fgi_presentation_mishe_ec_2019_12_13.pdf

12.13.2019
FGI Guidelines for Design &
Construction of Hospitals-
2018…..An overview of
Michigan’s latest Healthcare
Code
• Osborn Engineering
• Dave Chouinard, CBCP, LEED AP, Director | Healthcare
• Jeff Bodway, PE, PMP, LEED AP BD+C, Associate Director | Energy and Facility Systems

12.13.2019
Agenda/Objectives
1. Understand proposed administrative rules to update the Michigan Healthcare Design
Standard
2. An overview of the organization of FGI 2018
3. Learn about some differences from the 2007 Minimum Design Standard for Healthcare
Facilities in Michigan and FGI 2018

12.13.2019
Facilities Guidelines Institute
• What is the FGI?
• An independent not-for-profit organization dedicated in developing guidance for planning,
designing, and construction of hospitals, outpatient facilities and residential healthcare and
support facilities.
• FGI partners with numerous other organizations (HHS/CMS, ASHE, NIH, AIA) to help develop
the Guidelines and other practical, evidence-informed publications.
• They oversee the FGI Guidelines for Design and Construction revision process and publication,
fund research, and offer resources that support the development of safe, effective health and
residential care built environments.

12.13.2019
History
• Feburary 14, 1947 General Standards; Federal Register: Hill-Burton program
• 1974- Retitled: Minimum Requirements for Construction and Equipment for Hospital and
Medical Facilities
• 1984- Dept of Health and Human Services removed from Regulation and Requirements.
Federal government no longer retain guidelines in regulatory form.
• 1984- Now non-regulated, changed title to: Guidelines for Construction and Equipment of
Hospital and Medical Facilities. This document still used by many AHJ’s for
licensure/registration.
• 1983-84, HHS asked the AIA/CAH to form an advisory group, funded by the Public Health
Service for the next revision. Federal gov’t declined to publish the revised document. AIA/CAH
reach agreement with the AIA to publish the 1987 Ed.
• 1992-93 Ed. of the Guidelines published and distributed by the AIA and the name changed to:
“Guidelines for Design and Construction of Hospital and Health Care Facilities.”

12.13.2019
History
• To create a more formal process to keep the document current, the Facility Guidelines Institute was
founded and in 2001, the first revision cycle was completed under the direction of the FGI.
• FGI received major funding from: HHS, ASHE, NIH and the AIA provided staff and technical support.
• 2006 ed. Received major funding form HHS/Centers for Medicare and Medicaid, ASHE, NIH and
the AIA.
• 2010 ed. Major funding from HHS/CMS and now ASHE provided the staff and technical support.
One major change to the 2010 edition…the addition of the 2008 ANSI/ASHRAE/ASHE Standard
170: Ventilation of Health Care Facilities.
• Standard 170 has what ASHRAE terms “continuous maintenance” project status in keeping
170 current with practice in the field. Meet periodically to develop proposed changed rather
than waiting for the end of the three-year Guidelines cycle. Official addenda are issued, e.g.
Addendum D lowering minimum relative humidity in OR’s from 30% to 20%, to represent state-
of-the-art thinking in the industry.
• 2014- Continue efforts to increase clarity and consistency in content. 2014 Guidelines for Design
and Constriction of Hospitals and Outpatient Facilities. The 2014 Guideline is used by CMS
presently.

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2018
• 2018- In continuing effort to add clarity and better serve the Healthcare industry, FGI
published, for the first time, (3) separate targeted Guidelines:

12.13.2019
What’s changed since 2007?
iPhone 1-Introduced January 2007
• $499 for 4GB
• 3.5-inch screen
• 2G Data
• 2.0MP Camera
• No GPS
iPhone 11-Introduced September 2019
• $699 for 64GB
• 6.06-inch LED IPS LCD
• Dual-lens 12MP Camera array
• Six Colors

