2013 - Health Care Facility Management Report - Canada - Benchmarking PDF

Canadian Version
BENCHMARK ING 2 .0
Health Care Facility
Management Report
A Critical Sampling of North American

Health Care Facilities
BENCHMARK ING 2 .0
Health Care Facility Management Report Committee
Laverne Deckert, Product Manager, International Facility Management Association
William L. Gregory, IFMA Fellow, PE, CFM, Vice President Facility Management, Adelphoi USA
Todd Wilkening, CHST, Director of Facilities, Ridgeview Medical Center
Steve Rees, VP Capital Management, Edmonton Zone, Alberta Health Services
Dennis Smith, MS, CHFM, CEM, CCM, Director, Facilities Management, Catholic Health Initiatives
Yuanyuan Zhang, Ph.D., Market Researcher, International Facility Management Association
© Copyright 2013 by the International Facility Management Association. All rights reserved.
This publication may not be reproduced, stored in a retrieval system or transmitted in whole or part, in any form or by any
means, electronic, mechanical, photocopying, recording or otherwise without the written permission of the International
Facility Management Association.
For more information, please contact:

IFMA Research Department
800 Gessner Rd, Suite 900, Houston, TX 77024-4257 USA
Phone: +1-713-623-4362
E-mail: research@ifma.org
ISBN 978-1-883176-23-5
BENCHMARK ING 2 .0
Health Care Facility
Management Report
TABLE OF CONTENTS
6 -12 INTRODUCTION
6 Introduction
7 Using this Report
7 Acknowledgements
7 About this Report
8 Methodology
9-12 Definitions
13-24 SECTION 1
Facility
14 Institutions Represented
14 Facility Description
15 Regional Climate Zones
16 Facility Age
16 Facility Setting
17 Ownership
17 Ownership by Institutions
17 Developed Acres
18 Days and Hours of Operations
18 Central Plant
19-20 Exterior Gross Area
21 Adjusted Patient Days and Discharges
21 Space per FTE
22 Non-Profit
22 Data Centers
23 Facility Parking
24 Devoted Area
24 Alternative Power
25 -32 SECTION 2
Utilities
26-28 Utility Costs
29 Utility Consumption
30-31 Energy Use Index
32 Building Automation System
4 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

TABLE OF CONTENTS
33- 46 SECTION 3
Maintenance
34 Maintenance Categories
35-37 Maintenance Costs
38 Roads and Grounds
39 Facility Operating Current Replacement
Value (CRV) Index
39 Maintenance Tracking
40 Maintenance Management System Used
41-43 Maintenance Staffing
44 Maintenance Management
44 Administrative Support
45 Total Maintenance Staff
46 Service Provision
47-51 SECTION 4
Environmental Services
48-50 Environmental Services Costs
50 Environmental Services Staffing
51 Contractor Practices
52-53 SECTION 5
Waste
54 -55 SECTION 6
Linen Services
56 - 64 SECTION 7
Operations
57 Cost of Operations
58-60 Customer Satisfaction
61-62 Productivity Measure
63- 66 SECTION 8
Risk Management
64 Safety Initiatives
65 Injury Claims
66 Security
67-70 SECTION 9
Property, Real Estate and
Construction Management
68-69 Management
70 Project Delivery Models

INTRODUCT ION
Thank you for participating in the Benchmarking 2.0 survey. If you were a participant
in the survey, you have the ability to customize, filter and review results online. From
this you can harvest a wealth of information to help you manage your facilities as
efficiently and effectively as possible.
Our goal has been and continues to be to help the health care facility manager add
significant value to their organization and the populations they serve by better
controlling underlying drivers that impact their costs and quality of service delivery.
We are pleased to have completed this significant benchmarking report for health
care facility management operations as a joint effort by the Health Care Institute, an
IFMA Alliance Partner, the American Society for Healthcare Engineers (ASHE), and the
Canadian Healthcare Engineering Society (CHES). As a North American-wide effort,
Benchmarking 2.0 sets the stage for an expanded international effort in our industry
in the near future.
One of the main areas of differentiation of Benchmarking 2.0 from other surveys is the
inclusion of key business drivers that enable the facility manager to provide strategic
input to the core health care operation. Our survey guides the facility manager on the
path of continuous improvement by helping them identify information they need to
collect and know by formatting outputs into information they need to communicate
to their superiors to be more effective in their roles.
On behalf of the Health Care Institute, ASHE, and CHES, we would like to sincerely
thank each and every one of our participants in this exceptional effort, as well as the
support staff for their efforts to make this survey and report a success.
We plan to continue to improve our surveys and processes to enhance the value
of our members’ efforts in their organizations and look forward to your feedback in
achieving that goal.
Ron Kalich Dale Woodin John J. Knott

President, Health Care Executive Director, President, CHES
Institute, an IFMA ASHE
Alliance Partner

INTRODUCT ION
Using this Report Acknowledgements

The information contained in the report represents ASHE, IFMA and CHES rely on the willingness and
a “self-report” from ASHE, IFMA and CHES members. generosity of their members to compile the data and
All information was voluntarily provided and was not complete this lengthy benchmarking survey. Without their
checked with site visits. When interpreting the data, it data, there would be no report. We thank these dedicated
is important to remember that every facility is different, participants for their contributions and support.
and every organization operates using different We would like to express our appreciation to the
accounting and measurement practices. The data listed following individuals who have dedicated countless hours
in this report will not provide a perfect comparison of passion to furthering the success of Benchmarking 2.0
of your organization to that of another hospital, but it and those of their fellow facility managers:
should give you a good idea how your facility fits into
the range of performance. Steve Rees, CFM, Vice President, Capital Management-
Edmonton Zone
The percentile charts in this report allow you to see
how your operation ranks against other organizations. Dale Woodin, CHFM, FASHE, Executive Director, American
The arrows beside some charts show the “best-in- Society of Healthcare Engineers
class” direction. Using your facility’s numbers for the Lastly, we need to express our sincere and deep
performance indicator, determine whether your building appreciation to Shari Epstein, IFMA’s past Research
is above or below the median (50th percentile). If your Director who was instrumental in the development of
facility falls way above or below the median, you may Benchmarking 1.0. Shari recently lost her life in a tragic
want to examine your costs or procedures in that area. accident. We know that her initial guidance has made our
However, your hospital may differ from the median due continued benchmarking efforts possible.
to type of facility, climate or labor market. The data
should help you identify areas where you can improve About This Report
your facility operation.
This year was the second year the Health Care
Readers will see arrows pointing in an upward or Facility Management Benchmarking survey was
downward direction next to several of the percentile conducted in North America. To create this report, a
charts in this report. In many cases the arrow points committee of ASHE, IFMA and CHES volunteers with
toward the lowest cost; however, the organization expertise in environmental services, maintenance and
with the lowest cost may not profess to have the best energy management reviewed questions posed in
practice. There may be a reason why a cost is so low. For Benchmarking 1.0 Health Care Facility Management
example, a hospital building scheduled for demolition Survey and developed new questions to better match
would likely apply minimal resources and thus costs today’s practices. Findings are discussed in the sections
would be lower. that follow.
Using this report is the first step in benchmarking. After
you have identified areas where your facility operations
could be improved, you should conduct additional
research before reengineering the process. One should
not immediately rush to find out which health care
organization is “best in class” and copy their practice.
Instead you should look for a more homogeneous group
in which to compare.

INTRODUCT ION
Methodology
The Operations and Maintenance Benchmarking 2.0 statistic. An example of this can be seen in the sample
for Health Care Facilities survey was developed in size for facilities more than 50 years of age. As a result,
summer of 2012. Based on the Benchmarking 1.0 data for this category of facility age was not reported.
survey questionnaire, modifications were made and Additional calculations were made to determine cost
new questions related to risk management, property, and utility consumption per square meter, square meters
real estate and construction management were added. per FTE and cost per discharge. Utility consumption data
Committee members examined each question to was changed to match the unit specified. The cost data
make sure they were clear, unambiguous, concise with U.S. currency was converted to Canadian dollars by
and relevant. Questions were asked in an objective dividing costs by a factor of 1.01, the currency exchange
fashion in order to obtain responses that were truly rate on Dec. 20, 2012. English measures were converted
representative of industry practices. to metric measures.
The survey was developed through IFMA’s online survey Operations and Maintenance Benchmarking 2.0 for
management system entitled Benchmarks Exchange Health Care Facilities is a self-report survey. All data,
(BEX). In July 2011, IFMA, ASHE, and CHES members including respondent identification, was voluntary. As
received an e-mail directing them to a link to the online with any research, readers should exercise caution when
survey. Respondents were asked to provide information generalizing results and take individual circumstances
on the facilities they manage for a 12-month period of and experiences into consideration when making
time. The majority chose to report the data for calendar decisions based on the data. While IFMA is confident
year 2011. A total of 262 hospitals participated in the in its research, it is important to understand that the
survey during a five-month period. A survey completion results presented in this report represent the sample
rate of 80 percent or above was considered usable, of organizations that chose to supply the requested
yielding 184 surveys being included for analysis – facility information. A confidence level and margin of
compared to 151 in 2009. error provide readers some measure of how much they
To ensure high quality data, highly structured coding can rely on survey responses to represent all IFMA,
and data verification procedures were used. In addition, ASHE and CHES member organizations. Given the level
all variables and values were checked to verify that of response to this survey, we are 95 percent confident
they were within appropriate ranges and inappropriate that responses given by all responding organizations
outliers were corrected or removed. A full statistical can be generalized to all IFMA, ASHE and CHES member
analysis followed, using a professional software package organizations, in general with a margin of error of
called IBM SPSS Statistics. Standardized data analysis approximately +/- 7.0 percent. For example, 40 percent
procedures included reviewing descriptive frequency of the respondents reported that they conducted facility
counts and cross tabulations of responses for variables related customer satisfaction surveys. With a 7 percent
of interest. margin of error for the sample size of 167, the reader
To maintain the real world usability of these research can be 95 percent certain that between 33 percent
findings, statistics are most often provided in terms of and 47 percent of all managers within health care
absolute number of responses, percentages and mean settings collect some type of facility related customer
averages. Percentages may not add to 100 percent due satisfaction data. It is important to note that as the
to rounding or the acceptance of multiple responses. sample size decreases, which occurs in many of the
In many cases, some respondents did not answer all tables, the margin of error increases. For example, a
questions, so the base numbers differ among the findings. smaller sample of 115 increases the margin of error to
Several tables have blanks in lieu of a number because +/- 9 percent.
there were not enough responses to generate a valid

