Case Study: Leesburg Regional Medical Center

Recently, the South Campus of Leesburg Regional and the Day Surgery Center underwent a major infrastructure improvement project to increase the energy efficiency and comfort of the facilities. The hospital’s comprehensive program will reduce existing operational expenses of Central Florida Health Alliance by over $175,000 per year.

Project Name and Location: Leesburg Regional Medical Center, Leesburg, FL
Client/Owner Contact: David Taylor, System Director, Plant Operations/Facilities
Completion Date: April 2013

Project Scope: For nearly 50 years, Leesburg Regional Medical Center, part of Central Florida Health Alliance, has been serving the community’s healthcare needs.  Leesburg Regional is committed to providing quality care and service excellence, which includes energy efficient operations. On a national level “Healthcare organizations spend over $6.5 billion on energy each year, and that amount is rising to meet patients’ needs.  By being more energy efficient, hospitals around the country can save money, help prevent greenhouse gas emissions, improve the air quality of their communities, and support their commitment to public health.

Recently, the South Campus of Leesburg Regional and the Day Surgery Center underwent a major infrastructure improvement project to increase the energy efficiency and comfort of the facilities. The products and initiatives put in place have improved conditions for patients, the facilities operations and the environment.

The comprehensive program will reduce existing operational expenses of Central Florida Health Alliance by over $175,000 per year.  The project will fund itself through the reduced cost and will generate positive cash flow over the life of the systems installed.   Specifically the project consisted of the following energy conservation measures.

  • Energy recovery ventilators
  • High efficiency swing load chiller installation
  • High efficiency open heart chiller installation
  • Central energy plant energy dashboard
  • Variable speed cooling tower installation
  • Premium efficiency condensing boiler
  • Variable primary reheat water loop
  • Energy Management system

Quick Summary

Objectives: Improve hospital infrastructure and decrease operational costs

Project Location: Leesburg, Florida

Major Decision Drivers: Life cycle benefit of program, reduced operating costs, improved infrastructure

Building Type/Size: Hospital and Outpatient Surgery Center.  310,000 and 15,686 GSF respectively

HVAC Equipment: Centrifugal chillers, packaged dx equipments

Unique Features: Two energy recovery ventilators recover energy in exhaust stream and use that energy to pre-condition needed raw outdoor air

Installation Date: Q4 2012 – Q1 2013

Download: Leesburg Regional Medical Center Case Study (PDF)

Case Study: Leesburg Regional Medical Center Operating Rooms Renovations

Hill York executed a challenging implementation schedule to help Leesburg Regional Medical Center attain new indoor environmental code compliance for comfort in their operation rooms without disrupting surgeries.

Project Name and Location: Leesburg Regional Medical Center | 600 E Dixie Ave, Leesburg, Florida 34748
Client/Owner Contact: Central Florida Health Alliance
Completion Date: August 2013

Project Scope: In 2012 the Central Florida Health Alliance faced a double-edged challenge when new indoor environmental codes were adopted that dramatically changed the space comfort requirements for operating rooms. The existing HVAC systems serving Leesburg Regional Medical Center’s, LRMC, surgical suites required a major overhaul, and the work would have to be done without interfering with the hospital’s ability to perform surgeries.

Needing a project partner with a proven track record of managing implementation schedules that keep day to day operations running smoothly, LRMC called Hill York Air Conditioning and Energy Solutions.

“It was crucial to partner with a company that could not only attain code compliance, but also effectively coordinate and communicate with our project team,” stated David Taylor, Central Florida Health Alliance’s System Director, Plant Operations and Facilities. “Based on their past work for us, we were confident in Hill York’s ability to deliver results under the demanding circumstances.”

Project Challenges: The newly adopted American Society of Heating, Refrigerating and Air-Conditioning Engineers, ASHRAE, Standard 170-2008 outlines required indoor temperature, relative humidity conditions, and minimum outdoor air changes for surgical areas. This standard is more stringent than previous healthcare guidelines, calling for an increased amount of air changes while continuing to maintain temperature and relative humidity ranges. As a result, LRMC needed to install an HVAC system that was capable of maintaining these new requirements. A glycol chiller system was selected as the most appropriate design, and Hill York began the planning stages of the construction project.

