Uses of the Guidelines

The industry’s most widely recognized guidance for planning, designing, and constructing health care and residential health, care, and support facilities, the FGI Guidelines documents consolidate minimum program, space, risk assessment, infection prevention, architectural detail, surface, built-in furnishing, and building system requirements in one convenient place.

The Guidelines documents are made available for a wide variety of public and private uses. These include adoption by states for regulatory purposes and other reference in laws, codes, rules, and regulations as well as use in private self-regulation and standardization of space and equipment requirements and the promotion of safe practices and methods in planning, design, and con­struction for various types of outpatient facilities.

Regulatory Use

Use of the Guidelines or any portion thereof for regulatory purposes should be accomplished through adoption by reference. The term “adoption by reference” means citing title, edition, and publishing information only.

  • Any deletions, additions, and changes desired by the adopting authority should be noted separately in the adopting instrument.
  • To help FGI follow the uses made of this document, adopting authorities are requested to notify FGI at when they adopt an edition of the Guidelines or use the documents in any other regulatory fashion.

Authorities adopting the Guidelines should encourage design innovation and grant exceptions where the intent of the standards is met. These standards assume that appropriate architectural and engineering practice and compliance with applicable codes will be observed as part of normal professional service.

It is recognized that some health care services may be provided in facilities not subject to licensure or regulation, and the Guidelines is intended to be suitable for use by all care and service providers. It is further intended that when used as regulation, some latitude be granted in complying with the Guidelines requirements as long as the health and safety of the facility’s occupants are not compromised.

Code Language in the Guidelines

For brevity and convenience, these standards are presented in “code language.”

Use of words such as “shall” indicates mandatory language only where the text is applied by an adopting authority having jurisdiction (AHJ). However, when adopted by an AHJ, design and construction shall conform to the requirements of the Guidelines.

The word “Reserved” is used to help standardize numbering of the text and is not necessarily a placeholder for specific requirements.

Cross-references are used throughout the Guidelines to include language from another chapter in the text where the cross-reference is located. These references comprise the section number with the section name in parentheses. For example: See Section 2.2-3.1.4 (Resident and Participant Kitchen).

Use with Other Codes

The Guidelines documents address certain details of construc­tion and engineering that are important for outpatient facility design and construction, but they are not intended to be all-inclusive, nor shall they be used to the exclusion of other guidance or codes.

  • Local codes. For aspects of design and construction not included in the Guidelines, local governing building and licensing codes shall apply.
  • Model codes. Where there is no local governing building code, the prevailing model code used in the relevant geographic area is hereby specified for all requirements not otherwise specified in the Guidelines.
AHJ (Authority Having Jurisdiction) Certification

Some projects may be subject to the regulations of several different jurisdictions, including local, state, and federal authorities. While coordination efforts have been made, the Guidelines may not always be consistent with all applicable codes, rules, and regulations. Therefore, it is essential that individual project requirements be verified for compliance with all AHJs who have jurisdiction over a project. Where requirements appear to be conflicting or contradictory, the AHJ with primary responsibility for resolution should be consulted.


From time to time, FGI issues errata to correct an error in its published Guidelines documents. This information is posted on the FGI website and announced in the FGI Bulletin, a quarterly newsletter of the Facility Guidelines Institute. All errata are considered to be corrections to errors in the Guidelines text and should be applied as such.

Formal Interpretations of Requirements

Users of the Guidelines can request formal interpretations of the language in the documents. Interpretations, which are provided by members of the Health Guidelines Revision Committee, are intended to provide clarification; a summary of any background and previous discussion, if appropriate and available; and a rationale for the interpretation rendered.

It is understood that any such interpretation is advisory in nature and is intended to assist the designer, care or service provider, and adopting AHJ to maximize the value of the Guidelines. When an inquiry does not require a formal interpretation, an advisory opinion may be provided.

Requests for interpretation should be submitted through the FGI website.


Although FGI administers the revision process and establishes rules to promote fairness in the development of consensus, it does not independently test, evaluate, or verify the accuracy of any information or the soundness of any judgments or advice contained in the Guidelines.

FGI endeavors to develop performance-oriented and evidence-based minimum requirements as guidance for design of U.S. health and residential care facilities without prescribing design solutions. FGI disclaims liability for any personal injury or property or other damages of any nature, whether special, indirect, consequential, or compensatory, directly or indirectly resulting from the publication, use of, or reliance on the Guidelines documents. FGI also makes no guaranty or warranty as to the accuracy or completeness of any information published therein.

In issuing and making the Guidelines documents available, FGI is not undertaking to render professional or other services for or on behalf of any person or entity. Nor is FGI undertaking to perform any duty owed by any person or entity to someone else.

Anyone using these documents should rely on his or her own independent judgment or, as appropriate, seek the advice of a competent professional in determining the exercise of reasonable care in any given circumstance.

FGI does not have any power, nor do they undertake, to police or enforce compliance with the contents of the Guidelines documents. FGI does not list, certify, test, or inspect designs or construction for compliance with these documents.

Any certification or other statement of compliance with the requirements of the Guidelines documents shall not be attributable to FGI and is solely the responsibility of the certifier or maker of the statement.


The content of the Guidelines documents, in both print and digital form, is copyrighted by the Facility Guidelines Institute, Inc. By making these documents available for use and adoption by public authorities and private users, FGI does not waive any rights in copyright to these documents.

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