Why ‘going green’ hasn’t taken root in long-term care

I have been in long-term care (LTC) design for more than 17 years and finally have my first LEED LTC project. The city is actually the one pushing for this; the owner has no desire nor do any of my other LTC clients.

I have sat through numerous LEED certification courses and been bombarded with the benefits of “going green” from every manufacturer you can imagine. They always seemed surprised to find out our LTC clients really don’t seem to care.

I have to say that having previously been in-house as an acute care designer, there were many things that we were already doing that were green. Those practices are just now being validated by LEED.

Long-term care, on the other hand, has been slow to come along with the green movement. Some of this has been caused by the lack of stable reimbursement rates of Medicare and Medicaid. Also, there are generally too many different codes that already need to be complied with, let alone attempting to achieve LEED certification. Going green can be seen as certainly costing a bit more in fees on design and construction.

Another possible issue in why the green movement has not taken hold in the independent and assisted living markets is that LEED is typically marketed to commercial designers. Those that would be mandated to do a LEED building are commercial designers working on government-funded and educational projects. Acute care is somewhat engaged, but only in specific states such as California. Other early adaptors to LEED are clients that have a special interest in green buildings, such as corporate headquarters where part of their marketing position revolves around how responsible they are when it comes to the environment.

Those looking for independent living, assisted living and memory care accommodations are most concerned with the care being provided as well as the cost. Design comes much lower in their priorities and environmental impact typically does not even register with them. We may see this change but probably not for another 10 years or so until the Baby Boomers really start entering these communities.

Craig Fukushima

Craig T. Fukushima, NHA, is partner at The Fox Group, a consulting practice that serves a wide range of acute and post-acute healthcare providers. He has worked in the LTC industry for more than 30 years, starting as a skilled nursing facility administrator and later as operations vice president. He hosts a Twitter discussion (second Tuesday of every month at noon EST) on issues related to Alzheimer’s disease at #talkalz.