INTRODUCT ION
Definitions for Benchmarking 2.0

for Health Care Facility Management
Adjusted Patient Days BEX Central Mechanical Plant
This figure is used as a way to Benchmarks Exchange is the website A plant that is owned by, and on the
standardize the per unit measure that houses IFMA benchmarking grounds of, a multi-building facility
between hospitals, allowing for more surveys and results. Once a select that provides district heating, district
valid comparisons. Adjusted patient number of surveys have been cooling or electricity to one or more
days is calculated by dividing entered into a database, participants buildings within the same facility.
total charges by inpatient charges, can download customized reports The central physical plant may be by
then multiplying by the number of based on their specific industry, itself in a separate building or may
inpatient days and admissions. facility type, geographic region, be located in a building where other
(Gross Revenue/Inpatient Revenue) facility size and other needs. activities occur.
x Inpatient Patient Days = Adjusted
Patient Days
CAD Climate Zones
Computer-aided design is the use of The U.S. Department of Energy’s
Adjusted Discharges computer technology to assist in the Energy Information Administration
A calculation that adjusts design and especially the drafting issues a Commercial Buildings
the number of discharges (technical drawing and engineering Energy Consumption Survey every
(hospitalizations) to reflect the drawing) of a part or product, few years, which includes five
impact of both inpatient and including entire buildings. It is both climate zones based on its 30-year
outpatient volume. For this report, a visual (or drawing) and symbol- average heating degree days (HDD)
we used adjusted discharges as a based method of communication, the and cooling degree days (CDD) for
means to compare costs. conventions of which are particular the period of 1971 through 2000.
to a specific technical field. Designation of a climate zone serves
(Total Gross Revenue/Inpatient Gross as an indicator of heating and air
Revenue) x Discharges (or days) = CAFM conditioning use.
Adjusted Discharges
Computer-aided facility management Natural Resources Canada’s Office of
AHU – a software program that provides Energy Efficiency (OEE) regionalizes
integration of building design, Canada into four climate zones.
Air Handling Unit – a device used to construction and operational systems. These four zones are based upon an
condition and circulate air as part average number of heating degree
of a heating, ventilating and air- CAM Charges days during a 30-year period.
conditioning system.
Common area maintenance charges
Architectural Design – the amounts charged to tenants
Cooling Heating
for expenses to maintain hallways, Degree Degree
Designing architecture to include restrooms, parking lots and other Climate Zone Days (CDD) Days (HDD)
the planning, designing and common areas. US 1 (coldest) 2,000 < More than
constructing form, space and
7,000
ambience that reflect functional, Canadian Centre for
technical, social, environmental and US 2 2,000 < 5,500 to
Occupational Health and 7,000
aesthetic considerations.
Safety (CCOHS) US 3 2,000 < 4,000 to
Average The CCOHS functions as the primary 5,499
Average is also referred to as the mean national agency in Canada for the US 4 2,000 < 4,000 <
– the sum or total of all responses advancement of safe and healthy
US 5 (warmest) 2,000 or 4,000 <
divided by the number of respondents. workplaces and preventing work- More
related injuries, illnesses and deaths.
CN 1 (coldest) --- > 8000
BAS
CMMS CN 2 --- > 5500 to
Building Automation System uses ≤ 8000
computer-based monitoring to Computerized maintenance and
management system – a software CN 3 --- > 3500 to
coordinate, organize and optimize ≤ 5500
building control sub-systems such as program used to manage the
security, fire/life safety, elevators, etc. operations of a building. CN 4 (warmest) --- ≤ 3500

INTRODUCT ION
Competitive Bid utility systems and generating E-Waste

plants. Furthermore, it should meet
A method to deliver a project based Electronic waste, e-waste, e-scrap,
the current acceptable standards
upon the negotiated terms and or waste electrical and electronic
of construction and comply with
conditions of two parties. equipment, describes discarded
regulatory requirements. Insurance
electrical or electronic devices.
replacement values or book
Construction Management
values should not be used. Current
A method to deliver a project Facility Condition Index (FCI)
replacement value does not include
in which the overall planning, cost of contents. An industry term that describes
coordination and control of a project the process in which professionals
from inception to completion Data Systems Design perform an analysis of the condition
is aimed at meeting a client’s of a group of facilities that may vary
Includes the planning, designing and
requirements through a single in terms of age, design, construction
construction of data-based systems
process. methods and materials. The industry
to support the functional use of
professionals are typically engineers
building space, MEP and electronic
Cooling Degree Day (CDD) of various disciplines and skilled
business needs.
A measure of how warm a location is trade technicians. Architects are
sometimes used as well. This
during a period of time relative to a Deferred Maintenance
base temperature, most commonly analysis can be done by walk-
The total dollar amount of existing through inspection, mathematical
specified as 65 degrees Fahrenheit.
major maintenance repairs and modeling or a combination of both.
The measure is computed for
replacements identified by a The FCI is expressed as a ratio of
each day by subtracting the base
comprehensive facilities condition the cost of remedying existing
temperature (65 degrees) from the
audit of buildings, grounds, fixed deficiencies/requirements, and
average of the day’s high and low
equipment and infrastructure capital renewal requirements to the
temperatures, with negative values
needs. This estimate should not current replacement value.
set equal to zero. Each day’s cooling
include projected maintenance,
degree days are summed to create
a cooling degree day measure
replacement or other types of work Facility Operating Current
such as program improvements or Replacement Value (CRV)
for a specified reference period.
new construction, as these items are
Cooling degree days are used in
considered capital projects.
Index
energy analysis as an indicator of air This indicator represents the
conditioning energy requirements
Design Build level of funding provided for the
or use. (U.S. Department of Energy, stewardship responsibility of an
Energy Information Administration) A method to deliver a project in which
the design and construction services organization’s capital assets. The
indicator is expressed as a ratio
Cost of Operations are contracted by a single entity.
of annual facility maintenance
Annual cost of operations includes operating expenditure to current
Direct Digital Control (DDC)
the total costs associated with the replacement value (CRV). (Asset
day-to-day operation of a facility. It A control system utilizing voltage as Lifecycle Model for Total Cost of
includes all maintenance and repair a power source. Ownership Management, 2005)
costs (both fixed and variable),
administrative costs (clerical, time- Energy Type Facility Management
keeping, general supervision), labor Type of energy mass used to support Facility management is a profession
costs, janitorial, housekeeping and a utility. Includes natural gas, that encompasses multiple
other cleaning costs, utility costs and electricity, steam water and sewer disciplines to ensure functionality
indirect costs (all costs associated (sanitary). Fuel oil includes distillate of the built environment by
with roadways and grounds). fuel oil (Nos. 1, 2 and 4); but this integrating people, place, process
study requested consumption of and technology.
Current Replacement Value fuel oil No. 2.
The total amount of expenditure
in current dollars required to Exterior Gross Area
replace the organization’s facility/ The area of the floor measured to
facilities to its optimal condition the outside face of the walls that
(excluding auxiliary facilities). It enclose the floor(s) of the building.
should include the full replacement (ASTM E1836-08)
cost for all buildings, grounds,

INTRODUCT ION
Full-Time Equivalent Integrated Project Delivery Median

A measurement that standardizes (IPD) The middle value in a range
the mix of part-time and full-time A method to deliver a project in of responses. One-half of all
employees within a fiscal year. The which a collaborative alliance of respondents will be below this value,
measurement reflects the number people, systems, business structures while one-half will have a higher
of people necessary in terms of and practices create a process that value. The median is also known as
full-time status by dividing the total harnesses the talents and insights of all the 50th percentile. The advantage
number of paid hours in a year by a participants to optimize project results. in using the median is that it is not
factor of 2,080 hours. affected as much by extreme highs or
Interior Parking Space lows in the range of values as is the
Gross Square Meter (GSM) case with the mean.
The space used for vehicular parking
The basis used for most calculations that is totally enclosed within the
in this report. N
(occupied) building envelope.
The number of cases supplying the
HVAC Kilowatt Hour (kWh) data being described. It is important
Heating, ventilation and air- to note the size of the sample for
A unit of work or energy measured
conditioning system. the value you are comparing.
as 1 kilowatt (1,000 watts) of power
expended for 1 hour. One kWh is
Heating Degree Day (HDD) Negotiated Contract
equivalent to 3,412 Ltus.
USA: A measure of how cold a A method to deliver a project based
location is during a period of time Major Vertical Penetrations upon the negotiated terms and
relative to a base temperature, conditions of two parties.
Include stairs, elevator shafts, utility
most commonly specified as 65 tunnels, flues, pipe shafts, vertical
degrees Fahrenheit. The measure Occupational Safety and
ducts and their enclosing walls.
is computed for each day by Health Administration
subtracting the average of the Master Planning (OSHA)
day’s high and low temperatures OSHA is an agency of the U.S.
An organization’s process of
from the base temperature (65 Department of Labor. Its mission is
defining its building planning efforts
degrees), with negative values set to assure safe and healthful working
or direction and to support the
equal to zero. Each day’s heating conditions by setting and enforcing
business in making decisions on
degree days are summed to create standards and by providing training,
allocating its resources to pursue
a heating degree day measure for a outreach, education and assistance.
a plan for renovation, relocation or
specified reference period. Heating
construction.
degree days are used in energy PDA
analysis as an indicator of space
Mean Personal digital assistant.
heating energy requirements or use.
(U.S. Department of Energy, Energy See definition for “average.”
Information Administration) Mean and average are used Percentile
interchangeably, and the Indicates dispersion of data. A
Canada: A measure of the severity
interpretation is the same. specific percentile identifies where a
of the weather. One degree day is
counted for every degree that the value lies in relation to other values
Mechanical/Electrical/ in a range of responses. The 25th
average daily temperature is below
the base temperature of 18 degrees Plumbing Design (MEP) percentile is the lower one-fourth
Celsius. For example, if the average MEP includes the planning, point in the range of values in the
temperature on a particular day was designing and constructing of forms group. The 50th percentile, also
12 degrees Celsius, six degree days of utility systems to support the referred to as the median, represents
would be credited to that day. The functional use of building space. a value of which one-half of the
annual total is calculated by simply Generally excludes architectural group falls below and one-half falls
adding the daily totals. (Natural and low voltage, data and above. The median is not affected by
Resource Canada, Office of Energy telecommunication systems. extreme high or low values, whereas
Efficiency) the mean could be distorted.

