We would like expand on our session description: BR+A works in New York and Massachusetts, two states with aggressive energy efficiency codes. Further, the use of natural gas is discouraged and will soon be completely curtailed. Hospitals are faced with energy code compliance, rising energy costs and penalties for excess carbon emissions on the horizon. To meet these emerging challenges hospitals are constructing buildings with high performance facades, increasing equipment efficiencies and making extensive use of heat recovery technology. Applying new methodology to inform hospital design is combined with new materials and equipment technology for successful outcomes. BR+A provides MEP engineering consulting services on ground breaking projects such as Penn Medicine, Mass General Hospital and the IU Health Methodist Hospital campus expansion. To achieve the demanding energy efficiency goals of these projects we have expanded our services to include Passive House. In this context multidisciplinary professionals apply a set of design principles for attaining a rigorous level of energy efficiency while also creating safe, resilient, comfortable and – most importantly – energy efficient structures. These principles can be applied to all building types, including those with health and safety requirements, such as hospitals. Fundamental to the energy efficiency of these buildings, the following five principles are central to Passive House design and construction: 1) high performance envelopes 2) airtight construction 3) high-performance glazing, 4) thermal-bridge-free detailing 5) heat recovery systems Phius is the governing body which sets the standard for Passive House in North America. Phius certifies building projects, data for products and components that go into those buildings, and professionals who design and deliver those buildings. Phius was founded in 2003 and has certified 3,000+ professionals over past two decades. Hospitals are subject to numerous codes and standards such as the FGI and ASHRAE 170. Passive House works in concert with those requirements which are treated like any other environmental factor. The idea is to understand all of the factors that contribute to the health, safety, comfort and functionality of the space and develop a holistic approach. Passive House is complementary with other sustainability rating systems such as LEED. Through Passive House, design professionals and builders apply innovation to create climate-specific comfort and performance. Through LEED, builders work to reduce impacts in energy, water, waste, transportation and more, while investing in new design technique, improved materials and regional priorities. There are excellent projects which form the precedent for the application of Passive House to Hospitals. The first certified Passive House hospital is Klinikum Frankfurt Hörchst, located in Germany, which opened in early 2022. BR+A applied Passive House principles to the Soldiers’ Home in Holyoke, Massachusetts. Moving forward, with knowledge and confidence, new design techniques are being applied to the design of exciting new projects such as the Penn Medicine Princeton Health Cancer Center. Passive House design is relevant and impactful for hospital projects!