The Operating Rooms at LRMC are served by three separate air handling systems and consists of nine Operating / Surgical Cystoscopic Rooms, sterile storage rooms, and other critical areas. Virtually all major surgeries administered by the hospital occur in this area presenting immediate challenges as certain surgeries can only be performed in specific operating rooms. Additionally, executing this broad scope of work at the highest Infection Control Risk Assessment (ICRA) level added to the project’s degree of difficulty. Through coordination with the surgical staff, the AHU change-outs, CAV box replacements and DDC controls installation could be performed for each respective area without impeding the hospital’s ability to perform specific surgeries safely.

“The coordinating and implementing of construction-related ICRA life safety plans was critical,” observed Hill York Project Manager Seth Sturgill. “Our project partners at the hospital did a seamless job of keeping hospital staff updated on routing changes around and within the surgical suites. The appropriate Life Safety Plans were also clearly posted, implemented and ready for quick reference.”

Project Solution: To maintain the new strict guidelines, Hill York recommended that LRMC install a glycol system consisting of one new air-cooled glycol chiller, a pumping package, three air handling units, and 28 pressure independent constant air volume boxes with reheat coils. The design intent of this system is to maintain low temperatures between 60˚and 65˚F, while keeping relative humidity conditions within industry acceptable ranges of 30-60%, all while maintaining the required ventilation rates.

In collaboration with OR staff, the facilities team and project subcontractors, Hill York developed a detailed and aggressive construction phasing plan broken up by each air handling system. In order to keep portions of the operating areas functional during construction, the project was completed in five separate phases, all with strict timelines to minimize operating area disturbance. The Hill York project team
met with various personnel within the hospital including construction coordinators, maintenance supervisors, nursing staff, security staff members, and ICRA personnel in order to identify times when certain parts of the operating area could be temporarily closed for construction activity.

“Portions of the schedule for each phase were planned down to the hour and coordination between the different groups within the project team couldn’t have gone better,” explained Sturgill. “It flowed smoothly from the moment Director of Preoperative Services Laurie Harsh gave us the thumbs up that they were wrapping up in the operating rooms for the day and we were cleared to proceed with building our containment for construction, to the time we finished and environmental services came in for cleaning.”

At the completion of the renovation project, Leesburg Regional Medical Center had not only elongated the life expectancy of the operating rooms’ HVAC systems, but it had also improved the indoor environment within the surgical suites. Positive feedback from doctors and nursing staff cite both improved thermal comfort and work productivity. “This was a total team effort,” Sturgill stated. “Our project partners at the hospital were right by our side throughout – from onset all the way through AHCA inspections. This enabled day to day coordination to be spot on and allowed quick resolution of any issues that arose during construction. The team approach at LRMC led to a project that was completed on time and under budget, two very important criteria when gauging overall success.”

Download: Leesburg Regional Medical Center Operating Rooms Renovations Case Study (PDF)

Case Study: Central Florida Health Alliance – Alliance Day Surgery Center

Hill York executed an energy savings project to help the Alliance Center Day Surgery Center drastically lower monthly utility bills, improve space comfort, and extend the life of the building’s HVAC systems.

Project Name and Location: Alliance Day Surgery Center | 601 E Dixie Ave #501 | Leesburg, FL 34748
Client/Owner Contact: Central Florida Health Alliance | David Taylor
Completion Date: February 2013

Project Scope: In 2012, the Central Florida Health Alliance needed to reduce its utility costs at several of their facilities. One facility identified as a high energy consumer was the Alliance Day Surgery Center. Built in 1987, the 15,686 ft single story building has operating rooms, sterile areas, patient areas, and administrative offices that all have different climate control requirements.

After performing a detailed energy assessment, Hill York’s Energy Solutions Group determined that many energy inefficiencies resulted from the building’s mechanical systems and their controls. The baseline energy usage index revealed a unit cost of 10.44 $/ft, which is significantly higher than national averages for similar facilities. One apparent inefficiency involved failing control valves serving the variable air volume boxes. The boxes were equipped with hot water reheat coils, many of which failed in the open position. These failures caused the boiler to constantly run, which resulted in simultaneous heating and cooling that drove increased energy use and operational costs.