INTRODUCT ION
Planned Gross Area acquisition, control, accountability, not allowed to leave the power plant
responsibility, maintenance, to perform maintenance outside of
The portion of the floor that is totally
utilization and disposition. the power plant.
enclosed within the interior face
of perimeter encroachments at the
Real Estate Turnkey
floor plane, and where there is no
perimeter encroachments enclosed The business profession of buying, A method to deliver a project that
at the inside finished surface selling or renting land, buildings includes all of the steps involved
of the exterior walls. To obtain or housing. May consist of the land for completion including: the site
plannable gross area, one would and the buildings on it, along with selection, negotiations, space
subtract exterior gross to dominant its natural resources such as crops, planning, construction coordination
portion, excluded areas, interstitial minerals, or water; immovable and complete installation.
areas, restricted headroom areas, property.
interior parking and perimeter Units of Measure
encroachments from exterior gross Repair Maintenance (for the purposes of this survey)
area. (ASTM 1836-08) Work that is performed to put

US Canada
equipment back in service after
Pneumatic a failure to extend life of the Square Feet (SF) Square Meter (SM)
Control system utilizing compressed equipment or to make its operation Cubic yards (cubic Kilograms (kg)
more efficient. (Armstrong, 1996) yds)
air as a power source.
Pounds (lbs) Kilograms (kg)
Preventive Maintenance Site Population Gallons Gallons
Planned actions undertaken to The number of full- and part-time
retain an item at a specified level of employees, contract workers and/
performance by providing repetitive or tenants located at the facility/ UPS
scheduled tasks that prolong facilities.
Uninterruptable power supply.
system operation and a useful life
(inspection, cleaning, lubrication, Stationary Engineers
Workers Compensation
part replacement). (Cotts, Lee, 1992) Licensed personnel (also called
Board of Manitoba (WCB)
licensed engineers) assigned to
Property Management operate a power plant, including WCB is an agency of the Government
The operation, control and oversight the steam and hot water boilers or of Manitoba. It is regarded as an
of real estate involves the processes, a chilled water plant. Some states injury and disability insurance
systems and manpower required to and municipalities require licensed system for workers and employers
manage the life cycle of all acquired engineers on watch 24 hours, seven and is paid for by employers.
property as defined above including: days per week. These individuals are

SEC T ION 1
Facility Description
Institutions Represented
Facility Description
Locations of Hospitals
Hospitals by Region
Climate Zones
Facility Age
Facility Setting
Ownership
Ownership by Institutions
Developed Acres
Days and Hours of Operations
Central Plant
Exterior Gross Area
Adjusted Patient Days and Discharges
Space per FTE
FACILI T Y DESCR IPT ION
Institutions Number of Percentage

Represented Institution
Cases (N) of Sample
Definition
The adjacent chart describes Academic 17 9% Academic or research health care organizations are
the types of institutions that or Research those which are often linked to a medical school and/
Hospital or research facilities.
participated in the benchmarking
study in 2012. With a total of 184 Acute Care 118 64% An institution that is primarily engaged in providing
hospitals responding to this survey, Hospital diagnostic and therapeutic services for medical
diagnosis, treatment and care, by or under the
the distribution of institutions supervision of physicians, to injured, disabled, or sick
represented was skewed toward persons or rehabilitation services for injured, disabled,
large acute care hospitals. or sick persons.
Behavioral 2 1% An outpatient treatment center for psychiatric and

Care Facility mental disorders, Alzheimer’s and developmentally
disabled. Outpatient and psychiatric counseling for
substance abuse patients.
Children’s 9 5% An institution for health care providing patient treat-

Hospital ment by specialized staff and equipment, and often,
but not always, providing for longer-term patient
stays, which offers its services exclusively to children.
Children’s hospitals are characterized by greater
attention to the psychosocial support of children and
their families.
Outpatient 6 3% An outpatient clinic where persons can receive a

Health Care wide range of medical services including diagnostic
Center services, laboratory services and imaging.
Critical Access 9 5% Critical Access Hospitals (CAH) are rural community

Hospital hospitals that receive cost-based reimbursement.
Long-term 8 4% A facility that provides rehabilitative, restorative, and/

Care/Nursing or ongoing skilled nursing care to patients or residents
Home in need of assistance with activities of daily living.
Medical 13 7% A large medical complex that provides a comprehen-

Center sive array of health care services in both outpatient
and inpatient settings.
Rehabilitation 2 1% A recovery facility oriented toward long-term treat-

Center/ ment and training of sick/injured persons so they can
Hospital function in society. Rehabilitation centers specialize in
physical therapy for trauma/stroke victims.
Facility Description N=184

To provide a more accurate 1%
comparison of costs and practices,
respondents were asked to report 8%
on a single building, preferably the
largest or most active.
59% 32%
Space within a building

Multiple buildings in multiple
locations
Multiple buildings in one location
A single building

Number of Heating
Degree Days
Number of Cooling
Degree Days
Regional Climate
Climate Zone N
Zones
US 1 (coldest) 18 More than 7,000 Less than 2,000
Climate and severe weather
US 2 7 5,500 to 7,000 Less than 2,000 shifts can adversely affect
US 3 17 4,000 to 5,499 Less than 2,000 hospitals’ energy consumption
and landscaping costs. For that
US 4 14 Less than 4,000 Less than 2,000 reason, respondents were asked to
US 5 (warmest) 13 Less than 4,000 2,000 or more select the climate zone which best
corresponded to the location of
CN 1 (coldest) 2 More than 8,000
the reported hospital.
CN 2 58 5,501 to 8,000 While Canada accounted for 60
CN 3 47 3,500 to 5,500 percent of the survey results, it is
important to note that the US and
CN 4 (warmest) 8 Less than 3,500
Canada have similar climate zones
for a number of areas represented
by respondents.
The U.S. Department of Energy
(DOE) classifies the United States
into five climate zones, which are
derived by averaging the number
of annual heating and cooling
degree-days in a 30-year period.
Natural Resources Canada’s
Office of Energy Efficiency (OEE)
regionalizes Canada into four
climate zones. These four zones
are based upon an average
number of heating degree-days
during a 30-year period.
58
8
47
United States
18 Zone 1
Zone 2
7 Zone 3
Zone 4
17 Zone 5
14 Canada
Zone 1
Zone 2
13 Zone 3
Zone 4

Facility Age
<5 years 7%
Sixty-eight percent of the facilities
reported in this study were 21-50
N=184
years in age.
5-10 years 10%
11-20 years 11%
21-30 years 32%
31-50 years 36%
>50 years 4%
Facility Setting Central Business District

Secondary Downtown
Suburban Area
Business Park
Rural Area
Academic or Research Hospital 12% 82% 6%
Acute Care Hospital 7% 11% 34% 2% 46%
Behavioral Care Facility 50% 50%
Children’s Hospital 20% 40% 20% 20%
Critical Access Hospital 25% 38% 38%
Long-Term Care/Nursing Home 13% 63% 13% 13%
Medical Center 8% 25% 50% 17%
Outpatient Health Care Center 83% 17%

Ownership (N=184) Ownership

The vast majority of health care
centers are owned, and owner
1% occupied.
2%
77% 20%
Leased, owner occupied with

sublet space to other tenant(s)
Owned, completely leased
Owned, owner occupied with
leased space to tenant(s)
Owned, owner occupied
Leased, owner
Owned,
Owned, owner
Owned,
Ownership
occupied with
sublet space to
completely
leased
occupied with
leased space to
owner
occupied
by Institutions
Institution N other tenant(s) tenant(s)
Academic or 17 6% 12% 29% 53%

Research Hospital
Acute Care Hospital 118 0% 1% 18% 81%
Children’s Hospital 9 0% 0% 33% 67%
Outpatient Health 6 0% 0% 33% 67%

Care Center
Critical Access 9 0% 0% 22% 78%

Hospital
Long-term Care/ 8 12.5% 0% 12.5% 75%

Nursing Home
Medical Center 13 0% 8% 23% 69%
Note: Hospitals with a sample size of less than 5 are not included in the table.
Developed Acres
<5 acres 29%
In this report, the majority of
health care organizations have
5-10 acres 24% land masses of 20 acres (or 8
hectares) or less.
11-20 acres 16%
21-50 acres 22%
>50 acres 9%
N=141
B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013 17

Days and Hours of Institution N Hours/Day Days/Week

Operations Academic or Research Hospital 17 24 7
Acute Care Hospital 118 24 7
Children’s Hospital 9 22 7
Outpatient Health Care Center 6 21 7
Critical Access Hospital 9 24 7
Long-term Care/Nursing Home 8 22 7
Medical Center 13 21 7
Central Plant N=184

The majority in this survey
derived power from a central
mechanical plant.
38%
62%
Decentralized Plant
Centralized Plant

Exterior Gross Area (N=171) Exterior Gross Area

To provide uniformity, all of
the annual costs reported are
divided by exterior gross area.
8% Exterior gross area is defined as
the area of the floor measured
9% to the outside face of the walls
that enclose the floor(s) of the
5% building. For the rest of the
report, square meter is referred to
as gross.
9%
57% Numbers reported vary greatly
based upon the types of services
and supporting departments
12% located within the reporting
health care organization.
Less than 23,225.6 GSM 46,451.2-69,676.7 GSM 92,902.4-185,804.5 GSM

23,225.7-46,451.1 GSM 69,676.8-92,902.3 GSM More than 185,804.5 GSM
GSM GSM/Discharge
Percentile (N=171) Percentile (N=102)
90 151,216.83 90 125.67
75 64,192.77 75 96.41
50 13,656.63 50 56.87
25 6,239.97 25 26.43
10 3,646.97 10 10.30
Mean 52,564.20 Mean 84.89
Facility Size (GSM) N Total Adjusted Patient Discharges

Less than 23,225.6 61 4,068.15
23,225.7-46,451.1 14 19,831.00
46,451.2-69,676.7 10 177,994.90
69,676.8-92,902.3 6 93,116.67
92,902.4-185,804.5 9 99,366.89
More than 185,804.5 9 38,602.00
Overall 109 37,329.30

While the Academic or Research GSM

Hospitals reported the largest Institution N Mean Median
gross square meters, the
Academic or Research Hospital 16 193,998.61 173,082.87
Acute Care Hospitals had the
largest gross square meters per Acute Care Hospital 112 36,849.41 11,043.48
adjusted discharge.
Children’s Hospital 8 79,640.75 60,610.55
Outpatient Health Care Center 5 19,580.73 4,972.69
Critical Access Hospital 9 8,594.02 8,185.06
Long-Term Care/Nursing Home 7 7,967.86 6,688.96
Medical Center 10 77,380.99 49,702.71
GSM/Discharge
Institution N Mean Median
Academic or Research Hospital 11 855.88 662.94
Acute Care Hospital 64 1062.20 618.00
Children’s Hospital 5 541.40 299.39
Critical Access Hospital 7 303.21 297.05
Medical Center 7 699.49 736.99
Note: Hospitals with a sample size of less than 5 are not included in the tables.

