The new $70 million Providence Newberg Medical Center (PNMC) in Newberg, Oregon, enjoys the distinction of being the nation's first full-service healthcare facility to hold a LEED Gold certification. Designed by Mahlum Architects of Seattle and constructed by Skanska USA Building Inc. of Beaverton, Oregon, the 187,500-square-foot complex, consisting of a hospital and medical office building, is expected to repay the additional costs of its green design features in 14 months and cut its energy use substantially.

The facility, which opened on June 16, 2006, features a ventilation system that continually draws in outdoor air. Because the interior air is expelled, there is a dramatically healthier air quality for patients and staff. The facility also employs occupancy sensors that automatically turn off lights in unoccupied spaces and makes use of extensive natural lighting. In addition, PNMC is the only hospital in the United States that meets 100% of its electrical needs via green power, which PNMC purchases from utilities that produce a collective 50% of the facility's power from wind generation, 25% from geothermal sources, and 25% from low-impact hydro sources—an aspect of its operations that boosted its LEED rating. PNMC also participates in Oregon's Dispatchable Standby Generation program, in which it sells surplus power produced by its two 750-kilowatt emergency generators to Portland General Electric during peak demand periods.

Steve Clem, a preconstruction manager for Skanska who worked on PNMC, says creating a full-service hospital within the LEED Gold framework was a challenging task. Healthcare facilities have special safety and operational requirements, he notes, including for their heating, cooling, and ventilation systems, that can make it tougher to score points in the LEED certification matrix. “It can be difficult to a take a project that has a specific healthcare use and fit it into a LEED mold,” he says. (Much of the work was done pre-Green Guide for Health Care.) Moreover, new buildings start at a disadvantage technically, Clem adds, because LEED awards points to projects that reuse existing structures.

Another challenge resulted from the 100% outside air requirement. That meant the incoming air had to be constantly purified, as well as heated or cooled and humidified or dehumidified, depending on the season. All of these processes require energy use, Clem notes. Furthermore, hospitals require higher lighting levels than general office space. Finally, hospitals often operate via purchase agreement with vendors that provide discounts on such items as carpets and flooring, but which might not meet LEED criteria.

Clem says he first became involved in LEED several years ago, when he worked on the Kelley Engineering Center at Oregon State University in Corvallis. Carefully built within a border of existing trees, the center is the nation's first LEED Gold-certified academic engineering facility. Clem says watching LEED's popularization over the past few years has been like “watching popcorn”—at first only one or two kernels pop, but quickly the whole batch erupts, to the point where most or all of the largest contractors in the nation have adopted LEED points as operating principles. Skanska became one of those early “kernels,” he says, particularly after the company achieved ISO 14001 certification in 2004, the first general contractor in the United States to do so. That certification brings Skanska one LEED-certification point for every project it builds.

There is now a company-wide incentive to remain certified, he says, because if one particular project fails, then the entire company risks losing ISO certification. This means Skanska must maintain proper record keeping and provide special training to workers and supervisors during the design phase and prior to the start of construction, as well as conduct construction operations within the LEED framework. As a result, the company conducts awareness training for all of its workers, as well as competency training for its supervisors covering topics such as dust and erosion control, effluent runoff, hazmat handling, and minimizing light and noise pollution. “It's become part of our daily discussions prior to sending everybody to work,” Clem summarizes.

Incorporating LEED requirements seems to work best with negotiated contracts, Clem notes. In a hard-bidding situation, the costs required to meet LEED standards could easily discourage an owner from employing its framework. “These healthcare facilities use enormous amounts of energy, so payback cycles are not very long,” explains Clem, and yet the up-front costs might seem too high. It's only when the bidder can explain the benefits and payback associated with LEED components—an interaction that is more typical within a negotiated contract setting—that clients can be persuaded to incorporate LEED standards into the project.

Tony Church, Skanska's project manager for the PNMC construction, who was involved in the design process, lists some of the innovative features that garnered points for PNMC in the LEED evaluation system. They included a roof consisting of a reflective white-rubber membrane, low-flow plumbing fixtures to reduce water usage, plans for recycling postconstruction waste (Skanska recycled 79% of demolished and postconstruction material during the project), and a strict indoor air-quality (IAQ) plan.

The IAQ plan required protecting the HVAC system from contaminants during the entire construction process. That meant isolating the return side from the surrounding environment whenever possible, whether by blocking the inlets with plastic sheeting, fitting the system with temporary filters, or preventing the storage of construction or waste materials in the mechanical area. It also required dust-suppression procedures and using low-emitting adhesives, paints, and carpet during construction. Church says that, before the facility opened, Skanska conducted a two-week HVAC system flush to remove contaminants that might have accumulated during construction, “so that when they opened for business they would be starting fresh.”

Although air quality is an extremely important consideration, Church says energy management was an even bigger challenge in meeting LEED requirements. “They basically have to spend more energy just because they're a hospital,” he says, adding that the project got a big boost in the LEED rating by employing a unique and highly efficient condensing boiler in its heating system. The boiler (figure) was developed by Engineering Economics, Inc., of Seattle, the project's mechanical engineer. It reclaims heat from water vapor produced by its exhaust to boost operating efficiency.

Providence Newberg Medical Center employs a unique and highly efficient condensing boiler developed by Engineering Economics, Inc., of Seattle

Church says that the new facility (which earned 39 LEED points, the minimum level required for Gold certification) has quickly become a prototype for future projects, both within Skanska and among potential clients and even other hospital construction firms. “I've got counterparts who have come to take a look at the facility. They want to see the mechanical design and the energy studies, which are the hot topics, so they can see the kind of equipment that was installed and how to set it up so they can attempt to get certification.”

Richard Beam, Director of Energy Management Services for parent company Providence Health & Services in Seattle, calls the effort to incorporate LEED principles into PNMC a complete success. “We feel we're on track to meet or exceed our target of using 26% less energy than the Oregon Energy Code requires,” he says, adding that the LEED design features reduced the facility's energy bills “right from the start,” and will translate into an annual cost savings of $176,000. Beam also says the company developed an enhanced measurement and verification plan that tracks pathogens in the interior air and verifies that the air is clean, acceptance of which by the USGBC project committee constituted the LEED point that resulted in the Gold certification. It allows PNMC to claim state-of-the-art status for infectious disease control.

Providing yet another incentive, in short, for PNMC to take the LEED.

Phil Berardelli, a former science and technology editor for United Press International, is an independent writer based in McLean, Virginia. Contact him at philberardelli@gmail.com.

For further information on Providence Newberg Medical Center, phone 503.537.1555 or visit http://www.providence.org/yamhill/.