The Green Guide is the product of a two-year, multi-stakeholder development and review process, convened by the Center for Maximum Potential Building Systems. Sponsors include the New York State Energy and Research Authority, Merck Family Fund, and Hospitals for Healthy Environment (H2E), a joint project of American Hospital Association, American Nurses Association, Health Care Without Harm and the U.S. Environmental Protection Agency.

Major health care facilities have agreed to pilot test the Green Guide over the next year. The Green Guide's organizational structure has been borrowed by agreement from the U.S. Green Building Council's LEED rating system, modifying and adding to it to meet the needs and priorities of the health care industry. The Guide, however, is not a LEED Rating System nor a product of the U.S. Green Building Council.