Total Adjusted Patient Days (N=122) Adjusted Patient

Days and Discharges
More than 100,000 20% Unlike other industries that rely
exclusively on dollar per square
75,001-100,000
meter as a metric of operational
6%
efficiency, hospitals also use cost
per adjusted discharge and cost
50,001-75,000 8% per adjusted patient day.
Respondents were asked to
25,001-50,000 12% provide adjusted discharges and
adjusted patient days, as these
Less than 25,000
figures help standardize the per
54%
unit measure allowing for more
valid comparisons. Here are the
calculations used for these two
indicators:
Adjusted Patient Days
Total Adjusted Discharges (N=110) (Gross Revenue/Inpatient
Revenue) × Inpatient Patient Days
Adjusted Discharges
More than 30,000 21%
(Total Gross Revenue/Inpatient Gross
Revenue) × Discharges (or days)
20,001-30,000 6%
For this report, adjusted discharges
were used as a denominator for
10,001-20,000 14% costs and other consumption data.
These charts indicate the number
Less than 10,000 59% of Total Adjusted Patient Days and
Total Adjusted Discharges reported
from survey respondents.
SQ Meters per FTE

Percentile AdjustedFTE
Discharges/ Space per FTE
Percentile N=101
Even though hospitals are more
90 75.25 90 87.83 likely to use adjusted patient
days and adjusted discharges as a
75 58.62 75 24.09
means to measure throughput, this
50 44.13 50 11.19 report also includes a space per
person measurement.
25 32.89 25 5.95
This chart indicates the mean
10 23.13 10 4.16
for the number of Adjusted
Mean 48.68 Mean 37.96 Discharges supported per Full
Time Equivalent.

Non-Profit N=184
The majority of the hospitals that
participated in this survey were
For Profit
non-profit organizations.
2%
Non-Profit
98%
Data Centers N=184

Approximately 2/3rds of health
care organizations do not have
on-site data centers.
Yes
33%
No
67%

Facility Parking (N=184) Facility Parking

Surface parking remains by far the
most used type of parking.
Surface lot 92%
Separate structure 24%
Underground building 14%
Is the Maintenance and Operations of this Parking Structure/

Lot Included in Your Departmental Budget? (N=184)
No
30%
Yes
70%

Devoted Area
Area Devoted To N SM
Average square meters reported by
survey respondents for supporting Operating Suites 116 3,427
three questioned areas. Parking Structure(s) 70 35,220
Data Center 51 190
Alternative Power N=184

More than 50 percent of today’s
health care organizations
can operate 100 percent on
alternative power with nearly Can operate on 100% of
55%
100 percent of their facility being alternative power
cooled or heated.
Is air-conditioned/heated 97%

SEC T ION 2
Utilities
Utility Costs
Utility Consumption
Energy Use Index
Building Automation System
UT ILI T IES
Utility Costs
Utility costs are associated with the provision of electrical
power, potable water, central heating and cooling and sewage
service. The utility categories provided were those most
commonly used: electricity, fuel oil, natural gas, chilled water,
steam, water and sewage. About 86 percent of the respondents
reported sewage costs embedded in water costs, as they were
unable to separate the two. The overall utility cost does not
equal the sum of the separate utility costs because of different
sample sizes. Here utility costs are broken out by square meters
and adjusted discharges.
Based on the results for cost per gross square meter (GSM) for
utilities, electricity remained as the biggest contributor to the
total cost of utilities.
Utility Costs by Percentile

$/GSM
Total Natural Chilled Domestic
Percentile Utilities Electricity Fuel Oil #2 Gas Water Steam Water Sewer
90 52.17 35.68 0.69 13.31 24.22 16.39 6.45 4.05
BEST IN CLASS
75 43.27 30.22 0.38 10.84 4.88 13.86 4.73 2.70
50 35.55 24.95 0.15 9.01 2.53 12.74 3.03 1.54
25 25.89 19.24 0.11 6.47 0.82 8.90 1.84 0.98
10 13.38 10.93 0.05 2.53 0.33 2.09 0.60 0.21
Mean 34.29 24.42 0.31 8.59 10.74 11.15 3.42 1.97
N= 169 156 57 144 9 8 146 24
Utility Costs per Discharge by Percentile

$/Discharge
Total Natural Chilled Domestic
Percentile Utilities Electricity Fuel Oil #2 Gas Water Steam Water Sewer
90 478.11 364.37 2.54 136.82 99.09 209.59 52.35 26.20
BEST IN CLASS
75 349.11 249.07 1.40 77.78 33.14 106.18 28.54 17.90
50 187.62 127.55 0.66 42.45 12.15 83.50 15.31 5.11
25 89.30 59.44 0.17 15.20 1.51 14.95 8.40 3.75
10 14.21 16.38 0.12 3.63 0.75 11.28 1.65 1.05
Mean 227.49 163.63 1.08 60.52 31.86 92.43 20.97 10.46
N= 109 97 44 92 10 9 94 18

UT ILI T IES
Presence of a Central Plant Utility costs are affected by a variety of factors including: climate,
region, facility use and the presence of a central plant. These
Central Plant N $/GSM charts show the differences in utility costs for a variety of settings.
Yes 109 35.38 Colder environments have their advantages. According to the
results from this study, organizations with the highest utility
No 62 36.55
costs per gross square meter are in the warmer climate zones.
This is likely due to their higher demands for air conditioning.
Utility Costs by Climate While newer buildings are amongst the lowest in utility costs,
the oldest are also. Middle aged buildings demonstrate a higher
Climate Zone N $/GSM operating costs.
US 1 (coldest) 16 28.14
US 2 7 19.82
US 3 17 32.42
US 4 14 36.68
US 5 (warmest) 10 36.93
CN 1 (coldest) -- --
Utility Costs by Region
CN 2 54 40.14
Region N $/GSM
CN 3 45 32.33
Canada 102 36.20
CN 4 (warmest) 5 28.98
New England -- --
Northeast -- --
Utility Costs by Facility Age Mid-Atlantic 13 35.38
Facility Age N $/GSM Southeast -- --
Less than 5 years 12 31.78 Midwest 6 36.05
5-10 years 15 37.91 North Central 12 24.45
11-15 years 13 37.48 Heartland -- --
16-20 years 6 40.21 South Central 8 42.19
21-30 years 51 33.90 Mountain 5 28.36
31-50 years 64 34.83 Pacific 10 24.35
Utility Costs by Institution
Total Natural Domestic

Institution N Utilities Electricity Fuel Oil #2 Gas Steam Water Sewer
Academic or Research
16 31.96 23.59 0.41 7.48 -- 3.35 --
Hospital
Acute Care Hospital 111 36.65 25.66 0.30 9.18 1.85 3.44 2.08
Children’s Hospital 8 50.43 30.35 0.26 8.04 -- 5.58 --
Critical Access Hospital 9 21.44 17.75 -- 5.90 -- 2.30 --
Long-term Care/
6 21.55 13.25 -- 5.27 -- 3.51 --
Nursing Home
Medical Center 10 27.54 22.69 0.24 8.53 -- 2.89 1.92
Note: Hospitals with a sample size of less than 5 are not included in the table

UT ILI T IES
In 2012, approximately 50 percent Percentage Change in Utility Costs (N=150)

of health care organizations
experienced up to a 10 percent
increase in utility costs. >10.0% 12%
5.1-10.0% 17%
0.1%-5.0% 37%
0 3%
-0.1-5.0% 15%
-5.1-10.0% 9%
<-10.0% 7%
The number one contributor to Utility Budget Impacted By (N=184)

changes in utility costs was driven
by rate changes.
Change in Rates 92%
Change in Number of Units Consumed 67%
Expanding Total Space 15%
Implementing Energy Management Practices 18%
Implementing Sustainable Energy Practices 13%
Reducing Total Space 2%
Other 9%

UT ILI T IES
Utility Consumption
The tables below capture
consumption data for electricity,
fuel oil, gas, water and sewage.
Electricity, domestic water, and
sewage were key contributors
to the overall utility intensity in
health care.
The average number of
kilowatt hours (KWH) per
patient discharge is 1,829.04
KWH. Based upon the average
number of KWH used per day
(30.16 KWH) in US homes as
provided by the US Energy
Information Association, each
patient discharge is equal
to more than two months of
electricity in our homes.
Annual Utility Consumption by Percentile

Annual Consumption/GSM
Electricity Fuel Oil #2 Natural Gas Chilled Water Steam Domestic Water Sewage
Percentile kWh Gallons Therms Ton Hours M-LBS Gallons Gallons
90 368.33 0.19 25.21 342.67 3.71 767.03 718.49
75 311.45 0.12 21.25 24.66 1.75 567.36 587.82
50 261.85 0.05 16.54 3.89 1.11 379.62 314.99
25 199.70 0.03 10.10 0.02 0.75 205.07 57.36
10 126.80 0.01 1.62 0 0.02 24.92 0.98
Mean 254.07 0.08 15.55 74.02 35.24 413.32 378.04
N= 146 49 137 12 12 141 26
Annual Utility Consumption per Discharge by Percentile

Annual Consumption/Discharge
Electricity Fuel Oil #2 Natural Gas Chilled Water Steam Domestic Water Sewage
Percentile kWh Gallons Therms Ton Hours M-LBS Gallons Gallons
90 3380.40 0.72 190.72 898.47 838.84 5583.76 4106.94
75 2455.43 0.42 126.17 307.84 12.36 3724.04 2403.96
50 1463.77 0.19 62.59 4.71 5.53 1889.20 671.46
25 827.56 0.05 22.31 0.12 1.63 671.99 51.35
10 368.04 0.03 1.41 0.0009 0.73 33.03 8.58
Mean 1829.04 0.28 92.30 295.29 463.20 2529.97 1559.70
N= 94 41 89 9 9 90 23
B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013 29

UT ILI T IES
Energy Use Index Gas & Electric EUI by Percentile

Consumption for electricity and Electricity Gas
gas can also be measured using Percentile kBtus/GSM KBtus/GSM
an Energy Use Index (EUI). To 90 1,258 2,523
derive the EUI for electricity,
75 1,064 2,126
kilowatt hours are multiplied
by a conversion factor of 3.415 50 894 1,655
creating kBtus. The new number is
25 682 1,011
divided by gross square meters. To
calculate the EUI for natural gas, 10 433 163
therms (100 CF) are multiplied by a
Mean 868 1,557
factor of 100 and divided by gross
square meters. N= 146 137
Gas & Electric EUI by Institution

Electricity Gas
Institution N KBtus/GSM KBtus/GSM
Academic or Research Hospital 14 892 942
Acute Care Hospital 103 866 1,810
Critical Access Hospital 6 790 1,026
Long-Term Care/Nursing Home 5 633 748
Medical Center 6 927 859
Gas & Electric EUI by Climate

Electricity Gas
Climate Zone N KBtus/GSM KBtus/GSM
US 1 (coldest) 12 899 1,198
US 2 4 -- --
US 3 15 967 921
US 4 13 1,055 1,437
US 5 (warmest) 4 -- --
CN 1 (coldest) -- -- --
CN 2 51 928 2,141
CN 3 41 743 1,551
CN 4 (warmest) 5 661 1,073

