<![CDATA[Hospital operations provide healthcare services while generating environmental impacts through medical waste, hazardous and toxic waste, wastewater, and the consumption of energy, water, and other resources. These impacts require hospitals to adopt environmental management practices that extend beyond regulatory compliance and strengthen environmental awareness. This study aims to analyze the role of green accounting in fostering environmental awareness and supporting organizational sustainability at a specialized hospital (RSK X) in East Java, Indonesia. The study employed a qualitative approach within an interpretive paradigm using a case study design. Data were collected through in-depth interviews, observations, and documentation involving informants engaged in environmental management and hospital operations. Data were analyzed through data reduction, data display, conclusion drawing, and thematic analysis using NVivo 14 Pro. The findings indicate that green accounting practices at RSK X are reflected in medical and hazardous waste management, wastewater treatment plant operations, environmental monitoring, resource efficiency, environmental reporting, and environmental cost recording. These practices function not only as mechanisms for administrative compliance and cost control but also as instruments for fostering employees' environmental awareness through socialization, monitoring, habituation, and behavioral change. Green accounting implementation is supported by management commitment, government regulations, accreditation requirements, and organizational culture. However, constraints remain, particularly the absence of a dedicated green accounting report, limited integration of environmental information into the hospital information system, and varying employee understanding of green accounting. The study concludes that green accounting serves managerial and behavioral functions by improving environmental accountability, strengthening environmental awareness, and contributing to hospital sustainability.]]>
