The voluntary implementation of environmental management systems (EMS) according to Eco-Management and Audit Scheme (EMAS) is a proactive and comprehensive management initiative aiming to improve corporate environmental performance. EMS implementation and connected communication activities are seen as a possibility to strengthen stakeholder relationships. However, EMS development and implementation consumes significant time and financial resources. Therefore, in this empirical study with hospital managers, it is questioned if and to what extent hospital managers perceive stakeholders valuing the implementation of an EMS according to EMAS. The results show that only internal stakeholder pressure from owners and the management board exists. Other stakeholders know little and care less about EMAS, suggesting that they have other priorities and do not see a necessity for hospitals to engage in environmental management efforts. This low stakeholder interest reduces the value of EMAS registration for hospitals and limits future environmental management efforts. This could hinder sustainable development within the healthcare sector.