UT ILI T IES
Given the double digit increases

in utility rates, maximizing energy
efficiency is a priority within
the health care sector. Here are
some of the ways in which survey
respondents have reduced their
utility usage. “Replaced existing
light fixtures with new lights” and
“retrofitted existing light fixtures”
remained the top two choices for
energy efficiency in this survey.
In general, hospitals with a larger
Utility Conservation Practices facility size were more likely to
% have sustainability or energy
Practices N=184 management programs than those
with a smaller facility size.
Replaced existing light fixtures with new lights 68%
Retrofitted existing light fixtures 61%
Installed energy-efficient motors 32%
Installed occupancy sensors 35%
Set back thermostat 20%
Installed energy management system 17%
Installed energy-efficient chillers 22%
Installed energy-efficient ventilation equipment 16%
Installed energy-efficient heating equipment 16%
Recommissioned building systems 15%
Energy-efficient plumbing fixtures 22%
Energy-efficient windows 10%
Improved building shell insulation 4%
Retrofitted building envelope 3%
Adjusted HVAC operating hours 41%
HVAC flow reduction strategies 20%
Other 12%
Energy management
Have Sustainability or
program overseen by a
Facility Size (GSM) N Energy Management Program? Facility Size (GSM) N formal green team?
Less than 23,225.6 97 20% Less than 23,225.6 19 26%
23,225.7-46,451.1 21 33% 23,225.7-46,451.1 7 57%
46,451.2-69,676.7 15 53% 46,451.2-69,676.7 8 38%
69,676.8-92,902.3 9 44% 69,676.8-92,902.3 4 60%
92,902.4-185,804.5 16 75% 92,902.4-185,804.5 12 50%
More than 185,804.5 12 75% More than 185,804.5 9 56%
Overall 170 35% Overall 59 44%

UT ILI T IES
Building Automation BAS Usage

System Facility Size (GSM) N BAS Used
Forty-seven percent of the Less than 23,225.6 66 21%
hospitals managed their utilities
using a Building Automation 23,225.7-46,451.1 27 41%
System (BAS) in this survey. 46,451.2-69,676.7 25 68%
The majority of the hospitals in 69,676.8-92,902.3 24 71%
this study reported using Direct
Digital Control (DDC) technology. 92,902.4-185,804.5 28 71%
Overall 170 47%
Type of BAS Used

%
BAS Type N=85
Pneumatic 36%
Direct Digital Control (DDC) 62%
Direct Digital Control (DDC)/Pneumatic Retrofit 48%
Does your BAS trend utility Does your BAS serve as a single
utilization and provide energy integrated system
Facility Size (GSM) N management summary reports? Facility Size (GSM) N for multiple buildings?
Less than 23,225.6 27 22% Less than 23,225.6 27 48%
23,225.7-46,451.1 13 38% 23,225.7-46,451.1 14 43%
46,451.2-69,676.7 11 36% 46,451.2-69,676.7 11 73%
69,676.8-92,902.3 6 17% 69,676.8-92,902.3 6 83%
92,902.4-185,804.5 12 58% 92,902.4-185,804.5 12 83%
More than 185,804.5 8 50% More than 185,804.5 8 63%
Overall 77 35% Overall 78 60%
Does your BAS have the ability

to compare multiple building
energy performances
Facility Size (GSM) N with one another?
Less than 23,225.6 27 4%
23,225.7-46,451.1 14 29%
46,451.2-69,676.7 11 9%
69,676.8-92,902.3 6 17%
92,902.4-185,804.5 12 42%
More than 185,804.5 8 63%
Overall 78 22%

SEC T ION 3
Maintenance
Maintenance Categories
Maintenance Costs
Roads and Grounds
Facility Operating Current Replacement
Value (CRV) Index
Maintenance Tracking
Maintenance Management System Used
Maintenance Staffing
Maintenance Management
Administrative Support
Total Maintenance Staff
Service Provision
MA INTENANCE
Maintenance Categories
The survey divided maintenance costs into five distinct categories which are defined below.
External Building Maintenance Utility/Central System Maintenance

• Roof • Electrical (generation/distribution)
• Skin (siding, masonry, sash, glazing, window • Mechanical (steam, hot and cold water systems)
washing, external doors)
• Exterior signage Process Treatment and Environmental
Systems
Interior Systems Maintenance • Process cooling water systems
• Electrical systems (primary and secondary • Process gas systems
systems, emergency electrical systems, UPS,
• Air discharge scrubbers
lighting systems, egress signage, master clocks,
fire/life safety systems, alarms and remote • Waste water systems
monitoring, elevator maintenance/repair) • Water treatment plants
• Mechanical systems (HVAC, chillers, boilers, • Incinerator operation
plumbing, extinguishing systems, back flow
prevention, refrigeration and non-process related • Solid waste management system
pumps)
• Building and general maintenance (interior walls,
doors, ceilings, partitions and interior finishes,
pest control)
• Interior signage
• Administrative support services
• Trouble desks
Roads and Grounds Maintenance

• Roadways, sidewalks, parking lots (paving repairs,
sealing, striping, parking, roadway lighting, power
washing), snow removal, de-icing
• Landscaping (planting, mowing, irrigation)
• Parking structures (surface repairs, sealing,
striping, lighting and drainage systems)
• Storm sewers (catch basins, manholes, sub-
surface drainage systems)
• Underground fire systems and hydrants

MA INTENANCE
Maintenance Costs
Annual maintenance costs, also broken out by square meters
and adjusted discharges, include all repair, preventive, materials,
direct labor and contract costs. Similar to the utility cost data, the
costs listed in the “Total Maintenance” column do not equal the
sum of the component costs due to the different sample sizes
for each category.
With regards to total maintenance expenses, the average mean
was $54.25 Canadian dollars per gross square meter with 45
percent being spent on interior systems.
On a cost per patient discharge, only an average of 35 percent
was spent on interior systems.
Maintenance Costs by Percentile

$/GSM
Process
Treatment and
Total External Interior Roads and Utility/Central Environmental
Percentile Maintenance Building Systems Grounds Systems Systems
90 96.45 3.57 43.55 6.80 15.19 1.68
BEST IN CLASS
75 78.18 2.20 34.38 4.87 5.98 1.05
50 51.33 1.01 24.05 2.79 2.73 0.59
25 29.94 0.63 8.26 1.34 1.28 0.24
10 14.91 0.29 4.06 0.98 0.82 0.11
Mean 54.25 1.52 24.43 3.44 5.41 0.76
N= 140 47 56 58 34 36
Maintenance Costs per Discharge by Percentile

$/Discharge
Process
Treatment and
Total External Interior Roads and Utility/Central Environmental
Percentile Maintenance Building Systems Grounds Systems Systems
90 612.56 13.67 223.61 30.11 83.96 8.81
BEST IN CLASS
75 451.93 8.43 154.68 14.92 36.06 4.93
50 231.63 2.82 77.37 8.40 10.10 1.18
25 81.23 1.78 24.39 4.33 3.16 0.56
10 24.62 1.14 9.49 2.54 1.34 0.30
Mean 287.68 6.11 100.78 12.32 25.49 5.70
N= 82 35 43 44 27 31

MA INTENANCE
Maintenance Costs Maintenance Costs by Region

Region N $/GSM
Canada 83 59.15
New England -- --
Northeast -- --
Mid-Atlantic 13 39.82
Southeast -- --
Midwest 5 42.16
North Central 10 50.82
Heartland -- --
South Central 7 25.51
Mountain -- --
Pacific 8 54.61
Maintenance Costs by Institution

$/GSM
Process
Utility/ Treatment and
Total External Interior Roads and Central Environmental
Institution N Maintenance Building Systems Grounds Systems Systems
Academic
or Research 13 39.37 1.18 28.25 2.88 8.90 0.65
Hospital
Acute Care
89 59.36 1.80 24.89 3.48 6.03 0.70
Hospital
Long-Term
Care/Nursing 7 36.20 1.93 26.95 4.18 -- --
Home
Medical Center 9 43.13 0.74 -- 1.89 1.57 0.62
This survey indicates that % Target planned % Target demand

demand maintenance, repairs, Facility Age N maintenance maintenance
and breakdown maintenance
Less than 5 years 11 77% 23%
increase as a building ages. This
is consistent with increases in 5-10 16 64% 36%
the total costs of utilities as a
11-15 13 58% 42%
building ages.
16-20 8 60% 40%
21-30 57 56% 44%
31-50 62 53% 47%

MA INTENANCE
% Repair/ Maintenance Costs

% Preventive Breakdown
Age of Facility N $/GSM Maintenance Maintenance
Less than
10 43.98 70% 30%
5 years
5-10 14 43.03 58% 42%
11-15 12 53.65 53% 47%
16-20 6 54.71 41% 59%
21-30 45 54.29 47% 53%
31-50 48 57.37 45% 55%
% Preventive % Repair/Breakdown
Facility Age N Maintenance/Discharge Maintenance/Discharge
Less than 5 years 10 0.02% 0.01%
5-10 10 0.02% 0.02%
11-15 11 0.01% 0.01%
16-20 5 0.02% 0.03%
21-30 25 0.09% 0.08%
31-50 38 0.04% 0.07%
Annual Year’s Net Depreciated

Facility Size (GSM) N Depreciation Expense ($) Facility Size (GSM) N Plant and Equipment ($)
Less than 23,225.6 22 1,557,831.19 Less than 23,225.6 19 8,213,987.55
23,225.7-46,451.1 10 3,671,396.22 23,225.7-46,451.1 10 22,716,205.12
46,451.2-69,676.7 5 6,552,576.57 46,451.2-69,676.7 4 36,838,395.33
69,676.8-92,902.3 2 6,856,415.75 69,676.8-92,902.3 1 46,862,998.00
92,902.4-185,804.5 8 17,801,178.84 92,902.4-185,804.5 8 168,393,602.16
More than 185,804.5 4 57,324,842.21 More than 185,804.5 3 534,400,622.60
Overall 51 9,591,583.57 Overall 45 79,436,846.17

MA INTENANCE
Roads and Grounds $/Developed Acre $/Developed Hectare

Percentile N=48 N=48
The maintenance of roads,
grounds, parking surfaces and 90 15,477 38,244
structures are also represented 75 9,332 23,060
as dollar per developed acre
or hectare. Snow or lack 50 4,725 11,676
thereof, impacts the cost of 25 2,129 5,261
maintaining roads and grounds
as demonstrated by the climate 10 1,064 2,629
zone chart. Mean 6,493 16,045
Institution $/Developed Acre $/Developed Hectare

Academic or Research Hospital 10,654 26,327
Acute Care Hospital 6,424 15,874
Long-Term Care/Nursing Home 6,244 15,429
Note: Hospitals with a sample size of less than 5 are not included in the table..
Facility Use $/Developed Acre $/Developed Hectare

Single Building 6,065 14,987
Multiple buildings, one location 6,511 16,089
Multiple buildings, multiple sites 7,663 18,936
Note: “Space within a building” is not included in the table because the sample size is less than 5.
Facility Setting $/Developed Acre $/Developed Hectare

Central business district 9,415 23,265
Secondary downtown location 7,837 19,366
Suburban area 6,360 15,716
Rural area 4,006 9,899
Note: Business Park is not included in the table because the sample size is less than 5.
Climate Zone $/Developed Acre $/Developed Hectare

