Located in Kalispell, Montana, the Kalispell Regional Medical Center (KRMC) includes 174 hospital beds and 400,000 square feet of conditioned space. In 2006, the hospital’s facilities manager began developing the business case for strategic energy management and established annual energy savings goals based on his assessment of the KRMC’s systems-wide savings potential. The initial assessment identified many no- or low-cost operations improvements that, once implemented, saved the hospital 550,000 kilowatt-hours of electricity and 32,000 therms of natural gas annually. Specific improvements included turning off air handlers for non-essential zones at night and on weekends, identifying and repairing a malfunctioning air-handler return fan, cleaning airflow sensors, reducing the pressure drop in hot and chilled water loops, increasing the setpoint temperatures for surgery room air handlers to avoid unnecessary reheating, adding occupancy sensor controls to variable-air-volume flow controls, and sequencing boiler controls for more-efficient combustion. In addition to these operational measures, the facilities manager also adopted a web-based energy usage feedback tool that provided an additional 5 to 6 percent energy savings resulting from dynamic operational adjustments.