12.13.2019
Michigan Healthcare Code Background
Michigan Healthcare Code: (Issued in 2007) Code was formally adopted October 2015:
Minimum Design Standards for Healthcare Facilities in Michigan
• Enforced for 10+ years.
• Decision made to adopt FGI Guideline 2018 on June 2019 and is projected to go into effect
Q1 2020.
• Reason to adopt FGI 2018: FGI is more comprehensive and developed and it provides better
direction in all Disciplines.
• Environment of Care (EOC) / Architectural
• Fire Protection
• Technology
• HVAC
• Electrical
• Plumbing / Medical Gases
• Proposed Rules: https://dmbinternet.state.mi.us/DMB/ORRDocs/ORR/1778_2017-
101LR_orr-draft.pdf

12.13.2019
Michigan Healthcare Design Standards-Changing Times
2007 Minimum Design Standards for
Healthcare Facilities in Michigan
Facilities Guidelines Institute (FGI)
Hospitals, Residential Health Care, and
Outpatient Facilities, 2018 Edition

12.13.2019
Michigan - Rule 263
• “In performing a construction permit review for a health facility, the
department shall apply the following guidelines….”
• Facilities Guidelines Institute (FGI):
• Hospitals, Residential Health Care, and Outpatient Facilities, 2018
Edition
• ASHRAE 170-2017, Ventilation of Health Care Facilities

12.13.2019
Michigan - Rule 265
• Describes when plans shall be submitted to HFES for review:
• New Buildings
• Additions
• Building Change
• Added definition: “means alterations to an existing building involving a
change in the interior configuration or intended use, including alterations
to the mechanical, electrical, or plumbing systems. This term does not
include routine maintenance or replacement with comparable
mechanical, electrical or plumbing equipment that does not alter the
current physical structure.”
• Conversion of existing structures for use as a health facility

12.13.2019
2018 FGI Guidelines
• Hospital Guidelines
• Provides minimum design standards for:
• General Hospitals
• Freestanding Emergency Facilities
• Critical Access Hospitals
• Psychiatric Hospitals
• Rehabilitation Hospitals
• Children’s Hospitals
• Mobile/Transportable medical Units
• Elements of the FGI Guidelines for Hospitals
• Part 1: General
• Part 2: Hospital Facility Types
• Part 3: Ventilation of Health Care
Facilities (ASHRAE Standard 170-2017)

12.13.2019
2018 FGI Guidelines
• Outpatient Facilities Guidelines
• Provides minimum design standards for
outpatient facility types
• General & Specialty Medical Services
Facilities
• Outpatient Imaging Facilities
• Birth Centers
• Urgent Care Facilities
• Infusion Centers
• Outpatient Surgery Facilities
• Freestanding Emergency Facilities
• Renal Dialysis Centers
• Outpatient Rehabilitation Facilities
• Endoscopy Facilities,
mobile/transportable medical units, and
dental units.
• Residential Healthcare & Support Facilities
Guidelines
• Provides minimum design standards for:
• Nursing Homes
• Hospice Facilities
• Assisted Living Facilities
• Substance Abuse Treatment Facilities,
• Settings for Individuals with intellectual
and/or developmental disabilities
• Independent Living Settings
• Adult Day Care Facilities
• Wellness Centers
• Outpatient Rehabilitation Facilities
• Homes for the Aged

12.13.2019
Elements of the FGI Guidelines
• Part 1: General
1.1 Introduction (Minimum Standards,
earthquake, other regulations)
1.2 Planning, Design and Construction
• Functional Program
• Safety Risk Assessment
• Planning and Design Considerations
(Acoustic Design, Sustainable Design,
etc.)
• Commissioning
1.3 Site (Lighting, Signage, Parking,
Landscaping, etc.)
1.4 Equipment
• 1.2-4 Safety Risk Assessment
• Infection Control Risk Assessment
• Patient Handling & Movement
Assessment
• Fall Prevention Assessment
• Medication Safety Assessment
• Behavioral and Mental Health Risk
Assessment
• Patient Immobility Assessment
• Security Risk Assessment

