New Healthcare Construction Codes Effective 2023: MEP Systems Impact

Every four years, the Facility Guidelines Institute (FGI) updates their Guidelines for Design and Construction of Hospitals and Outpatient Facilities to stay up to date with current technologies and design concepts. From an MEP standpoint, the guidelines are updated to improve patient well-being, necessitate safer system operation, and to improve environmental quality in our health care facilities. As of February 1, 2023, the Pennsylvania Department of Health will adopt the 2022 FGI Guidelines for new construction and renovation projects of hospitals, outpatient, and residential care facilities.  

Significant mechanical changes to this batch of updates include revisions to the ventilation tables and updated requirements for operating room diffusers. The ventilation tables, which list the required air change rates for various room types, have been improved upon to include minimum filter efficiencies for each separate space function. A column permitting system turndown dependent on room type was also added to the ventilation tables.

Operating rooms or class 3 imaging rooms designated for orthopedic procedures, transplants, neurosurgery, or dedicated burn unit procedures are now required to have accessible HEPA filters provided in each air terminal device in the ceiling. These filters will require routine upkeep, so maintaining accessibility to the laminar flow diffuser array will be important when planning an operating room ceiling system. 

Only minor changes were noted with respect to plumbing systems. Spouts on faucets for handwashing sinks are now required to reach at least 6”. Requirements for various human waste disposal systems, such as washer disinfector systems and bedpan macerator systems, have been added. The medical gas outlet table has also been revised.

The progression to the 2022 version of the code brings minimal change electrically.  Additional requirements for video surveillance of public entrances have been added as a result of Laura’s Law.  The telecommunication system requirements have been modernized to better align with industry terminology and standards.  Nurse call requirements have been updated to incorporate newer communication technologies. 

Although not all changes to the 2022 FGI Guidelines were mentioned above, this article is meant to highlight some of the significant changes. As you work through upcoming and current projects this year, Barton Associates has the expertise to help navigate the 2022 FGI Guideline updates through your design and construction process. If you have questions regarding the potential impact of the 2022 FGI Guidelines update on current or potential projects, please do not hesitate to contact Ryan Davie, EIT at 717-845-7654 or

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