US 1 (coldest) 5,579 13,786
US 2 6,758 16,699
US 3 7,708 19,047
US 4 3,830 9,464
US 5 (warmest) 2,430 6,005
CN 1 (coldest) -- --
CN 2 8,655 21,387
CN 3 8,691 21,476
US 4 (warmest) 6,796 16,793

MA INTENANCE
CRV Index % Facility Operating

Percentile N=52
Current Replacement
90 1.92
Value (CRV) Index
75 1.50
The CRV index represents the level
50 1.20 of funding provided for maintaining
an organization’s portfolio of capital
25 0.89
assets. This percentage is derived by
10 0.51 dividing total annual maintenance
by current replacement value and
Mean 1.25
multiplying 100. The 1990 National
Research Council report Committing
to the Cost of Ownership: The
Maintenance and Repair of Public
Buildings recommends a budget
allocation for routine maintenance
and repair to be in the 2 percent to
4 percent range of aggregate current
replacement value.
How Do Customers Request Work? (N=184) Maintenance

Tracking
Send request electronically 61% It is clear that facilities departments
are getting their primary number of
work requests electronically, which
Contact a call center or help desk 40% can include email. Direct telephone
communication also ranks as a key
means of obtaining work requests.
Personally tell maintenance personnel 38%
Fill out a paper request 35%
Contact the individual FM function needed 16%
Other 2%

MA INTENANCE
Maintenance Percentage
Management Maintenance Productivity Data Collected N=184
System Used Response time for work requests 31%

In this chart are key productivity Percentage of work orders closed on time 39%
measures being collected by
facilities departments. Staffing Cost per square meter 38%
levels and the backlog of Number of service complaints 26%
corrective work remain as top
focus points. Maintenance staffing per square meter 55%
Percentage of budget spent on breakdown (unplanned) maintenance 12%
Corrective backlog and PM completion 55%

MA INTENANCE
Respondents were asked to complete a detailed worksheet
indicating the number of workers employed or contracted in
the respective hospital operation. The worksheet was split into
three categories: maintenance workforce (trades), maintenance
management and administrative support. Custodial workers and
groundskeeping staff were not included in this maintenance
headcount. The data provided shows the number of FTEs based
upon facility size, provision of labor, and number of shifts
and days worked. Variation swings may be explained by cross
training of different trades.
Electricians
Number of Number of
Facility Size (GSM) N Number of FTEs % In-house % Contract shifts per day days per week
Less than 23,225.6 23 1.05 87% 13% 1.0 4.5
23,225.7-46,451.1 18 1.51 94% 6% 1.2 5.0
46,451.2-69,676.7 10 3.20 91% 9% 1.3 5.3
69,676.8-92,902.3 7 2.21 86% 14% 1.3 5.0
92,902.4-185,804.5 11 4.45 97% 3% 1.3 5.2
More than 185,804.5 10 8.18 100% 0% 1.4 5.3
Plumbers
Number of Number of
Less than 23,225.6 13 0.80 95% 5% 1.2 4.8
23,225.7-46,451.1 15 1.05 100% 0% 1.1 4.9
46,451.2-69,676.7 6 1.90 100% 0% 1.4 5.8
69,676.8-92,902.3 7 1.64 86% 14% 1.1 5.0
92,902.4-185,804.5 11 3.18 100% 0% 1.3 5.2
More than 185,804.5 9 6.78 100% 0% 1.3 5.3
Controls & Low Voltage

Number of Number of
Less than 23,225.6 8 0.61 81% 19% 0.9 4.1
23,225.7-46,451.1 5 0.82 100% 0% 1.0 5.0
46,451.2-69,676.7 3 0.87 100% 0% 1.0 5.0
69,676.8-92,902.3 3 1.70 67% 33% 1.0 3.7
92,902.4-185,804.5 7 2.71 86% 14% 1.0 5.0
More than 185,804.5 6 3.95 83% 17% 1.0 4.2

MA INTENANCE
HVAC & Central Plant Operators

Number of Number of
Less than 23,225.6 21 1.04 89% 11% 1.2 4.6
23,225.7-46,451.1 14 2.27 100% 0% 1.4 4.8
46,451.2-69,676.7 10 2.23 99% 1% 1.5 5.5
69,676.8-92,902.3 5 5.12 100% 0% 2.3 6.5
92,902.4-185,804.5 8 7.38 100% 0% 1.7 6.0
More than 185,804.5 9 8.51 89% 11% 1.7 5.6
Stationery Engineers
Number of Number of
Less than 23,225.6 11 1.59 100% 0% 1.7 5.6
23,225.7-46,451.1 11 3.57 100% 0% 1.3 5.8
46,451.2-69,676.7 7 6.57 100% 0% 2.3 6.5
69,676.8-92,902.3 4 7.24 100% 0% 2.4 6.2
92,902.4-185,804.5 11 11.64 100% 0% 2.2 6.6
More than 185,804.5 8 11.00 100% 0% 2.4 7.0
Carpenters
Number of Number of
Less than 23,225.6 11 0.84 90% 10% 1.1 4.2
23,225.7-46,451.1 11 1.57 100% 0% 1.0 4.9
46,451.2-69,676.7 7 2.08 83% 17% 1.2 5.3
69,676.8-92,902.3 5 1.80 100% 0% 1.0 5.0
92,902.4-185,804.5 8 2.88 100% 0% 1.0 5.0
More than 185,804.5 9 5.14 100% 0% 1.0 5.0

MA INTENANCE
Locksmiths
Number of Number of
Less than 23,225.6 4 0.42 71% 29% 1.0 5.0
23,225.7-46,451.1 5 0.59 80% 20% 1.0 5.0
46,451.2-69,676.7 6 0.89 80% 20% 1.2 5.8
69,676.8-92,902.3 6 1.00 100% 0% 1.0 5.0
92,902.4-185,804.5 4 1.40 100% 0% 1.0 4.5
More than 185,804.5 9 1.67 100% 0% 1.0 5.0
Painters
Number of Number of
Less than 23,225.6 10 0.77 95% 5% 1.1 3.9
23,225.7-46,451.1 9 0.91 89% 11% 1.0 5.0
46,451.2-69,676.7 6 1.46 84% 16% 1.25 5.0
69,676.8-92,902.3 6 2.00 92% 8% 1.2 5.0
92,902.4-185,804.5 9 2.00 100% 0% 1.0 5.0
More than 185,804.5 11 4.18 100% 0% 1.3 5.1
Generalists
Number of Number of
Less than 23,225.6 76 2.39 99% 1% 1.2 5.1
23,225.7-46,451.1 14 4.96 100% 0% 1.3 5.4
46,451.2-69,676.7 12 4.80 99% 1% 1.9 5.9
69,676.8-92,902.3 5 7.80 100% 0% 1.8 5.8
92,902.4-185,804.5 8 18.05 100% 0% 1.9 6.1
More than 185,804.5 7 10.86 100% 0% 1.7 6.0

MA INTENANCE
Maintenance Management
Group Supervisor
% Exempt % Non-exempt
Facility Size (GSM) N Number of FTEs % In-house % Contract (Salaried) (Hourly)
Less than 23,225.6 16 0.72 94% 6% 69% 31%
23,225.7-46,451.1 12 1.10 92% 8% 69% 31%
46,451.2-69,676.7 9 3.67 100% 0% 38% 62%
69,676.8-92,902.3 6 1.67 100% 0% 71% 29%
92,902.4-185,804.5 11 2.45 100% 0% 57% 43%
More than 185,804.5 11 4.64 100% 0% 30% 70%
Operations and Maintenance Manager

% Exempt % Non-exempt
Facility Size (GSM) N Number of FTEs % In-house % Contract (Salaried) (Hourly)
Less than 23,225.6 65 0.47 98% 2% 94% 6%
23,225.7-46,451.1 19 0.97 95% 5% 100% 0%
46,451.2-69,676.7 12 1.29 100% 0% 100% 0%
69,676.8-92,902.3 5 1.77 100% 0% 100% 0%
92,902.4-185,804.5 12 2.50 100% 0% 92% 8%
More than 185,804.5 11 3.95 100% 0% 90% 10%
Administrative Support
Help Desk Administrative Assistant
Facility % % Facility % %
Size (GSM) N # of FTEs In-house Contract Size (GSM) N # of FTEs In-house Contract
Less than Less than
7 1.00 83% 17% 37 0.41 97% 3%
23,225.6 23,225.6
23,225.7- 23,225.7-
3 2.00 95% 5% 17 1.01 97% 3%
46,451.1 46,451.1
46,451.2- 46,451.2-
6 1.67 83% 17% 9 0.91 92% 8%
69,676.7 69,676.7
69,676.8- 69,676.8-
6 1.00 100% 0% 5 1.20 100% 0%
92,902.3 92,902.3
92,902.4- 92,902.4-
7 4.41 100% 0% 12 1.90 97% 3%
185,804.5 185,804.5
More than More than

9 2.78 98% 2% 11 3.97 100% 0%
185,804.5 185,804.5

MA INTENANCE
Total Maintenance Staff by Facility Size Total Maintenance

Facility Size (GSM) N # of FTEs Staff
Less than 23,225.6 94 4.12 Because of the different
sample sizes for each type of
23,225.7-46,451.1 20 14.59 maintenance staff, the total
46,451.2-69,676.7 14 19.73 maintenance staff does not equal
to the sum of the numbers of all
69,676.8-92,902.3 8 26.00 maintenance staffing categories.
92,902.4-185,804.5 15 46.42 Hospitals with a facility size of
More than 185,804.5 11 83.50
less than 23,225.6 GSM reported
0.005 maintenance staff per
adjusted discharge, the highest
number among all hospitals of
Total Maintenance Staff per Discharge by Facility Size different facility sizes.
While the critical access
Facility Size (GSM) N Total Maintenance Staff/Discharge hospitals had the lowest
Less than 23,225.6 59 0.005 number of maintenance staff
per adjusted discharge (i.e.,
23,225.7-46,451.1 13 0.002
0.001), Acute Care Hospitals
46,451.2-69,676.7 9 0.001 reported the highest number of
maintenance staff per adjusted
69,676.8-92,902.3 5 0.001
discharge. This variation may be
92,902.4-185,804.5 8 0.001 due to the number of reporting
organizations that were Acute
More than 185,804.5 9 0.002
Care Hospitals, representing
nearly 70% of the data sampled.
Total Maintenance Staff by Institution Type

Institution N # of FTEs
Academic or Research Hospital 15 63.05
Acute Care Hospital 113 11.75
Children’s Hospital 9 26.64
Critical Access Hospital 8 4.77
Long-term Care/Nursing Home 8 3.23
Medical Center 13 26.69
Total Maintenance Staff per Discharge by Institution Type

Institution N Total Maintenance Staff/Discharge
Academic or Research Hospital 11 0.002
Acute Care Hospital 66 0.004
Children’s Hospital 6 0.002
Critical Access Hospital 6 0.001
Medical Center 7 0.002