12.13.2019
Elements of the FGI Guidelines
• Part 2: Hospital Facility Types
2.1 Common Elements for Hospitals
2.2 Specific Elements for General
Hospitals
2.3 Specific Requirements for
Freestanding Emergency Care Facilities
2.4 Specific Requirements for Critical
Access Hospitals
2.5 Specific Requirements for Psychiatric
Hospitals
Rehabilitation Hospitals
2.7 Specific Requirements for Children’s
Hospitals.
Mobile/Transportable Medical Units
• 2.1 Common Elements for Hospitals
2.1-1 General
2.1-2 Patient Care Units
2.1-3 Diagnostic and Treatment Areas
(Exam/Treatment, Telemedicine)
2.1-4 Patient Support Facilities (Lab,
Pharmacy, Food Services)
2.1-5 General Support Facilities (SPD,
EVS, Linen, Engineering, etc.)
2.1-6 Public and Administrative Areas
2.1-7 Design and Construction
Requirements
2.1-8 Building Systems (HVAC, Plumbing,
Electrical, Communications, Security)

12.13.2019
Environment
of Care /
Architectural

12.13.2019
Michigan Rule 291-Handrails
• Must be provided on both sides of a corridor, ramp, or stairway used by patients.

12.13.2019
Room Use
Design Requirements2
Room Type Location Surfaces
Exam or
treatment
room
Patient care that may
require high-level
disinfected or sterile
instruments but does
not require the
environmental controls
of a procedure room
Unrestricted
area
Accessed from an
unrestricted area
Flooring: cleanable and wear-resistant for the
location; stable, firm, and slip-resistant
Wall finishes: washable
Ceiling: cleanable with routine housekeeping
equipment; lay-in ceiling permitted
Table 2.2-1: Examination Rooms

12.13.2019
Room Use
Procedure
room
Patient care that requires
high-level disinfection of
the room, sterile
instruments, and some
environmental controls but
does not require the
environmental controls of
an operating room
Endoscopic procedures
Semi-restricted
area
Accessed from an
unrestricted or a semi-
restricted area
Flooring: cleanable and wear-resistant for the location;
stable, firm, and slip-resistant
Floor and wall base assemblies in cystoscopy, urology, and
endoscopy procedure rooms and endoscope processing
room: monolithic floor with integral coved wall base
carried up the wall a minimum of 6 inches
Wall finishes in endoscopy procedure room and
endoscope processing room: washable; free of fissures,
open joints, or crevices
Ceiling: smooth and without crevices, scrubbable, non-
absorptive, non-perforated; capable of withstanding
cleaning chemicals; lay-in ceiling permitted if gasketed or
each ceiling tile weighs at least one pound per square
foot and no perforated, tegular, serrated, or highly
textured tiles
Table 2.2-1: Procedure Rooms

12.13.2019
Room Use
Operating
room
Invasive procedures
3
Any procedure during
which the patient will
require physiological
monitoring and is
anticipated to require
active life support
Restricted
area
Accessed from a
semi-restricted
area
Flooring: cleanable and wear-resistant for the
location; stable, firm, and slip-resistant
Floor and wall base assemblies: monolithic floor
with integral coved wall base carried up the wall a
minimum of 6 inches
Wall finishes: washable; free of fissures, open
joints, or crevices
Ceiling: monolithic, scrubbable, capable of
withstanding cleaning and/or disinfecting
chemicals, gasketed access openings
Table 2.2-1: Operating Rooms

