How the 2026 FGI Codes Reimagine Care Spaces

How evolving needs and clinical realities are shaping next-generation care spaces

By Barbara Stretchberry

A few hours can change the rhythm of a hospital. Yet for years, the end of a patient’s stay often occurred in the inpatient room, one of the hospital’s most valuable resources. Patients who were medically ready to leave stayed put while waiting for transportation or final instructions, tying up beds long after their clinical needs had been met. The result wasn’t a design flaw but an operational one.

At the 2024 Summer Leadership Summit, an FGI-led workshop brought this shared challenge into focus. Designers, clinicians and hospital leaders all pointed to the same gap: discharge was missing a dedicated place.

The 2026 FGI Hospital Code responds by creating standards for discharged patient waiting facilities, formalizing a space many hospitals had begun to build on their own. Designed for visibility and comfort, these rooms give medically cleared patients somewhere to wait that isn’t an inpatient bed. They help hospitals regain flow, reduce pressure on units and support smoother transitions home. It’s a small space with an outsized impact, an example of how design can solve what once seemed like purely operational problems.

And the discharged patient lounge is just the beginning; across all three documents, the 2026 FGI Codes add or redefine spaces created in direct response to how care is evolving.

Supporting patients with complex needs: medical psychiatry units
Behavioral health care remains one of the most rapidly evolving areas of design, and the 2026 FGI Codes reflect that through several updates.

A major addition to the 2026 FGI Hospital Code is the introduction of requirements for medical psychiatry patient care units, created for individuals who require both behavioral health support and active medical treatment. These patients often end up on medical units not equipped for behavioral needs or in behavioral health units unable to provide appropriate medical care. The result is environments that strain staff and put patients at risk.

The requirements in this new section provide minimum requirements for the following:

• Support areas for family centered care
• Ligature-resistant strategies appropriate for medically complex patients
• Access to medical equipment without compromising patient safety
• Rooms needed for group therapy and social spaces.

By defining the minimum expectations for medical psychiatry environments, the FGI Hospital Code acknowledges the growing population of patients whose needs span both domains and the necessity of creating settings that don’t force trade-offs between medical treatment and behavioral safety.

Crisis response: behavioral health spaces built for safety and stabilization
The FGI Outpatient Code relocates and expands requirements for Behavioral Health Crisis Centers, clarifying expectations for both outpatient community-based facilities and those embedded in freestanding emergency care facilities. These environments must balance safety and dignity through:

• Continuous-observation zones
• Calming rooms designed to support sensory regulation
• Accessible toilet rooms with appropriate safety features
• Spaces that enable stabilization rather than containment.

In parallel, the 2026 Hospital Code adds requirements for wearable duress alarm systems in behavioral health units. The emphasis is on reliability: devices must be simple to activate, able to pinpoint staff location and connected to a continuously staffed monitoring point.

Together, these changes demonstrate a cultural shift; behavioral health is no longer peripheral to facility design. It is shaping the core of how environments are planned and used.

Readiness as infrastructure: incident command centers
The COVID-19 pandemic highlighted the need for purpose-built spaces for emergency operations. During the pandemic, many hospitals activated command centers in makeshift rooms lacking the infrastructure to support prolonged incident response.

The 2026 FGI Hospital Code introduces requirements for incident command centers that can activate quickly, support essential electrical systems and maintain operations throughout emergencies. These rooms formalize a function that had long existed informally and recognize resiliency as a defining element of modern healthcare architecture.

Care on the move: strengthened requirements for mobile units
As health systems reach deeper into communities, mobile units have shifted from episodic outreach and infrastructure support tools to core components of distributed care. The 2026 Hospital and Outpatient Codes clarify expectations for mobile units that connect to host facilities, addressing onboard systems, site infrastructure and safety requirements.

These updates acknowledge a growing reality; care is no longer confined to traditional facilities. The environment must adapt to support it wherever it’s delivered.

Ambulatory specialization: short-stay centers and sleep disorder centers
Two new chapters in the 2026 FGI Outpatient Code reflect the increasing expansion of ambulatory care.

Short-stay centers, designed for patients who need up to 72 hours of monitoring, occupy a space between outpatient and inpatient care. The new requirements define expectations for patient rooms, observation strategies and support services.

Sleep disorder centers also receive a dedicated chapter, recognizing the diagnostic importance of occupant-controlled environmental conditions such as acoustics, lighting and privacy. These new facility types illustrate how outpatient environments are evolving to support highly specialized care.

Residential care reimagined

Residential care and support settings also undergo significant evolution in the 2026 FGI Codes, reflecting growing awareness of how deeply the built environment shapes daily life, safety and well-being for long-term residents.

One of the most consequential changes is the shift to single-resident rooms as the minimum standard, moving away from shared bedrooms that once dominated long-term care settings. The update recognizes what many providers and residents have long understood: privacy is a cornerstone of dignity, infection prevention and autonomy. The requirement also aligns residential environments more closely with contemporary expectations for personal space and individualized care.

The 2026 Residential Code includes several additional updates that strengthen safety and quality of life:

• A new chapter for residential behavioral and mental health treatment, establishing minimum requirements for environments serving individuals with dementia, neurocognitive disorders or behavioral health needs. These spaces balance safety, calm and autonomy, ensuring residents receive therapeutic support without feeling confined.
• Expanded requirements for individuals of size, including planning for clearances, fixtures, staff safety considerations and documentation that supports resident dignity and mobility.
• Enhanced expectations for social and community spaces, including strengthened requirements for dining rooms, activity areas and shared day spaces. The updates address square footage, accessibility and access to natural light, reinforcing the role of communal environments in resident engagement.
• Clarified storage and support space requirements to ensure staff have the resources they need without encroaching on resident living areas.
• Improved provisions for environmental safety, addressing flooring, acoustics and wayfinding elements that mitigate fall risk and support residents with sensory or cognitive impairments.

Together, these updates signal a renewed commitment to residential environments that function not as clinical institutions, but as true homes, places where comfort, privacy, safety and community coexist.

Designing what the future will need
The new spaces in the 2026 FGI Codes illustrate how health and residential care continue to evolve and reveal the points where operational needs, patient experience and clinical realities converge. A decade ago, these facility types and patient care spaces in the 2026 FGI Codes either didn’t exist or were improvised. Now they have definitions, minimums and a place in the shared language of health and residential care design. They are the spaces the future needs, and together, they begin to map the next era of care.

Barbara Stretchberry is managing editor, FGI.