Project Solution: To align with the goals of the Day Surgery Center, Hill York recommended a mechanical system overhaul with a web-enabled energy management system, giving managers complete control of the facility. The renovation’s bundled energy solution included the installation of a pulse fired condensing boiler, a variable speed hot water pump, a heat exchanger for domestic hot water, replacement of all pneumatic hot water valves and actuators, and the energy management system to integrate all components together. Collectively, the Alliance Day Surgery Center and Hill York implemented energy saving control strategies including temperature setbacks, heating hot water reset, discharge air reset, and many more. The design intent was to allow for greater control over the system while making sure only essential equipment would run when it was needed.

The program results are remarkable, with natural gas usage plummeting by over 62%. Believing that the gas meter was malfunctioning, the local utility company replaced it twice, but the savings continued. Electrical consumption was also reduced by 32%. Annual electric and natural gas savings of $61,000 has been documented through an energy services agreement.

Download: Central Florida Health Alliance – Alliance Day Surgery Center (PDF)

Case Study: New Vision Eye Center

Hill York engineered a turnkey energy management system to help New Vision Eye Center obtain greater control over their indoor climate and cooling costs.

Project Name and Location: New Vision Eye Center | 1055 37th Place | Vero Beach, FL 32960
Client/Owner Contact: Mike Minotty, Facility Manager | New Vision Eye Center
Completion Date: May 2014

Project Scope: 19,000 square foot single story building has surgical suites, patient areas, and administrative offices that all have different climate control requirements.

Less than two years after moving into the building, New Vison’s management team grew alarmed at excessive energy bills and an overall lack of control of their HVAC system. Turning to Hill York for help, they cited a litany of issues, including air constantly running at peak capacity and extreme cold in the surgical suites that caused the medical staff to wear extra layers of clothes to keep warm.

Conducting a detailed assessment of the facility’s systems, Hill York’s Energy Solutions Group quickly zeroed in on a major problem: The originally designed HVAC control strategy called for systems to run 24 hours a day, 365 days a year, regardless of occupancy.

“With a four-day-a-week surgical schedule and normal business hours for the eye center, this control platform was extremely out of sync with New Vision’s operational needs,” observed Rob Pulsifer, Hill York’s vice president of energy solutions. “We knew right away that many of the energy inefficiencies resulted from a flawed engineering approach that didn’t consider the best use of the facility’s mechanical systems and their controls.”

Project Solution: As a member of the American Society for Healthcare Engineering (ASHE), Hill York’s expertise in optimizing health care physical environments consistently achieved client goals and passed Agency for Health Care Administration (AHCA) inspections. With New Vision in need of major changes to get costs and comfort back on track, the project team recommended a comprehensive energy management system.

Hill York implemented advanced energy control strategies including temperature setbacks, discharge air reset, modulation of outside air, and many more. Supporting the effort from the top down, technicians applied their specialized knowledge of the intricacies of sophisticated rooftop systems to ensure that the equipment would run only when needed and ramp down during non-business hours. With no interruption to the eye center’s day to day operations, Hill York’s cost saving turnkey solution transformed a grossly inefficient system that ran at full capacity all the time to one that greatly reduced facility cooling loads and energy use.

“Hill York did a seamless job from start to finish,” noted Mike Minotty, New Vision Eye Center’s facility manager. “They completely upgraded our mechanical and control systems, kept us in the loop at every stage, and enabled us to continue with business as usual throughout the project. Staff comfort, reliable system performance, and the addition of remote access are just some of the many benefits we’re enjoying.”

Empowering New Vision to obtain greater control over indoor climate and costs, the results have been exceptional. In the first three months of the energy management system, New Vision saved 27% over their previous spending. Through a convergence of services model that included system optimization and ongoing management and monitoring provided under an Energy Services Agreement, Hill York has nearly doubled the projected annual savings and continues to identify opportunities for efficiency gains. Based on usage reductions to date the New Vision Eye Center is on trend to outperform more than half of similar buildings in the ENERGY STAR® database nationwide for energy efficiency.

Download: New Vision Eye Center (PDF)

Case Study: The Villages Regional Hospital – Central Energy Plant Expansion

Hill York was selected by Central Florida Health Alliance to work with the consulting engineer as a design assist partner for the expansion of the central energy plant at The Villages Regional Hospital. Based on a successful track record of comparable projects, the hospital group sought to tap Hill York’s expertise in achieving optimal plant configuration, lowest lifecycle cost design having the highest efficiency, and high quality construction.

