This paper presents the findings of a comprehensive energy audit conducted at a large healthcare facility in North America, highlighting the critical role of Building Management Systems (BMS) in optimizing energy efficiency and driving sustainability. The audit identified opportunities for energy savings through chiller and boiler system improvements, retro-commissioning of the BAS, lighting upgrades, and minor repairs. The study emphasizes the importance of real-time energy monitoring and control, predictive maintenance, and staff training and engagement to ensure a truly optimized system. The implications for BMS include enhanced operational efficiency, integration with renewable energy sources, data-driven decision-making, policy compliance, and future-proofing infrastructure. The audit provides a practical framework for improving energy consumption patterns in healthcare facilities, demonstrating the essential role of BMS in managing energy use and reducing carbon footprints in energyintensive environments.