12.13.2019
Room Use
Class 1 imaging
room
Diagnostic radiography, fluoroscopy,
mammography, computed
tomography (CT), ultrasound,
magnetic resonance imaging (MRI),
and other imaging modalities
Services that use natural orifice entry
and do not pierce or penetrate natural
protective membranes
Unrestricted area Accessed from an
unrestricted area
Flooring: cleanable and wear-resistant for the location; stable, firm, and slip-
resistant
Ceiling: cleanable with routine housekeeping equipment; lay-in ceiling permitted
Class 2 imaging
room
Diagnostic and therapeutic
procedures such as coronary,
neurological, or peripheral
angiography
Electrophysiology procedures
Semi-restricted area Accessed from an unrestricted or
a semi-restricted area
resistant
Floor and wall base assemblies: monolithic floor with integral coved wall base
Wall finishes: washable; free of fissures, open joints, or crevices
Ceiling: smooth and without crevices, scrubbable, non-absorptive, non-
perforated; capable of withstanding cleaning chemicals; lay-in ceiling permitted
if gasketed or each ceiling tile weighs at least one pound per square foot and no
perforated, tegular, serrated, or highly textured tiles
Class 3 imaging
room
Invasive procedures
3
Any Class 2 procedure during which
the patient will require physiological
monitoring and is anticipated to
require active life support
Restricted area Accessed from a semi-restricted
area
resistant
Floor and wall base assemblies: monolithic floor with integral coved wall base
Wall finishes: washable; free of fissures, open joints, or crevices
Ceiling: monolithic, scrubbable, capable of withstanding cleaning and/or
disinfecting chemicals, gasketed access openings
Table 2.2-2: Imaging Services

12.13.2019
Patients of Size
The term “Patients of Size” is used for
patients who require increased space for
care and mobilization.
“Bariatric Patient” refers to patients
specifically in for Bariatric surgery.

12.13.2019
Accommodations for Patients of Size
• Patient Room Clearance Requirements
• 5’-0” Clearance at foot of patient bed
• 5’-6” on non-transfer side of the bed
• On Transfer side of the bed
• Ceiling/Wall Lift: Rectangle 10’-6” by 5’-6”, located 2’ from the headwall
• Mobile Lift: Rectangle 10’-6” by 7’-0”, located 2’ from the headwall
• Door Opening: Minimum 57” clear width
• Patient Toilet Room
• Expanded capacity toilet located a minimum of 36” from finished wall to centerline (each
side)
• Regular toilet located a minimum of 44” from finished wall to centerline (each side)
• 46” Wide clear area in front of toilet 72” deep
• Shower Stall: Minimum of 4’-0” by 6’-0”
• Door Opening: Minimum 45.5” clear width

12.13.2019
Airborne Infectious Isolation (AII) Rooms-Arch
• Permitted to have either self-closing door or audible alarm that can be activated when the
room used as an isolation room.
• PPE storage at the entrance to the room.
• Doors will have edge seals along sides & top of the door frame, bottom edge door sweep is
permitted to assist in maintaining negative pressure.
• Ante-room is not required, but is allowed and shall meet the following:
• Space for putting on PPE prior to entering patient room.
• All doors have either self-closing device or audible alarm.
• Hand-Washing Station
• Storage and disposal for PPE

12.13.2019
Airborne Infection Isolation, Protective
Environment and Combo AII/PE Rooms
Mi2007 HC
• AII – Discussed in several sections and
design parameters outlined.
• PE – HEPA filters and directed airflow (clean
to less clean) required.
• Combo AII/PE – mentioned only as a facility
specific requirement and when present an
Ante Room must be provided.
• Automated continuous monitoring –
mentioned as being a requirement only
when required by AIA Guidelines
FGI 2018
• AII – specific requirements defined, Ante
Rooms recommended but optional
• PE – specific requirements defined, Ante
Rooms recommended but optional
• Combo AII/PE Rooms available to customize
pressure relationships to specific
medical/infection control needs. Ante Room
Required.
• Detailed pressures and relationships clearly
defined.
• Continuous pressure monitoring required.

12.13.2019
Ventilation Requirements
Mi2007 HC FGI 2018
The comparable FGI tables for ventilation have been expanded to include specific tables for Hospitals,
Outpatient Spaces and other facility types. FGI Tables also combine the information for acceptable humidity
and temperature ranges with the ventilation tables. Mi2007 provided this information in separate tables.