Project Name and Location: The Villages Central Energy Plant | 1451 El Camino Real The Villages, FL 32159
Client/Owner Contact: Central Florida Health Alliance | David Taylor | System Director of Facilities
Completion Date: November 2014

Project Scope: In 2013, The Villages Regional Hospital sought to expand their facilities to meet the needs of the growing community and continue to offer high-level healthcare and service. When completed, a new five-story tower will add operating rooms, treatment rooms, inpatient and surgical beds, a new intensive care unit, and will double the size of the emergency department. With this sizeable expansion to the hospital, the central energy plant needed to be redesigned. Building on a successful partnership with Hill York, including a low-temp operating room project at Leesburg Regional Medical Center, Central Florida Health Alliance secured their services again with a focus on energy efficiency and design assist capabilities.

Hill York’s design assist capabilities improve project constructability, serviceability, and ensure maximum cost effectiveness and efficiency throughout the life of the system. The original plans for the plant expansion were published in May of 2013 and Hill York’s Energy Solutions team partnered with key Central Florida Health Alliance personnel, including David Taylor, System Director of Facilities; Angel Martinez, Manager of Facilities; and Barry Bolte, Supervisor of Facilities. Working closely with their Central Florida Health Alliance collaborators, Hill York’s energy engineers, certified energy managers, and LEED accredited professionals reviewed the plans and identified areas for improvement. First, the overall design and orientation of the plant was reconfigured to decrease materials used and increase access to the equipment for improved serviceability. The team then pinpointed several ways to increase lifecycle savings through equipment selection, water reclamation methods, and the sequence of operations.

Utilizing chilled water, the team immediately advocated the use of high efficiency, magnetic bearing chillers with the ability to efficiently operate at different load conditions. The original plans also called for electric steam generators that were highly efficient, but not cost effective. The energy solutions team generated a fuel cost analysis for an electric vs. natural gas steam generator and found the natural gas model to be more cost effective. Another cost saving measure involved the reclamation of hot water condensate from the sterilizers to decrease waste and increase efficiency. With a central energy plant of five chillers, six boilers, and two steam generators, a detailed and functional sequence of operations was critical to ensure optimal plant efficiency. Utilizing the most efficient equipment more often, and at their top efficiencies, was a key component in the sequence of operations. Working with both the client and consulting engineer, Hill York provided vital consultation to optimize the sequence and maximize the efficiency of the plant.

While the complete benefits and overall cost savings from these recommendations can’t be easily quantified, they are virtually limitless. The energy savings alone are projected to save the hospital $2.7 million over the 20-year lifecycle of the systems. Often in a leadership role on taking projects from concept to completion, here Hill York worked solely in a design assistant capacity for Central Florida Health Alliance. The result was no less impactful, adding value and creating a partnership that ultimately produced a highly successful project.

Download: The Villages Regional Hospital – Central Energy Plant Expansion (PDF)

Case Study: GulfCoast Surgery Center

Hill York’s rapid retrofit of a surgery center’s mechanical and control systems enhanced comfort and improved climate management of diverse indoor spaces.

Project Name and Location: GulfCoast Surgery Center | 4947 Clark Road | Sarasota, Florida 34233
Completion Date: July 2014


Project Scope: GulfCoast Surgery Center is an outpatient surgical facility in Sarasota that performs knee and hip replacements, cervical fusions, lumbar fusions, and arthroscopic and pain management procedures. The 17,179 square foot single story building has operating rooms, patient areas, and administrative offices that all have different climate control requirements.

When the condenser on the facility’s large split cooling system began to fail, the surgery center’s management sought a quote on a new condenser, air handler evaporator coils and an HVAC control system. GulfCoast reached out to Hill York after rejecting an unattractive bid from a national contractor and receiving a referral from a leading HVAC equipment distributor.

Hill York visited the site on a Friday and had a proposal ready on Monday. The recommendation to install a new McQuay condenser unit, change out the DX coils in the air handler to match the new refrigerant, and outfit the center with a new HVAC control system was quickly accepted.

Project Solution: Hill York’s expertise in optimizing health care environments enabled work to move forward on a fast-track schedule. The project team wasted no time in executing on-site prep work, including running new line sets for refrigerant and pulling wire throughout the building to update the variable air volume system. Once the cooling equipment arrived and the installation was scheduled, the retrofit team overhauled the center’s mechanical system in just three days, starting on a Friday and finishing on a Sunday.

