Prior to December 2014, most hospital facility directors had the option of whether to pursue commissioning for new construction or renovation projects. However, fifteen states (shown below in orange) have just adopted the 2012 International Energy Code (IECC), which mandates commissioning for many healthcare projects. Twenty four additional states (shown in blue) will likely adopt the 2012 IECC code in the very near future.
STATUS OF STATE ENERGY CODE ADOPTION
Source: United States Department of Energy
Which projects must comply with the new codes?
For hospitals in the orange states, current new construction and major renovation projects must comply with the new commissioning requirements. Minor exceptions include projects with cooling systems that have a capacity less than 480,000 BTU/h and heating systems with a capacity less than 600,000 BTU/h.
What do the codes require?
The new codes require a mechanical system commissioning plan, and evidence that commissioning was performed prior to the final mechanical inspection. It mandates HVAC air and water flow rate balancing, as well as performance testing on HVAC equipment, HVAC controls, and lighting control systems.
What are the potential pitfalls of this code change?
We anticipate that many engineering firms will specify that the installing contractor is responsible for procuring the commissioning service. While this approach achieves minimum code compliance, it may not align with your best interest, or with best engineering practices. It gives the contractor control over the individual validating his or her own installation, creating a conflict of interest.
We recommend that facility directors contract directly with third party commissioning providers to ensure they receive the benefits intended by the commissioning process.
What should I look for when selecting a commissioning provider?
The provider should employ a hands-on approach to functionally test equipment. As an example, a qualified provider will delve into the sequence of operations to ensure the controls are tuned for maximum performance, without sacrificing the number of air changes or air quality necessary to maintain infection control.
It is imperative that a commissioning provider has healthcare experience in order to understand the design intent of these complex facilities. Such individuals have the distinct advantage of commissioning systems in a way that conserves future operating costs.
What will commissioning cost?
According to the ASHRAE Journal, the commissioning cost for HVAC, HVAC Controls, and Lighting Control Systems, as required by the IECC, can be as low as 2.0% of the total construction cost of the system being tested, depending on its complexity. In contrast, the savings generated by decreased energy usage, lower operating and maintenance costs, and improved occupant comfort that affect staff productivity can significantly improve the bottom line well beyond the median commissioning payback period of 4.2 years.
Closing thoughts
Third party verification that air quality and life safety systems function as intended ensures patient well-being, saves energy, and saves money. It follows that subsequent editions of the IECC will expand commissioning requirements, suggesting whole building commissioning in the foreseeable future.
ABOUT THE AUTHOR Charlie Hall PE QCxP 
Charlie Hall is skilled in complex healthcare campus engineering infrastructure and works effectively with architects and other engineers to integrate engineering systems into the total project design. His expertise in commissioning gives him a holistic view of complex systems, maximizing the potential for energy savings on our projects.
Have a question for Charlie? charlie@freemanwhite.com
