The old buildings (and many of the newer ones) on the SFGH campus are incredibly energy IN-efficient, and mostly for very basic structural reasons - windows that simply do not close completely, windows and doors that close but leak, etc.  Summer cooling and winter warming of areas with these problems, for one thing, must be expenisve.  Addressing these issues could potentially save a lot of money on annual overhead costs for the hospital, and the costs of repairs or building upgrades would not necessarily need to be passed onto hospital health consumers.  Addressing these things could also have little to no impact on patient care, as many of these old buildings are in use for research or administrative purposes.