Frequently Asked Questions About the Guidelines

Is the FGI Guidelines the same document as the document often called the AIA Guidelines?

The short answer: Yes.

The long answer: The Guidelines began with a U.S. federal government program after World War II, but was dropped during President Reagan's tenure, when the federal government was downsized. Those individuals in a leadership position with the Guidelines looked for an organization to continue updating and publishing the Guidelines, and the AIA Academy of Architecture for Health took it on.

At the end of the 1990s, a small nonprofit called the Facility Guidelines Institute (FGI) was formed to shepherd the Guidelines through the revision process and ensure it would be regularly updated using a public, multidisciplinary process. FGI and the AIA wrote a contract for each edition of the Guidelines (beginning with the 2001 edition) in which the AIA agreed to provide support for the Guidelines revision process—a staff member's time, meeting planning services, and publishing and marketing services—and to publish the updated document.

In the last few years, the AIA significantly reduced its publishing program and support for the Guidelines revision process no longer fit into its strategic or business plans. As a result, FGI had to find a new publisher, and the 2010 edition was published under an agreement between FGI and ASHE.

It is now appropriate to call the document the FGI Guidelines, which emphasizes the multidisciplinary source of its content as FGI is not associated with any one group of stakeholders interested in health care design and construction.

For more information about the history of the Guidelines, refer to the preface of the book.

Can we post the Guidelines CD on our office intranet? Can we print from the CD?

The Guidelines CD is offered with a single-user license only and may not be posted on an office intranet site. (Single-use use may include use on a single computer that can be accessed remotely by one employee at a time, which would be similar to sharing a bound book copy of the Guidelines—that is, only one person is able to use the document at a time.)

To determine whether their actions constitute fair use of the copyrighted Guidelines content, users of the Guidelines CD should consider the factors cited by Section 107 of the U.S. Copyright Act for determining fair use:

  • The purpose and character of the use, including whether such use is of commercial nature or is for nonprofit educational purposes
  • The nature of the copyrighted work
  • The amount and substantiality of the portion used in relation to the copyrighted work as a whole
  • The effect of the use upon the potential market for, or value of, the copyrighted work

The license user may print several pages of the Guidelines as necessary for his or her own use (e.g, for reference or to include with project files). The license user may also copy and paste paragraphs for insertion into other documents as needed.

The user license permits you to download the PDF from the CD to your computer and to keep the CD itself stored in the office as backup.

I am getting an error message when I try to open the PDF on the Guidelines CD; what shall I do?

The CD can be viewed using Adobe Reader 8 or 9. If you have an earlier version of Adobe Reader, please visit the Adobe website and download a current version of this free software.

When does [any section of] the Guidelines become effective?

The text of the Guidelines does not become a requirement until a state adopts the document, or portion thereof, to enforce as code in reviewing plans for health care construction, both new construction and renovations. Therefore, the answer to this question depends on what state the health care facility is in. Check with the relevant state department of health, usually the health facility licensing section.

Which states use the Guidelines as regulations?

Forty-two states use the Guidelines in some form. Some states adopt the whole document, and a few of these automatically update to the new edition when it is published. Other states only use part of the document, often the General Hospitals chapter, to regulate facilities and only use the rest as a reference. Some information about how different states use the Guidelines has been collected, but it is not up-to-date across the board. To ask about a specific state, contact the pertinent state agency (often the department of health) or send an e-mail to info@fgiguidelines.org.

Does the Joint Commission require health care organizations to use the Guidelines?

The Joint Commission does not mandate use of the Guidelines if another state or national standard is being applied to a project. For example, the VA and DOD have developed their own version of the Guidelines, many states reference an earlier edition, many states modify language in the Guidelines to address a state-specific issue, and some states write their own code with little input from the Guidelines.

Beginning in January 2011, the Joint Commission references the 2010 edition of the Guidelines in its accreditation manuals. See the Advocacy section of the ASHE website for a brief explanation.

Does CMS require health care organizations to use the Guidelines?

CMS doesn't require health care facilities to follow the Guidelines, but it does require them to follow an established standard and local building codes/requirements. Since many states require facilities to follow the Guidelines that makes the Guidelines a back door CMS requirement in those states. To our knowledge, CMS is not surveying for the requirements of the Guidelines.

Why aren’t the book and CD sold as a package as they were for the 2006 edition?

The 2006 edition of the FGI Guidelines for Design and Construction of Health Care Facilities (published by the AIA) was the first Guidelines edition of to have an electronic version. After the fact, the Facility Guidelines Institute (the nonprofit that holds the copyright in the content of the Guidelines) determined that giving away a free CD with purchase of the book was not a good business arrangement as income from the sale of the document is needed to pay for revision cycle expenses and research to improve the content. Thus, FGI decided to sell the printed version and the CD separately for the 2010 edition of the Guidelines (published by ASHE).

Where can I find past editions of the Guidelines?

References to the Guidelines editions from 1976 through 1984, which were published by the federal government, can be found on the Facility Guidelines Institute website at www.fgiguidelines.org/pasteditions.php. Also on this page are PDF versions of the 1987, 1992-93, 1996-97, and 2001 editions and a read-only version of the 2006 edition.

Other questions? Send suggestions for FAQS to info@fgiguidelines.org or call 312-422-3821.