This is the first edition of the Guidelines in which requirements for hospitals, outpatient facilities, and residential care facilities are presented in three independent documents. Facility types covered in the 2018 Guidelines for Design and Construction of Hospitals include general hospitals, freestanding emergency care facilities, critical access hospitals, psychiatric hospitals, rehabilitation hospitals, children’s hospitals, and mobile/transportable medical units.

Changes in the 2018 Hospital Guidelines include a new section on accommodations for care of patients of size; addition of an option for flexibility by combining pre- and post-procedure patient care areas; and a complete overhaul of imaging requirements. Other notable updates address telemedicine spaces, acoustic design, airborne infection isolation rooms, sterile processing facilities, and mobile/transportable units.

As with the previous two editions, ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities was incorporated into the Guidelines to provide ventilation requirements for health care facilities. The 2018 edition of the Guidelines for Design and Construction of Hospitals includes the 2017 edition of ASHRAE 170, with all addenda approved through November 2017.

This is the first edition of the Guidelines in which requirements for outpatient facilities are presented independently from hospital and residential care facility requirements. Facility types covered in the 2018 Guidelines for Design and Construction of Outpatient Facilities include general and specialty medical services facilities, outpatient imaging facilities, birth centers, urgent care centers, infusion centers, outpatient surgery facilities, freestanding emergency care facilities, endoscopy facilities, renal dialysis centers, outpatient psychiatric centers, outpatient rehabilitation therapy facilities, mobile/transportable medical units, and dental facilities.

Changes in the 2018 Outpatient Guidelines provide guidance on two approaches for applying the Guidelines requirements to outpatient facility projects; a new section on accommodations for care of patients of size; a classification system for imaging rooms; and expanded laboratory, new pharmacy, and revised sterile processing facility requirements.

As with the previous two editions, ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities was incorporated into the Guidelines to provide ventilation requirements for health care facilities. The 2018 edition of the Guidelines for Design and Construction of Hospitals includes the 2017 edition of ASHRAE 170, with all addenda approved through November 2017.

The 2018 edition of the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities restructured the previous edition for clarity, and—based on needs in the residential long-term care marketplace—guidance for additional facility types was added. As with the previous edition, the document covers nursing homes, hospice facilities, assisted living facilities, independent living settings, adult day care and adult day health care facilities, wellness centers, and outpatient rehabilitation therapy facilities.

This edition continues moving away from institutional models to foster development of person-centered living environments that support a variety of care models and add to quality of life for residents. The goal is to help care organizations and designers create homelike physical environments that support positive resident outcomes. Included are a new section on post-acute care facilities and new chapters on substance abuse treatment facilities and settings for individuals with intellectual and/or developmental disabilities.

Facility types covered in the Hospital Guidelines include general hospitals, children’s hospitals, critical access and other small hospitals, behavioral and mental health hospitals, rehabilitation hospitals, and mobile/transportable medical units.

The 2022 Hospital Guidelines includes several notable new sections as well as revisions aimed at providing flexibility, reducing cost, and clarifying intent. New sections were written for a behavioral and mental health crisis unit, low-acuity patient treatment station (intended for “walking well” patients), and a burn trauma intensive care unit. New flexible design options include a provision allowing subdivision of trauma/resuscitation rooms as well as design guidance for a flexible secure holding room (i.e., a single-patient treatment room that can easily be converted to a secure holding room). Major updates appear in requirements for mobile units, imaging facilities, behavioral and mental health facilities, and neonatal intensive care units.

As with the last three editions, ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities has been incorporated into the Guidelines as minimum requirements for ventilation systems. Included in the 2022 Guidelines for Design and Construction of Hospitals is the 2021 edition of Standard 170 dated November 2021, which incorporates addenda c and d.

Note: The 2018 Hospital Guidelines included Chapter 2.3, Specific Requirements for Freestanding Emergency Care Facilities. This chapter does not appear in the 2022 Hospital Guidelines because a freestanding emergency care facility is not an inpatient facility. Requirements for freestanding emergency care facilities can now be found exclusively in the 2022 Outpatient Guidelines.

Facility types covered in the Outpatient Guidelines include general and specialty medical services facilities, outpatient imaging facilities, birth centers, urgent care centers, infusion centers, outpatient surgery facilities, freestanding emergency care facilities, endoscopy facilities, renal dialysis centers, outpatient behavioral and mental health centers, outpatient rehabilitation facilities, mobile/transportable medical units, and dental facilities.

The 2022 Outpatient Guidelines includes several notable new sections as well as revisions aimed at providing flexibility, reducing cost, and clarifying intent. New sections were written for a behavioral and mental health crisis unit, low-acuity patient treatment station (intended for “walking well” patients), sexual assault forensic exam room, and hyperbaric oxygen treatment facilities. New flexible design options include a provision allowing subdivision of trauma/resuscitation rooms as well as design guidance for a flexible secure holding room (i.e., a single-patient treatment room that can easily be converted to a secure holding room). Major updates appear in requirements for mobile units, imaging facilities, renal dialysis centers, and birth centers.

As with the last three editions, ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities has been incorporated into the Guidelines as minimum requirements for ventilation systems. Included in the 2022 Guidelines for Design and Construction of Outpatient Facilities is the 2021 edition of Standard 170 dated November 2021, which incorporates addenda c and d. Two new ventilation tables with design parameters specific to outpatient facilities have been added.

Facility types covered in the Residential Guidelines include nursing homes, hospice facilities, assisted living settings, independent living settings, long-term residential substance abuse treatment facilities, settings for individuals with intellectual and/or developmental disabilities, adult day care and adult day health care facilities, wellness centers, and outpatient rehabilitation therapy facilities.

The 2022 edition of the Residential Guidelines features a user-friendly restructuring that presents elements common to most facility types in one location—Chapter 2.1, Common Elements. Revisions that appear in this chapter include new design criteria for individuals receiving palliative care, expanded accommodations for telemedicine services, and changes to room size for individuals of size. Facility-specific requirements are listed in subsequent chapters, and updates include a minimum square footage for resident rooms in nursing homes, clarification of assisted living care model descriptions and requirements, and expanded requirements for facilities serving individuals with intellectual and/or developmental disabilities.

ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities has been incorporated into the 2022 Residential Guidelines to provide ventilation requirements for nursing homes and hospice facilities. The 2022 edition of the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities includes the 2021 edition of Standard 170 dated November 2021, which incorporates addenda c and d. A new ventilation table with design parameters specific to nursing homes, hospice facilities, and assisted living settings has been added.