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Connection to the natural world

SS11 | Possible point


To provide patients, staff, and visitors with the health benefits of the natural environment by creating outdoor places of respite on the healthcare campus.

To provide patients and staff with the health benefits associated with direct access to the natural environment.


Provide places of respite that are accessible to patients and visitors, equal to 5% of the net usable program area of the building.
Provide additional dedicated places of respite for staff, equal to 2% of the net usable program area of the building.
Places of respite must be outdoors, or be located in interior atria, greenhouses, solaria, or conditioned spaces; such interior spaces may be used to meet up to 30% of the required area if 90% of each qualifying space’s gross floor area achieves a direct line of sight to unobstructed views of nature.

All areas must meet the following requirements.

  • The area is accessible from within the building or located within 200 feet (60 meters) of a building entrance or access point.
  • The area is located where no medical intervention or direct medical care is delivered.
  • Options for shade or indirect sun are provided, with at least one seating space per 200 square feet (18.5 square meters) of each respite area, with one wheelchair space per five seating spaces.
  • Horticulture therapy and other specific clinical or special-use gardens unavailable to all building occupants may account for no more than 50% of the required area.
  • Universal-access natural trails that are available to visitors, staff, or patients may account for no more than 30% of the required area, provided the trailhead is within 200 feet (60 meters) of a building entrance.
  • Additionally, outdoor areas must meet the following requirements.

  • A minimum of 25% of the total outdoor area must be vegetated at the ground plane (not including turf grass) or have overhead vegetated canopy.
  • The area is open to fresh air, the sky, and the natural elements.
  • Signage must meet the 2010 FGI Guidelines for Design and Construction of Health Care Facilities (Section 1.2-6.3 and Appendix A1.2-6.3:Wayfinding).
  • Places of respite may not be within 25 feet (7.6 meters) of a smoking area (see EQ Prerequisite Environmental Tobacco Smoke Control).
  • Existing places of respite on the hospital campus may qualify if they otherwise meet the credit requirements.

    Provide direct access to an exterior courtyard, terrace, garden, or balcony. The space must be at least 5 square feet (0.5 square meters) per patient for 75% of all inpatients and 75% of qualifying outpatients whose clinical length of stay (LOS) exceeds four hours.

    Patients whose length of stay exceeds four hours, and whose treatment makes them unable to move, such as emergency, stage 1 surgical recovery, and critical care patients, may be excluded.

    Places of respite outside the building envelope that meet the requirements of SS Credit Places of Respite that are immediately adjacent to clinical areas or with direct access from inpatient units may be included.

    Qualifying spaces must be designated as nonsmoking The spaces must also meet the requirements for outdoor air contaminant concentrations enumerated in EQ Credit Enhanced Indoor Air Quality Strategies, Option 2 and be located more than 100 feet (30 meters) from building exhaust air locations, loading docks, and roadways with idling vehicles.

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