FGI Seeking Opinions on Proposals to Update the Guidelines for Design and Construction

The Facility Guidelines Institute (FGI) has issued a call for public opinions on proposals that have been submitted to update the 2022 edition of the FGI Guidelines documents.

These opinions will be visible to members of the Health Guidelines Revision Committee (HGRC) when they vote on the proposals beginning in October. Because the FGI Guidelines has been adopted in 43 of the 50 states in some form, it is essential that members of the health care facility management field weigh in on the changes being considered before the Sept. 30 deadline. 

FGI publishes three documents relevant to health care facilities: 

  • Guidelines for Design and Construction of Hospitals
  • Guidelines for Design and Construction of Outpatient Facilities
  • Guidelines for Design and Construction of Residential Health, Care, and Support Facilities 

If adopted at the state or local jurisdictional level, the Guidelines must be followed during new construction and major renovation projects.  

FGI revises the Guidelines documents every four years. The most recent edition was published in 2022. The 2026 edition revision cycle began with a public proposal period that was open from February to June 2023 and resulted in a total of 1,538 proposed updates to the documents.

There were 632 proposals for the Hospital Guidelines, 429 proposals for the Outpatient Guidelines, and 477 proposals for the Residential Guidelines. A full list of the proposals is available for review by the public at www.fgiguidelines.net. After creating a login and password, website visitors can filter the proposals by document, chapter, section or search term to find the proposed changes most relevant to their work and expertise and submit their opinions on the proposals.

A first draft of the 2026 Guidelines documents will be published in late spring 2024. From July to August 2024, the public will have an opportunity to make comments on the updates proposed for the 2026 edition. Once the comment period closes, the public will have more time to submit opinions before the HGRC votes on the public comments. The 2026 edition of the FGI Guidelines is scheduled to be published in April 2026.

Major 2026 Hospital Proposals

Due to the vast number of total proposals, ASHE Advocacy staff reviewed those for the Guidelines for Design and Construction of Hospitals and have highlighted below the proposals (listed by topic and ID number) most likely to impact ASHE members: 

  • Phasing during renovations: ID-85, ID-149, ID-201
  • Disaster planning: ID-699, ID-700
  • Service spaces in restricted and semi-restricted areas: ID-1267
  • Nitrous oxide systems: ID-1053
  • Airborne infection isolation room anterooms: ID-1114
  • Specialty infection control exam rooms: ID-1596
  • Multiple-diagnosis patient care units: ID-1699
  • Redefining procedure, operating, and imaging room definitions: 
    • Procedure rooms: ID-1233, ID-1265
    • Operating rooms: ID-754, ID-1266, ID-752, ID-1157
    • Imaging rooms: ID-1156, ID-1160, ID-1723, ID-1724
    • Exam/treatment, procedure, and operating room classification: ID-1150, ID-90, ID-1154, ID-1441, ID-1682 
  • Rural emergency hospitals: ID-1177, ID-1444, ID-1525

Please review these proposals and submit your opinions to FGI to ensure your views are heard.