implemented.
7.1.2.1 At minimum, materials shall be identified that can be recovered, reused, and/or recycled
and plan to divert them from disposal in landfills or incinerators.
7.1.2.2 The disposal method shall be identified for each material, and whether materials will be
sorted or co-mingled on-site shall be determined.
7.1.2.3 At least 50 percent of non-hazardous construction and demolition debris shall be
recovered, reused, recycled, and/or salvaged.
7.1.3 Hazardous waste
7.1.3.1 For requirements, see Section 5.1.5 (Hazardous waste containment) under Airborne
Emissions, Effluent, and Pollution Controls in this document.
7.1.3.2 Management of hazardous waste disposal shall comply with all applicable state and
federal regulations.
7.1.3.3 Certification shall be made that waste minimization activities have been undertaken as
stated in 40 CFR 262.27 (Waste minimization certification).
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