MA INTENANCE
Service Provision
The majority of the study
respondents (80 percent) rely on
a separate department such as
biomedical or clinical engineering
to handle maintenance for
medical equipment.
Medical Equipment Management Performed By (N=167)
In-house, separate biomedical or clinical

80%
engineering department
In-house, part of facilities operations

4%
Contracted (not included in the facilities

10%
operations budget)
Contracted (part of facilities operations)

5%

SEC T ION 4
Environmental Services
Environmental Services Costs
Environmental Services Staffing
Contractor Practices
ENV IRONMENTAL SERV ICES
Environmental Environmental Services Costs by Percentile

Services Costs Percentile $/GSM $/Discharge
Environmental services costs 90 88.60 722
BEST IN CLASS
are the costs associated
with the cleaning of patient 75 62.36 329
rooms, offices and work areas, 50 47.91 159
restrooms and common support
space. Also included in this 25 28.58 81
cost are wages, benefits, 10 19.65 32
staff support, supervision,
administration, supplies, Mean 53.44 273
paper goods and non-capital N= 77 62
equipment. Labor is the major
component of the cost, therefore
any change in wages can affect
the overall cost significantly.
Environmental Services Costs by Staff or Contract

Environmental
Services Performed by: N $/GSM $/Discharge
In-house staff 60 56.52 259
Contracted service 5 43.77 196
Combination by both 12 42.39 256
Environmental Services Costs by Institution Type

Institution N $/GSM $/Discharge
Academic or Research Hospital 13 49.30 364.20
Acute Care 32 53.33 210.23
Children’s Hospital 5 36.65 282.28
Critical Access Hospital 8 27.94 85.87
Long-Term Care/Nursing Home 6 84.89 --
Medical Center 7 49.72 270.44

Environmental Services Costs by Facility Age Environmental

Facility Age N $/GSM $/Discharge Services Costs
Less than 5 years 11 71.08 231 Unlike the cost of maintenance
and utilities, the cost of
5-10 10 54.93 279 Environmental Services falls as
11-20 12 54.82 193 the building ages.
21-30 15 48.23 398
31-50 25 43.77 293
Environmental Services Costs by Region

Country/Region N $/GSM $/Discharge
Canada 24 61.62 424
Mid-Atlantic 12 57.69 322
Midwest 5 24.22 --
North Central 11 34.63 134
Mountain 5 55.46 155
Pacific 8 77.34 125
Note: Regions with a sample size of less than 5 are not included in the table.

Environmental Labor 46%

Services Cost
Although labor is a major
Cleaning Supplies/Paper Products 6%
component of the environmental
services cost, it only accounted
for 46 percent of the total cost in Supervisors/Staff Support 3%
this survey.
The second major component of Day-porters/Matrons 3%
the total cost fell into the “other”
category. This may be contracted
services, capital equipment, or Non-Capital Equipment 2%
sustainability activities.
(Note: respondents were not Other 40%
asked to specify, “other”)
N=174
Environmental Number of
Services Staffing Facility Size (GSM) N
Number of Environmental
Services FTEs
In-House Employees
Supervising Contract
Eighty-two percent of the Less than 23,225.6 32 11.20 1.0
institutions represented in this
study hired predominantly in- 23,225.7-46,451.1 15 34.30 1.1
house employees to staff the 46,451.2-69,676.7 9 53.41 1.0
environmental services function.
Nine percent used contracted 69,676.8-92,902.3 5 91.34 --
staff to perform this function, 92,902.4-185,804.5 8 140.83 2.0
and another 9 percent used a
combination of both. More than 185,804.5 10 211.42 1.5
Number of Environmental
Services FTEs/Discharge
Facility Size (GSM) N Mean
Less than 23,225.6 25 0.008
23,225.7-46,451.1 11 0.003
46,451.2-69,676.7 7 0.003
69,676.8-92,902.3 5 0.005
92,902.4-185,804.5 6 0.005
More than 185,804.5 9 0.006
Note: Results for the number of in-house employees supervising contract per adjusted discharge
are not reported because the sample size is less than 5 for all facility size categories.

Terms of Contract (N=19) Contractor Practices

When contracted, health care
organizations are mixed in terms
of paying for performance or
based upon tasks and frequencies.
Health care organizations who
choose to contract out services
tend to stay with a contractor for
58% 42% longer terms.
Tasks and frequencies

Performance based
Contractor Provides (N=31)
Background Checks 48%
Supplies 45%
Equipment 39%
Paper Products 35%
Number of Years Contract has been in Place (N=18)
22% 22%
11%
11+ years
34%
11% 6-10 years
5 years
3-4 years
Less than 3 years

SEC T ION 5
Waste
WA STE
Waste Utilization
Waste management has become
increasingly important, as waste
is often viewed as a measurement
of overall business performance.
The ability to manage and reduce
waste impacts the bottom line.
Cost per Pound

$/KG
Hazardous Hazardous
Waste Waste
Solid Infectious (Non-Pharma- (Pharmaceu- Chemo Compost Recyclables
Percentile Waste Waste ceutical) tical) Waste and Food (co-mingled) E-Waste
90 0.35 3.63 15.68 14.14 8.73 2.26 0.33 1.65

BEST IN CLASS
75 0.24 1.67 3.60 6.91 5.34 0.17 0.17 1.19
50 0.15 0.89 1.80 3.26 1.17 0.13 0.11 0.65
25 0.11 0.72 1.09 0.93 0.61 0.11 0.04 0.46
10 0.07 0.46 0.46 0.74 0.56 0.09 0.02 0.30
Mean 0.20 1.45 5.21 5.97 3.71 0.83 0.15 0.89
N= 34 23 25 25 10 6 14 7
Cost per Adjusted Discharge

$/Discharge
Hazardous Hazardous
Waste Waste
Solid Infectious (Non-Pharma- (Pharmaceu- Chemo Compost Recyclables
Percentile Waste Waste ceutical) tical) Waste and Food (co-mingled) E-Waste
90 16.90 13.46 5.27 6.57 1.12 2.10 4.08 1.47

BEST IN CLASS
75 8.44 6.29 3.42 3.19 0.87 1.24 2.23 0.53
50 5.28 1.98 1.61 0.94 0.20 0.66 0.99 0.14
25 1.72 0.70 0.63 0.40 0.07 0.29 0.15 0.04
10 0.78 0.26 0.28 0.21 0.03 0.27 0.09 0.02
Mean 8.15 4.58 2.30 2.20 0.53 1.00 1.71 0.44
N= 42 26 26 27 14 7 14 8

SEC T ION 6
Linen Services
LINEN SERV ICES
Is Linen Processed and Laundered at this Facility? (N=172) Linen Processed

Health care organizations by far
contract out laundry services.
The table below shows annual
linen processing cost by kilograms
and by adjusted discharges.
Yes
33%
No
67%
Annual Linen Processing Costs
Percentile $/KG $/Discharge

90 2.19 225.04
BEST IN CLASS
75 1.85 197.40
50 1.41 131.27
25 1.11 48.36
10 0.80 18.75
Mean 1.45 127.32
N= 37 34

SEC T ION 7
Operations
Cost of Operations
Customer Satisfaction
Productivity Measure
OPER AT IONS
Cost of Facility Operations by Percentile Cost of Facility

Percentile $/GSM $/Discharge $/FTE
Operations
Combining the utility, maintenance
90 166.90 1,287.05 8,440
and environmental services
75 129.30 822.17 6,495 costs together will provide a
facility’s cost of operations,
50 101.57 537.92 4,616
another indicator of performance.
25 60.34 231.95 3,085 These annual costs are broken
out by square meters, adjusted
10 34.53 63.17 1,445
discharges and FTEs.
Mean 102.42 599.11 4,930
N= 170 109 100
Cost of Facility Operations by Institution

Outpatient health care centers
Institution N $/GSM $/Discharge $/FTE and long-term care/nursing homes
rank amongst the highest. The
Academic or Research
Hospital
16 104.01 765.91 4,496 total cost of operations is much
lower for critical access hospitals.
Acute Care Hospital 111 99.65 572.46 5,266
Children’s Hospital 8 116.33 585.29 5,309
Outpatient Health Care

5 141.09 620.82 4,757
Center
Critical Access Hospital 9 74.37 221.09 2,760
Long-term Care/Nursing
7 127.49 -- 7,368
Home
Medical Center 10 101.14 562.59 3,495

OPER AT IONS
Customer Satisfaction Conduct Satisfaction Surveys? (N=167)
Only 40 percent of those surveyed

conduct customer satisfaction
surveys, the vast majority are
doing them yearly using web
based tools.
Yes
40%
No
60%
Satisfaction Surveys: If Yes, How Often? (N=66)
2%
9%
9%
11%
69%
Daily
Weekly
Monthly
Quarterly
Yearly
Survey Format (N=67)
Web-based survey tool 54%
CMMS generated 15%
In-house electronic form 22%
Paper 43%

OPER AT IONS
Most Common FM Complaints or Concerns (N=67) Customer Satisfaction

Communication of work status,
Communication of work status 52% delays of work, and comfort rank as
the top three customer complaints.
Delays of work 40%
Thermal comfort 40%
Timelines 37%
Aged equipment 30%
Parts not available 10%
Coordination of work 7%
Number of repairs 7%
Unpredictable failure 4%
Inability to perform in-house 4%
Electronic Hand-
Do Service Staff Use Electronic Devices for Documentation of held Devices
Work Orders and PMs? (N=165)
Only 12 percent of the hospitals
reported using electronic hand-
held devices for documentation of
Yes work orders and PMs
12%
No
88%
Type of Hand-Held Device Used (N=20)

OPER AT IONS
Help Desk Do You Utilize a Help Is the Help Desk

Desk? (N=182) Integrated Across Multiple
Departments? (N=81)
No
Yes 35%
45%
No Yes
55% 65%
What is the Output of the Help Desk?(N=82)
Departments Supported by the Help Desk (N=53)

OPER AT IONS
Which of the Following Departmental or Organizational Key Key Performance

Performance Indicators (KPIs) Do You Track?
Indicators
This chart represents the number
KPIs Tracked Percentage (N=184)
of health care organizations
Financial variation 58% conducting key performance
Service response
indicators in the referenced areas.
21%
Delays of work 5%
Man hour productivity 26%
Process variation 0.5%
Market rents 3%
Current Replacement Value (CRV) Ratio 28%
Preventive Maintenance (PM) 72%
PM completion rate 47%
PM accuracy 20%
FTE per square foot/meter 45%
FTE per piece of equipment 4%
Compliance 48%
Safety events 35%
Percent of vacant space 8%
Facility Condition Index (FCI) 34%
Waste audits 10%
Energy use 42%
Utility failures/Disruption avoidance 40%
OSHA logs 15%
Adjusted discharge 13%
Adjusted patient days 16%

OPER AT IONS
CAFM System Does Your Organization Use a CAFM System?