12.13.2019
Table 7.1 Design Parameters-Hospital Spaces
Function of Space
Pressure
Relationship
to Adjacent
Areas (n)
Minimum
Outdoor ach
Minimum Total
ach
All Room Air Exhausted
Directly
to Outdoors (j)
Air Recirculated by
Means of Room Units
(a)
Design
Relative
Humidity (k),
%
Design Temperature (l),
°F/°C
SURGERY AND CRITICAL CARE
Critical and intensive care NR 2 6 NR No 30–60 70–75/21–24
Delivery room (Caesarean) (m), (o) Positive 4 20 NR No 20–60 68–75/20–24
Emergency department
decontamination
Negative 2 12 Yes No NR NR
Emergency department
exam/treatment room (p)
NR 2 6 NR NR Max 60 70–75/21–24
Emergency department public
waiting area
Negative 2 12 Yes (q) NR Max 65 70–75/21–24
Intermediate care (s) NR 2 6 NR NR Max 60 70–75/21–24
Laser eye room Positive 3 15 NR No 20–60 70–75/21–24
Medical/anesthesia gas storage (r) Negative NR 8 Yes NR NR NR
Newborn intensive care Positive 2 6 NR No 30–60 72–78/22–26
Operating room (m), (o) Positive 4 20 NR No 20–60 68–75/20–24
Operating/surgical cystoscopic
rooms (m), (o)
Positive 4 20 NR No 20–60 68–75/20–24
Procedure room (o), (d) Positive 3 15 NR No 20–60 70–75/21–24
Radiology waiting rooms Negative 2 12 Yes (q), (w) NR Max 60 70–75/21–24
Recovery room NR 2 6 NR No 20–60 70–75/21–24
Substerile service area NR 2 6 NR No NR NR
Trauma room (crisis or shock) (c) Positive 3 15 NR No 20–60 70–75/21–24
Treatment room (p) NR 2 6 NR NR 20–60 70–75/21–24
Triage Negative 2 12 Yes (q) NR Max 60 70–75/21–24
Wound intensive care (burn unit) NR 2 6 NR No 40–60 70–75/21–24

12.13.2019
Function of Space
Pressure
Relationship
to Adjacent
Areas (n)
Minimum
Outdoor ach
Minimum Total
ach
Directly
to Outdoors (j)
Air Recirculated by
Means of Room Units
(a)
Design
Relative
Humidity (k),
%
°F/°C
INPATIENT NURSING
AII anteroom (u) (e) NR 10 Yes No NR NR
AII room (u) Negative 2 12 Yes No Max 60 70–75/21–24
Combination AII/PE anteroom (e) NR 10 Yes No NR NR
Combination AII/PE room Positive 2 12 Yes No Max 60 70-75/21-24
Continued care nursery N/R 2 6 N/R No 30–60 72–78/22–26
Labor/delivery/recovery (LDR)
(s)
NR 2 6 NR NR Max 60 70–75/21–24
Labor/delivery/recovery/postpa
rtum (LDRP) (s)
NR 2 6 NR NR Max 60 70–75/21–24
Newborn nursery suite NR 2 6 NR No 30–60 72–78/22–26
Nourishment area or room NR NR 2 NR NR NR NR
Patient corridor NR NR 2 NR NR NR NR
Patient room NR 2 4 (y) NR NR Max 60 70–75/21–24
PE anteroom (t) (e) NR 10 NR No NR NR
Protective environment room
(t)
Positive 2 12 NR No Max 60 70–75/21–24
Toilet room Negative NR 10 Yes No NR NR

12.13.2019
Function of Space
Pressure
Relationship
to Adjacent
Areas (n)
Minimum
Outdoor ach
Minimum Total
ach
Directly
to Outdoors (j)
Air Recirculated by
Means of Room Units
(a)
Design
Relative
Humidity (k),
%
°F/°C
DIAGNOSTIC AND TREATMENT
Autopsy room Negative 2 12 Yes No NR 68–75/20–24
Bronchoscopy, sputum
collection,
and pentamidine
administration
Negative 2 12 Yes No NR 68–73/20–23
Dialysis treatment area NR 2 6 NR NR NR 72–78/22–26
Dialyzer reprocessing room Negative NR 10 Yes No NR NR
ECT procedure room NR 2 4 NR NR Max 60 72–78/22–26
Endoscope cleaning Negative 2 10 Yes No NR NR
Gastrointestinal endoscopy
procedure room (x)
NR 2 6 NR No 20–60 68–73/20–23
General examination room NR 2 4 NR NR Max 60 70–75/21–24
Nuclear medicine treatment
room
Negative 2 6 Yes NR NR 70–75/21–24
STERILE PROCESSING DEPARTMENTz
Clean workroom Positive 2 4 NR No Max 60 68–73/20–23
Decontamination room Negative 2 6 Yes No NR 60–73/16–23
Sterile storage room Positive 2 4 NR NR Max 60 Max 75/24