Hot and cold spots throughout the facility were another issue that needed a strategic upgrade. Hill York’s Energy Solutions Group implemented a new HVAC control system that included temperature setbacks, discharge air reset, modulation of outside air and more. The new controls eliminated fluctuations in space comfort, reduced energy consumption, and allowed more efficient management of on and off-hour cooling.

Hill York provided GulfCoast Surgery Center with the cross benefits of a convergence of services approach that included retrofit, HVAC repairs, and energy solutions. It was the key to upgrading mechanical and control systems on an accelerated schedule with no interruption to the center’s day-to-day operations. Impressed with the positive project management experience and value-added results, GulfCoast showed their appreciation with a strong vote of confidence: They moved their annual mechanical and energy system maintenance exclusively to Hill York.

Case Study: Express Scripts – A Multi-Tiered Efficiency Program

When the project was completed, the enhanced comfort at the energy efficient facility sparked another big change: higher employee productivity.

Project Name and Location: Express Scripts Call Center | 10045 S. US Highway 1 | Port St. Lucie, FL 34952
General Contractor: Hill York | 3921 Westgate Ave. | West Palm Beach, FL 33409 | 561.689.7344
Completion Date: March 2015

Project Scope: A Fortune 100 company and one of the nation’s leading pharmacy benefit management services, Express Scripts operates a number of call centers around the country. The HVAC equipment at their flagship call center in Port St. Lucie, Florida was near the end of its lifecycle and problems were mounting. More frequent breakdowns and repairs had become the norm, and unusually high humidity and hot and cold spots throughout the facility were causing a crisis in comfort and employee productivity.

Having retained Hill York to handle maintenance on the building after acquiring it in 2012, in 2014 Express Scripts asked for a quote to replace the aging HVAC units with new “like for like” systems. Hill York’s Energy Solutions Group conducted a detailed facility efficiency assessment at the Call Center, uncovering a disturbing trend. Not only were the humidity levels abnormally high, but they peaked in the winter months – a clear sign of frequent short-cycling and inefficiency.

The extreme humidity issues were contributing to declines in worker productivity, which required an alternate approach to system replacements. Hill York’s recommended strategy: Convert the system design from a decentralized, air cooled application to a central chilled water application. The upgrade consisted of a 200 ton water cooled plant with air handling units having complete variable capacity. Also key to the plan was the installation of an energy smart ventilation system to reduce cooling loads and a web-accessible HVAC control system that allows remote monitoring and management of the building from off-site locations. The overall system increases energy efficiency, enhances system control, and improves employee comfort all while reducing utility costs.

The plan included one more attractive feature that was consistent with Express Scripts’ corporate commitment to promoting sustainable business practices. The chiller plant recaptured condensate and recirculated it back into the system rather than send it down the drain as is often done in construction projects.

Building on their success in helping the City of Port St. Lucie save in excess of $154,000 a year in energy costs, Hill York began discussions with Express Scripts management to recommend a value-added course of action in addition to the requested replacement option. At a meeting led by Vice President of Energy Solutions Rob Pulsifer and Vice President of Construction Mike Senecal, a data-backed proposal presented some meaningful statistics to Express Scripts’ corporate executives at the national level.

Hill York’s financial analysis showed that by switching to a chilled water system, the resulting energy efficiency improvements would produce utility savings of $71,000 a year. Even more impressive, the value of increased employee productivity resulting from a more comfortable working environment far surpassed the energy savings. Express Scripts executives approved the plan on the spot and green-lighted the project within days.
“Express Scripts initially viewed the project as an air conditioning issue with utility cost savings at stake,” observed Pulsifer. “We were able to show them the even bigger potential to impact their core business – the productivity of a 450-person call center.”

Completing the project with no interruption to day-to-day operations, Hill York’s comprehensive approach to facility efficiency programs has provided Express Scripts with initial results and a path for company-wide improvements. Humidity levels that once hovered around 70% at the Port St. Lucie call center are now consistently below 50% and employee productivity has rebounded. Through an Energy Services Agreement, building performance continues to be monitored on an ongoing basis to generate additional efficiency benefits and cost reductions over the long haul. The Port St. Lucie project has become a springboard for even greater gains in sustainable success, including ENERGY STAR™ benchmarking and LEED certification of their facilities in Florida and across the country.