Overall, 41 percent of the hospitals Use CAFM System?
Facility Size (GSM) N Yes No
participating in this survey reported
using a CAFM system. When facility Less than 23,225.6 97 25% 75%
size was taken into account, the
23,225.7-46,451.1 21 38% 62%
results show that, in general, the
larger hospitals were more likely 46,451.2-69,676.7 15 60% 40%
to use a CAFM system than the
69,676.8-92,902.3 9 56% 44%
smaller hospitals.
92,902.4-185,804.5 16 81% 19%
More than 185,804.5 12 92% 8%
Overall 170 41% 59%
Based on the results from this

survey, computerized maintenance For What Applications Do You Use Your CAFM System?
management system (CMMS),
space management, construction CAFM Application Percentage (N=72)
or project management, and asset
Construction or Project Management 39%
management (FFE) were the top
four applications for which the Space Management 47%
hospitals used a CAFM system.
Computerized Maintenance Management System (CMMS) 69%
Leasing 24%
Move Management 5%
Energy Management 14%
Asset Management (Fixtures, Furniture and Equipment (FFE)) 36%
Telecom 5%
Personnel Plans 11%
Security Plans 5%
Life Safety Plans (Emergency Action Plan) 21%

SEC T ION 8
Risk Management
Safety Initiatives
Injury Claims
Security
R ISK MANAGEMENT
Safety Initiatives To What Degree Does Your Department Lead Organizational

Nearly one half of the hospitals
Safety Initiatives? (N=170)
reported that their department led
only a few organizational safety
initiatives.
Most
More than 50 percent of the 14%
hospitals in this survey reported
being directly responsible for fire
safety (74 percent), construction Some
(55 percent), and life safety (51 40%
percent).
Only a few
46%
Which of the Following Organizational Safety Related Programs is your Department Directly
Responsible For? (N=184)

R ISK MANAGEMENT
Number of Your Organization’s Reportable Injuries You Have Injury Claims

Experienced Annually:
Among all position types,
Reporting Number of Annual housekeeping had the highest
Agency N Reportable Injuries number of claims per FTE (1.97),
followed by maintenance (0.58).
OSHA 19 66.53
CCOHS/WCB 18 55.72
Does Your Organization Track the Number of Work Injury

Claims per FTE? (N=121)
Yes
41%
No
59%
Number of Claims per FTE Position Type

Position Type N Mean Number of Track Claims per FTE
Utility Engineering 30 0.13
Maintenance 38 0.58
Clinical Engineering 30 0
Groundskeeping 31 0.10
Security 36 0.10
Housekeeping 39 1.97
Linens 30 0

R ISK MANAGEMENT
Security Total Annual Number of Documented Security Incidents

Facility Size (GSM) N Total Annual Security-Related Incidents
Less than 23,225.6 13 895.31
23,225.7-46,451.1 11 8,545.91
46,451.2-69,676.7 9 11,060.44
69,676.8-92,902.3 0 --
92,902.4-185,804.5 6 43,274.17
More than 185,804.5 4 1,900.50
Overall 43 10,975.98
In the Past Year, the Number of Security-Related Events at

Organization Has: (N=100)
Increased
32%
Remained the
Same
59%
Decreased
9%

SEC T ION 9
Property, Real Estate
and Construction
Management
Management
Project Delivery Models
PROPERT Y, REAL ESTATE AND CONSTRUCT ION MANAGEMENT
Management Which of the Following Does Your Department Directly

More than half of the hospitals
Oversee? (N=184)
reported directly overseeing
construction. Thirty-six percent
of the hospitals chose “none of
the above.”
Percentage of Space Types Offered (N=18)
Other
30% Institutional -
Inpatient
21%
Warehouse Storage
1%
Residential Institutional -
3% Outpatient
15%
Medical Office
Retail 22%
1% Clinical
7%

The Institutional – Inpatient had

Projects N Annual Market Rate
the highest annual market rate of
Institutional - Inpatient 2 31.85 31.85 percent, followed by retail
with the annual market rate of
Institutional - Outpatient 3 26.23
30.75 percent.
Clinical 2 20.92
Medical Office 5 21.26
Retail 5 30.75
Residential 1 18.00
Warehouse Storage 2 6.75
Other 3 46.00
Which of the Following Projects are You Planning in the Next

12 Months? What Is the Proposed Size of These Projects?
Planned in the Proposed Size While no hospital planned a
Next 12 Months vertical expansion in this survey,
Projects (N=184) N Mean
almost half of the hospitals
Relocations 17% 26 1,893.37 planned to do renovations
in the next 12 months. The
Renovations 49% 52 34,221.98
horizontal expansion had the
Additions – Horizontal
3% 6 36,707,157.30 largest proposed size with
Expansion 36,707,157.30 square meters
Additions – Vertical among all planned projects.
0% 0 --
Expansion
New Construction/New
6% 8 34,840.88
Building
What Percentage of these Functions is Managed Internally

and What Percentage is Outsourced?
Functions N % In-House % Outsourced According to the survey results,
more than 60 percent of each
Master Planning 100 35.25 64.75 of the functions listed here was
outsourced with architectural
Architectural Design 102 8.09 91.91
design (91.91 percent) and
Mechanical/Electrical/
102 9.75 90.25 mechanical/electrical/plumbing
Plumbing Design design (90.25 percent) ranked as
Data Systems Design 99 20.25 79.75 the top two outsourced functions.
Real Estate and Land
101 27.23 72.77
Development
Legal 101 25.64 73.47
Property Management 101 38.02 61.88

Project Delivery Which of the Following Project Delivery Models Does Your
Organization Use?
Models
Project Delivery Models N % Yes % No
Design Build 109 72% 28%
Negotiated Contract 108 83% 17%
Competitive Bid 108 96% 4%
Construction
104 77% 23%
Management
Turn Key 103 30% 70%
Integrated Project
102 28% 72%
Delivery
Frequency of Using Project Delivery Models (N=184)
Integrated Project Delivery 3% 13%
Turn Key 3% 14%
Construction Management 6% 36%
Competitive Bid 45% 9%
Negotiated Contract 24% 24%
Design Build 7% 35%
Most of the time

Some of the time

The IFMA Health Care Institute ASHE is the advocate for The Canadian Healthcare En-
consists of hospital administra- optimizing the health care gineering Society is a national
tors, facility managers, design physical environment including professional association rep-
and construction professionals, representation on many codes, resenting approximately 1,000
consultants, vendors and stu- standards and guidelines com- health care engineers and
dents serving academic medical mittees, government agencies associates across Canada.
centers and community hospi- and accreditation bodies. ASHE CHES seeks to help members to
tals, retirement facilities, and is dedicated to being a trusted better manage the healing envi-
specialty hospitals and clinics. source of information, provid- ronment which is imperative for
Our mission is to holistically ing education, publications, efficient and effective health
enhance the skills of facility web based information and care delivery.
management professionals with- networking opportunities.
CHES promotes the principle of
in the health care industry and ASHE provides opportunities integrated design by improved
to further the profession overall. for professional growth through collaboration using a team
its Senior and Fellow programs, approach between the profes-
leadership opportunities, and sions, and providing leader-
through Certified Healthcare ship in creating more efficient
Facility Manager (CHFM) and management of the operation,
the Certified Healthcare Con- maintenance, and safety of
structor (CHC). hospitals, their engineering
With more than 11,000 mem- systems, equipment, buildings
bers, ASHE is the largest asso- and allied support services.
IFMA is the world’s largest ciation devoted to optimizing
and most widely recognized For more information, please go
the health care physical envi- to www.ches.org.
international association for ronment. As a trusted industry
professional facility managers, resource, ASHE is committed to
supporting 23,170 members in its members, the facilities they
85 countries. The association’s build and maintain, and the
members, represented in 130 patients they serve.
chapters and 17 councils world-
wide, manage more than 37 For more information about
billion square feet of property ASHE contact 312-422-3800 or
and annually purchase more go to www.ashe.org.
than US$100 billion in products
and services. Formed in 1980,
IFMA certifies facility managers,
conducts research, provides
educational programs and
produces World Workplace, the
world’s largest facility manage-
ment conference and exposi-
tion. To join and follow IFMA’s
social media outlets online,
visit the association’s LinkedIn,
Facebook, YouTube and Twitter
pages. For more information,
visit the IFMA press room or
www.ifma.org.

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Canadian Version

A Critical Sampling of North American

For more information, please contact:

4 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

5 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Ron Kalich Dale Woodin John J. Knott

6 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Using this Report Acknowledgements

7 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

8 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Definitions for Benchmarking 2.0

9 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Competitive Bid utility systems and generating E-Waste

10 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Full-Time Equivalent Integrated Project Delivery Median

11 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

area. (ASTM 1836-08) Work that is performed to put

12 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Institutions Number of Percentage

Behavioral 2 1% An outpatient treatment center for psychiatric and

Children’s 9 5% An institution for health care providing patient treat-

Outpatient 6 3% An outpatient clinic where persons can receive a

Critical Access 9 5% Critical Access Hospitals (CAH) are rural community

Long-term 8 4% A facility that provides rehabilitative, restorative, and/

Medical 13 7% A large medical complex that provides a comprehen-

Rehabilitation 2 1% A recovery facility oriented toward long-term treat-

Facility Description N=184

Space within a building

14 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

15 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

11-20 years 11%

21-30 years 32%

31-50 years 36%

Facility Setting Central Business District

Academic or Research Hospital 12% 82% 6%

Acute Care Hospital 7% 11% 34% 2% 46%

Behavioral Care Facility 50% 50%

Children’s Hospital 20% 40% 20% 20%

Critical Access Hospital 25% 38% 38%

Long-Term Care/Nursing Home 13% 63% 13% 13%

Medical Center 8% 25% 50% 17%

Outpatient Health Care Center 83% 17%

16 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Ownership (N=184) Ownership

Leased, owner occupied with

Academic or 17 6% 12% 29% 53%

Acute Care Hospital 118 0% 1% 18% 81%

Children’s Hospital 9 0% 0% 33% 67%

Outpatient Health 6 0% 0% 33% 67%

Critical Access 9 0% 0% 22% 78%

Long-term Care/ 8 12.5% 0% 12.5% 75%

Medical Center 13 0% 8% 23% 69%

21-50 acres 22%

B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013 17

Days and Hours of Institution N Hours/Day Days/Week

Acute Care Hospital 118 24 7

Outpatient Health Care Center 6 21 7

Critical Access Hospital 9 24 7

Long-term Care/Nursing Home 8 22 7

Central Plant N=184

18 B E NCHM A R K I NG 2 . 0 Health Care Facility Management Report © IFMA 2013

Exterior Gross Area (N=171) Exterior Gross Area

Less than 23,225.6 GSM 46,451.2-69,676.7 GSM 92,902.4-185,804.5 GSM