12.13.2019
HVAC Filtration Efficiency
Mi2007 HC FGI 2018
The filtration requirements are similar in FGI to the current Michigan requirements, 2018 FGI provides much more
detail for more specific spaces and adds greater requirements such as the MERV 13 requirement for Hospice facilities.

12.13.2019
Humidification
Mi2007 HC
• Recommends “clean-steam” injection via
steam-to-steam generators for
humidification steam.
• Direct steam injection is permitted provided
only FDA approved additives used to treat
boiler feed-water.
• Humidification feed-water may be supplied
either from soft or RO water.
FGI 2018
• Humidification can be provided via steam or
adiabatic high-pressure water-atomizing
humidifiers.
• All chemical additives used in steam
systems serving humidifiers shall comply
with FDA requirements.
• When Adiabatic Atomizing Humidifiers are
utilized the water shall be treated with RO
process, a UV-C sterilization light source and
a sub-micron filter.

12.13.2019
Electrical /
Communications
/Security

12.13.2019
Essential Electrical System
• FGI 2018 References:
• NFPA 70 National Electrical Code
• NFPA 99 Health Care Facilities Code
• NFPA 101 Life Safety Code
• NFPA 110 Standard for Emergency and
Standby Power Systems
• NFPA 111 Standard on Stored Electrical
Energy Emergency and Standby Power
Systems
• Acoustical Considerations for Generators
• Rule 301: Emergency Electrical Service
• Must be permanently installed.
• Capable of providing a minimum of 72
hours of service, more it the Emergency
Preparedness Plan (EP) requires it.
• Freestanding surgical outpatient facility
MAY reduce 72 hour requirement in
accordance with its EP to evacuate the
building.

12.13.2019
Table 2.1-1: Electrical Receptacles for Patient Care Areas
Section Location Number of Single
Receptacles
1
Receptacle Locations
PATIENT BED LOCATIONS
2.1-2.4.2 AII room
2
12
2 at each side of the head of the bed
2 on all other walls
1 for a television, if used
1 for each motorized bed
2.2-2.2.2 Medical/surgical unit patient room
2
2.2-2.2.4.4 Protective environment room
2
2.2-2.5.2 Intermediate care unit patient room
2.2-2.9.2.2 Postpartum unit patient room
2
2.2-2.11.2 Pediatric and adolescent unit patient room
2
2.6-2.2.2 Rehabilitation unit patient room
2.2-2.6.2 Critical care unit (CCU) patient room
16
Convenient
3
to head of bed with one on each wall
2.2-2.7.2 Pediatric critical care unit patient room
2.2-2.8.2 Neonatal intensive care unit (NICU) patient care
station
2.2-2.9.3 LDR/LDRP room
16
8 convenient
3
to head of mother’s bed
4 convenient
3
to each bassinet with one on each wall
2.2-2.10.3.1 Newborn nursery patient care station 4 Convenient
3
to each bassinet
2.2-2.10.3.2 Continuing care nursery patient care station
5
Convenient
3
to head of each bed, crib, or bassinet (At least
50% of these outlets shall be connected to emergency
system power and be so labeled.)
2.5-2.2.2 Psychiatric nursing unit No minimum

