According to Energy Star, operated by the U.S. Environmental Protection Agency (EPA), healthcare organizations in the United States, including long-term and acute care facilities, spend more than $6.5 billion every year on energy. That amount is expected to rise in years to come.

There are many reasons for this massive consumption of energy, and at the top of the list is the fact that most healthcare facilities are 24/7 operations. Further, there is rarely a “lull,” when less power is needed. Also, the tools and much of the equipment used in healthcare require large amounts of electricity to operate. The goal of this equipment is to assist medical teams in achieving better healthcare results. The amount of energy consumed is of secondary concern.

However, we must look beyond the amount and costs of energy to fully understand the impact this consumption has on our environment. Most of the electricity generated in the United States comes from the burning of fossil fuels and natural gas. Renewable energy sources such as wind and solar power make up only about one-tenth of all the energy consumed in the country.

When fossil fuels are burned, they release greenhouse gases. According to the EPA, greenhouse gases trap heat, which is making the planet warmer. Further, the EPA adds that it is “human activities [that] are responsible for almost all of the increase in greenhouse gases in the atmosphere over the last 150 years.”

The high cost of electricity combined with a desire to operate more sustainably has led many healthcare organizations to look for ways to reduce their electricity consumption. Some facilities are fortunate enough to have the funds to install solar panels on their buildings and select energy efficient mechanicals such as water heaters and HVAC systems long before their current systems have reached the end of their life spans to achieve this goal.

However, most medical facilities – including long-term and acute care facilities –are not in this fortunate position. Nevertheless, these facilities do have options to help them become more environmentally responsible and sustainability-focused. The entire process begins by understanding some of the key terms encountered along what we could call their electric sustainability journey.

Renewable Energy Credits

One of the options long-term and acute care administers have to increase their sustainability is to purchase renewable energy credits, or RECs. When you purchase an REC, you are buying one megawatt-hour of electricity generated from a renewable energy source such as wind or solar power. This power is sold into local power grids, helping them reduce their use of fossil fuels, replacing them with clean, renewable energy.

This means the REC does not benefit the healthcare facility directly. Instead, each REC purchased is poured into a subsidy to make clean energy sources more viable and economically competitive, thus reducing our use of fossil fuels and the greenhouse gases they release.

However, there’s more to RECs that administrators should know about. These are national, marketable instruments. That means administrators can buy and sell them, sometimes at a profit. In California, for example, RECs are selling for about $17 to $19 each. If you are located in California, you can buy RECs from 28 other states and territories, including Washington, D.C., and Puerto Rico, where prices may be lower.

Carbon Footprint

We have all heard this term many times, but may wonder how the two words – carbon and footprint – came together. Footprint is used here as a metaphor for the total impact something has. Carbon (CO2) is shorthand for greenhouse gases. The carbon footprint, then, is an estimate of how much impact we have on our climate through carbon emissions. This would include the burning of fossil fuels, but it could also be applied to the raising of farm animals, manufacturing of goods, food processing, packaging, and more.

According to recent research, the average person in the United States is responsible for 16.5 metric tons of carbon dioxide (CO2) emissions released into the environment each year. Most of these emissions come from driving vehicles or having nonrenewable energy generated and delivered to our homes.

As to ways long-term and acute care facilities can reduce their carbon footprint, one of the most effective ways is the purchasing of RECs just discussed. Another way is to use a sustainability dashboard system to track energy usage. Several systems are available, and they vary as to the information they provide and the services they offer. When selecting a sustainability dashboard, look for systems that keep tabs on several metrics, including electricity, fuel and water consumption, and waste. Some systems also provide “human monitoring.” These are people, not technology, that evaluate a facility’s consumption in real time. The value here is that if irregularities are noted – for instance, a jump in electrical use – facility administrators can be notified quickly, allowing for faster remediation.


According to the investing website Investopedia, “efficiency signifies a level of performance that describes using the least amount of input to achieve the highest amount of output.” How does this apply to long-term and acute care facilities as they travel on their electric sustainability journey? Possibly the following example will help us understand.

A medical facility in Chicago replaced all the fluorescent tube lighting in its underground garage with LED tube lights. The light bulbs look the same, but that is where the similarity ends. While LED lights are more expensive than fluorescents, they last about 10 times as long as a conventional fluorescent and consume one-quarter of the energy.* This longer life and the fact that they use so much less energy means the return on the investment is relatively quick. But the medical facility got another big surprise: the LED lights were noticeably brighter.

In this scenario, increased efficiency means transferring to a lighting system that produces more light but uses only about a fourth of the energy of the lighting system being replaced.

Rebound Effect

One more term administrators should be aware of is the rebound effect. This happens when people increase their energy usage in a way that eats up any gains they may have achieved through updating fixtures. The garage lighting example we just discussed can show us how this works.

Let’s say that before the transfer to LED lighting, the lights in the garage were turned on eight hours per day and never on the weekend. However, now that administrators realize they are using so much less energy and their costs for that energy have been reduced so significantly, they decide to leave the lights on 24 hours a day, seven days per week.

The result is that administrators find their energy savings are not all that great, which also means the return on the LED investment will take much longer. Administrators then question whether the investment was worth the money. This is an example of the rebound effect. If the administrators had turned on the lights as they had before, the savings they were hoping for would have materialized.

The electric sustainability journey can be confusing at times. Knowing the terms discussed here will help administrators of long-term and acute care locations as they transition to greater energy efficiency. These terms are likely to become more common as we move into 2020, and understanding them now is a big first step in reducing energy consumption, promoting sustainability, and protecting our planet.


Katrina Saucier is program manager for Sustainability Dashboard Tools, LLC.  She can be reached at


*These statistics can vary due to a number of factors.


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