S2 E1 – What’s New in the 2026 FGI Facility Code Drafts

Podcast — August 2, 2024

Introduction

This is your chance to weigh in! The change in title from the 2022 Guidelines for Design and Construction documents to the 2026 FGI Facility Code documents is one of several changes you will see during the 2026 draft public comment period (now through September 30, 2024). For this episode, John Williams and Leah Hummel sit down with Bridget McDougall for an overview of the draft changes discussed as part of a presentation they gave at the Health Care Facilities Innovation Conference in Anaheim, CA. From new chapters to revised requirements, hear about the language that you have an opportunity to comment on before the next edition is published in early 2026. Note: This episode was recorded on July 20, 2024, while at ASHE’s Health Care Facilities Innovation Conference in Anaheim, CA.

About Leah Hummel

Leah Hummel, AIA, CHFM, CHC, is a senior associate director of the American Society for Health Care Engineering’s (ASHE) advocacy team where she represents ASHE members’ interests through involvement with several code committees applicable to health care facilities. Her career, spanning more than two decades, has been dedicated to health care environments, with a passion for code development and compliance. Leah previously worked for the North Dakota Department of Health Division of Life Safety and Construction as a plan reviewer and construction inspector and also for The Joint Commission, first as a Life Safety Code surveyor and later as an engineer with the Standards Interpretation Group.

About John Williams

John first began using the Guidelines in the 1990s, starting with the purple-covered 1992-93 edition, and has been a devoted student of the Guidelines ever since. An AHJ and self-admitted “code nerd,” John’s office full of old (and new) code books points to his long-term interest in code development. John loves to talk about health care codes and is honored to contribute as FGI’s VP of content and outreach and chair of the 2026 Health Guidelines Revision Committee. He lives in Olympia, Washington with his wife and two sons. 

2026 FGI Facility Code draft sections for draft language mentioned in this episode (in order of episode appearance):

Hospital draft Section 2.4-1.1.1: rural emergency hospital (REH) and critical access hospital (CAH) designations

Hospital draft sections 1.2-2.1.1.3, 2.2-3.4.2.1 (1), 2.2-3.4.3.1 (1), and outpatient draft sections 1.2-2.1.1.3, 2.1-3.2.2.1 (1), 2.1-3.2.3.1 (1), 2.1-3.2.4.1 (1): Changes to address the often-asked questions about which procedure can be done in which room

Outpatient draft Chapter 2.12: A new chapter in the outpatient document specifically for behavioral health crisis centers (both those part of a freestanding emergency department and those designated as “community-based” crisis centers

Hospital draft sections 1.3-3.5.1.1, 1.3-3.5.1.2, and 1.3-3.5.1.3: New requirements for emergency room signage

Hospital draft Section 2.2-2.17: A new section for behavioral health medical complexity patient care units

Outpatient draft Chapter 2.16: A new outpatient chapter for sleep disorder clinics

Hospital draft Section 2.1-6.2.4: New sections for patient discharge lounge and external transport discharge unit

Hospital draft Section 2.1-8.4.2.3: New medical device processing water distribution section (including reference to AAMI ST108: Water for the Processing of Medical Devices).

Hospital draft Section 2.1-8.4.2.4 (6)(b): Elimination of dead-end piping

Hospital draft Section 2.1-8.4.2.1 (4): Flushing locations for mains and branches

Outpatient draft Section 2.1-8.4.2.1 (4): Dead legs flushing

Hospital draft Section 2.1-8.4.3.1 (5)(a) and outpatient draft Section 2.1-8.4.3.1 (5): Shower and tub/shower valves

“There was an interesting proposal that was put forward in FGI to require patient room sinks and toilet rooms to be on the corridor side of the patient room rather than be [placed] outbound on the exterior wall of the building.” Note: This proposal did not reach consensus when voted on by the HGRC and therefore does not appear in the draft document.

Residential draft Section 3.1-3.7: Dialysis treatment area for nursing home residents

Single-resident rooms

Residential draft Section: 3.1-2.2.2.1 (1): In nursing homes

Residential draft Section 4.1-2.2.2.1 (1)(a): In assisted living settings

Residential draft Section 4.3-2.2.2.1 (1): In long-term residential substance use disorder treatment facilities

Residential draft Section 4.4-2.2.2.1 (1): In settings for individuals with intellectual and/or developmental disabilities

Outpatient draft Section 2.1-3.8.11: A new requirement in the outpatient document to allow for a clean supply area (as opposed to a room), when indicated by the safety risk assessment

Acronyms Mentioned

AAMI: The Association for the Advancement of Medical Instrumentation

AHJ: Authority having jurisdiction

ASHE: The American Society for Health Care Engineering

ASHRAE: The American Society of Heating, Refrigerating and Air-Conditioning Engineers

CAH: Critical access hospital

CMS: Centers for Medicare & Medicaid Services

EMS: Emergency medical services

FGI: Facility Guidelines Institute

ICRA: Infection control risk assessment

IIDD: Individuals with intellectual and/or developmental disabilities

QSO: Quality, safety, and oversight

REH: Rural emergency hospital

Mentioned in this episode

Health Care Facilities Innovation Conference: Previously the “ASHE Annual Conference.” This year’s conference was held in Anaheim, California from July 21-24, 2024.

Comment Period: July 1-September 30th, public comment is welcomed on the 2026 draft FGI Facility Code documents. Visit www.fgiguidelines.net.

FGI Facility Code documents: Previously the FGI Guidelines for Design and Construction documents.

Center for Medicare & Medicaid Services: The federal agency that provides health coverage through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.

American Society of Anesthesiologists classification system: A physical status classification system used to assess and communicate a patient’s pre-anesthesia medical comorbidities.

Behavioral health crisis centers: A supportive environment that provides emergency access to behavioral health care for those experiencing behavioral health crises.

Dr. Scott Zeller: Leading expert in psychiatric emergencies and creator of the EmPath Unit concept which informed much of the behavioral health crisis unit requirements in the 2022 Guidelines document.

Episode 5: Episode 5 of Between the Lines with FGI aired on March 8, 2024, and featured an interview with Dr. Scott Zeller about behavioral health crisis centers.

Infection control risk assessment: A documented process to proactively assess the risk of infection during construction or renovation in health care facilities and settings.

Laura’s Law: A Massachusetts law that took effect on January 1, 2024, to improve emergency department access. It’s named after Laura Levis, who died in 2016, after unsuccessfully trying to gain entry into a locked ED facility.

B occupancies: Includes, among others, the use of a building or structure, or a portion thereof, for office, professional, or service-type transactions, including storage of records and accounts.

Discharged patient lounge: A space for patients that are medically ready for discharge but awaiting transportation out of the facility.

External transport discharge unit: A space for patients who have received discharge orders (or whose discharge orders are pending) but who require transportation by stretcher.

Legionella: A waterborne pathogen causing legionellosis.

AAMI 108: ANSI/AAMI ST108:2023 Water for the Processing of Medical Devices

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