For decades, the Facility Guidelines Institute (FGI) has shaped healthcare construction through its Guidelines for Design and Construction. The FGI Guidelines have long set the bar for healthcare facility design, influencing codes, shaping projects, and guiding authorities in nearly every state. But starting in 2026, they’re evolving into something more: an enforceable Facility Code.
Written in regulatory language and optimized for adoption, this new format signals a major shift in how healthcare design standards will be applied and enforced across the country.
From Advice to Enforcement
The most visible shift is in the name: Guidelines will become Code. Rather than optional design recommendations, the new FGI Facility Code will be written entirely in enforceable language. Commentary and design rationales — traditionally found in the appendices — will be moved to separate handbooks.
This structural change provides two benefits:
- Regulators will have a cleaner, enforceable document to reference
- Designers can still access deeper context through optional handbooks
By drawing a sharper line between what’s required and what’s recommended, FGI is aligning with how healthcare authorities enforce compliance today.
Free Access, Paid Tools: A New Distribution Model
FGI is also revamping how the Facility Code will be accessed:
- The base code will be free to the public
- Handbooks and digital tools (e.g., annotation, highlighting, presentation mode) will be available via subscription
This tiered model reflects a broader trend in the world of codes and standards. Designers can view the essential rules at no cost, while power users can opt into enhanced features for collaboration and compliance tracking.
These digital features started rolling out to subscribers in 2025 and will become central to FGI’s long-term platform strategy.
What’s Changing Inside the Code
The 2026 Facility Code isn’t just about branding and distribution — there are major content changes, too.
Key updates include:
- New provisions for rural emergency hospitals, behavioral health units, and short-term outpatient centers
- Reorganization of imaging, procedure, and OR spaces for increased flexibility
- New mandates for single-occupancy rooms in residential care (a COVID-era lesson on infection control)
- Expanded guidance for modular, mobile, and mental health-focused environments
These additions reflect a more dynamic healthcare landscape, where facilities need to adapt to public health crises, behavioral health demands, and hybrid care models.
Why It Matters to Healthcare Leaders and Facility Managers
This isn’t just a semantic upgrade — it’s a functional transformation of how healthcare design standards will be created and enforced moving forward.
What it means for your organization:
- You’ll have free access to the core Facility Code, removing prior cost barriers to compliance
- Regulatory agencies will be better equipped to enforce standards uniformly
- Design teams will gain clearer direction on what is required vs. what is flexible
- You may need to budget for handbook subscriptions or digital licenses as part of your compliance stack
For construction managers, engineers, and healthcare leadership, these changes signal a new era of more accessible — but also more enforceable — facility design standards.
Timeline and Next Steps
The 2026 FGI Facility Code went through proposal and comment periods in 2023 and 2024. Final publication is expected in early 2026, with print and digital versions available shortly after.
What to do now:
- Review draft documents and start assessing where your current design standards may need to evolve
- Prepare for the digital shift by evaluating your platform subscriptions
- Begin internal discussions on how your team will handle handbook adoption, project documentation, and facility audits going forward
Final Thoughts
The 2026 Facility Code marks a turning point for healthcare construction and operations. By separating enforceable code from interpretive guidance — and making core access free — FGI is modernizing how the entire industry engages with design standards.
For healthcare organizations, the takeaway is clear: facility design is no longer guided by recommendations alone. It’s governed by code — and it’s time to prepare accordingly.
Frequently Asked Questions (FAQs)
The FGI Facility Code 2026 is the rebranded and enforceable version of the Facility Guidelines Institute’s Guidelines for Design and Construction. Unlike the previous guidelines, the new Facility Code uses enforceable language and separates recommendations into optional handbooks.
The FGI Facility Code is scheduled for publication in early 2026 following proposal and comment periods in 2023 and 2024. Print and digital versions will be released shortly after.
Key updates include new provisions for rural emergency hospitals, behavioral health units, and outpatient centers; reorganization of imaging and OR spaces; mandates for single-occupancy residential care rooms; and expanded guidance for modular and mental health-focused environments.
Yes, the base Facility Code will be free to the public. However, handbooks and enhanced digital tools such as annotation, highlighting, and collaboration features will be available through paid subscriptions.
Organizations should review the draft code, assess current design standards, plan for digital subscriptions, and prepare internal strategies for handbook adoption, documentation, and compliance audits.