12.13.2019
Table 2.1-1: Electrical Receptacles for Patient Care Areas
Section Location Number of Single
Receptacles
1
Receptacle Locations
DIAGNOSTIC AND TREATMENT AREAS
2.1-3.2
Table 2.2-2
Examination room
Class 1 imaging room
8
4 convenient
3
to head of gurney or bed or on each lateral
side of the imaging gantry
2.2-2.9.11 Cesarean delivery room
30
4
16 convenient
3
to table placement
2 on each wall
6 in the infant care area
2.2-3.1.2.6 Treatment room for basic emergency services 12 Convenient
3
to head of gurney or bed
2.2-3.1.3.3 Triage room or area in the emergency department
6
Convenient
3
to head of gurney or bed (At least 50% of these
outlets shall be connected to emergency system power and be so
labeled.)
2.2-3.1.3.6 (2)
and (3)
Emergency department treatment room
12
Convenient
3
2.2-3.1.3.6 (4) Trauma/resuscitation emergency room 16 Convenient
3
2.2-3.2.2 Observation unit patient care station 8 4 convenient
3
2.2-3.3.2
Table 2.2-2
Procedure room (including endoscopy)
12
4 8 convenient
3
to table placement with at least one on each
wall
2.2-3.3.3
Table 2.2-2
Operating room
36
4 16 convenient
3
to table placement
2 on each wall
2.2-3.10.2 Hemodialysis patient care stations
8
4 on each side of a patient bed or lounge chair. (Two on each
side of the bed shall be connected to emergency power.)
POST-ANESTHESIA CARE LOCATIONS
2.1-3.4.4 Phase I post-anesthetic care (PACU) patient care
station
8
Convenient
3
2.1-3.4.5 Phase II recovery patient care station 4 Convenient
3
to gurney, lounge chair, or bed

12.13.2019
Lighting Requirements
NO CHANGE!
Rule 273-includes Table 1:
Illumination of Healthcare
Facilities.

12.13.2019
Nurse Call system
NO CHANGE!
Rule 321-includes Table 2:
Location of Nurse Call Devices
(same Table from 2007
Minimum Design Standards)
Per FGI, system must meet
requirements of UL 1069:
Standard for Hospital Signaling
and Nurse Call Equipment.

12.13.2019
Telecommunications Systems
FGI 2.1-8.5.2
Telecommunications Service Entrance Room (TSER)
At least one dedicate room for telecommunications functions
Restricted access
HVAC system must be on emergency power
Telecommunications Equipment Center (TEC)
Restricted access
All computer & networking equipment in TEC shall be served by UPS power
Electrical circuits serving TEC shall be dedicated to serving TEC.
HVAC system must be on emergency power

12.13.2019
Telecommunications Systems
FGI 2.1-8.5.2
Technology Distribution Room (TDR)
At least one per floor
Additional rooms as required to meet 292 foot maximum cabling distance for Ethernet cables
Minimum 3’ clearance on all sides of the equipment rack(s)
(2014 FGI previously had a minimum room size of 12’ x 16’ interior dimension)
Electrical circuits serving TDR will be dedicated to TDR
Cooling for rooms shall be on emergency power
Emergency Communication System
Emergency radio communication system shall be provided in each facility.
System shall operate independently of the buildings service and emergency power systems.
System shall have frequency capabilities to communicate with state emergency networks.

12.13.2019
Security System
Rule 323: A security system must be
provided that meets all of the following
objectives:
• Meet the needs of the population served
and services provided.
• Provide safe ingress and egress to the
health facility
• Restrict access to specific areas
including, but not limited to, all of the
following:
• Surgical Suites
• Central Sterile Supply
• Obstetric Unit
• Pediatric Unit
• Medication Storage Areas
2.1-8.6.2 Electronic Surveillance systems
• Not required, but if provided for the safety
of patients, devices installed in tamper
resistant enclosure
• Emergency power required for systems

12.13.2019
Medical Gas Outlets
Mi2007 HC FGI 2018
FGI has more detailed space breakdowns and includes recommendations for WAGD and instrument
air in spaces where those services are applicable.

12.13.2019
CONCLUSION
Michigan is transitioning to FGI 2018
• FGI is continuously updated with major updates every 4
years
• FGI is more comprehensive and developed to address
evolving health care facility design
• FGI offers “Beyond Fundamentals” series to address Best
Practices in Health Care Design

fgi_presentation_mishe_ec_2019_12_13.pdf

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