Healthcare facilities face water management requirements that no other commercial sector encounters: infection control requirements that constrain water system modifications, regulatory compliance documentation that must be maintained continuously, and water-intensive systems — sterilisation, cooling, laundry, food service — running 24 hours a day. WST works within these constraints to identify and document the savings that are available without compromising clinical water quality standards.
The Healthcare Challenge
Healthcare facilities comply rigorously with clinical water quality requirements but almost never audit the billing and infrastructure systems that surround those clinical circuits. The result is regulatory compliance on one side and unmanaged cost overruns on the other.
Healthcare facilities typically divide their water systems into clinical (domestic hot/cold, dialysis, sterile processing) and non-clinical (cooling towers, chilled water, irrigation, food service, laundry) categories. Clinical systems receive intensive scrutiny under CMS and ASHRAE 188 water management plan requirements. Non-clinical systems typically receive no systematic audit or monitoring at all — despite often representing 50–60% of the total water cost. Cooling towers on hospital campuses are frequently running at manufacturer default bleed rates and paying sewer charges on evaporated water.
CMS Conditions of Participation require healthcare facilities to maintain a water management programme that identifies water risk areas, assesses risk, and documents actions taken to reduce risk across all water-using systems. Most facilities meet the Legionella-specific requirements but underperform on the broader water risk quantification that modern CMS survey expectations require — particularly RA4-equivalent risk documentation across non-clinical systems including cooling towers and irrigation.
Large medical campuses typically have multiple utility connections, multiple meters across buildings and phases, and billing structures that have evolved over years of campus expansion. Cross-billing between buildings, meters that haven't been reconciled since construction, and common utility areas that aren't allocated to any cost centre are all common sources of unrecovered cost that WST's billing forensics identify.
WST Approach
Typical Outcomes
| Metric | Outcome |
|---|---|
| Water cost reduction (non-clinical) | 15–25% |
| Cooling tower sewer exemption | $20–50K/yr where applicable |
| Billing audit recovery | 8–12% of non-clinical bill |
| CMS documentation coverage | Non-clinical systems included |
| Monitoring alert response time | Under 48 hours |
| Clinical system modifications required | None — non-clinical only |
Important: WST does not modify domestic hot or cold water systems, sterile processing water, dialysis water, or any clinical water circuit without review and approval by the facility's infection control and water management programme teams. WST's scope is limited to non-clinical systems unless specifically authorised otherwise.