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1996-97 Guidelines for Design and Construction of Hospital and Health Care
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Technical Report · January 1996

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GUIDELINES FOR
DESIGN AND
CONSTRUCTION OF

The American lnstitute of Architects Academy

of Architecture for Health with assistance from

the U.S. Department of Health and Human Services

The American lnstitute of Architects press
1735 New York Avenue, N.W.
Washington, D.C.20006

Compilation
tt OSO by The American lnstitute of Architects
All rights reserved
Printed in the United States

tsBN 1-55835-151-5
 1.1 Surgical Suites 22
7.8 ObstetricalFacilities 25
1.9 Emergency Service 28
1.10 Imaging Suite 30
1.ll Nuclear Medicine JJ
7.12 Laboratory Suite 35
7.13 Rehabilitation Therapy Department 36
7.14 Renal Dialysis Unit (Acute and Chronic) 37
7.15 Respiratory Therapy Service 38
7.16 Morgue 39
'7.17 Pharmacy 39
7.18 Functional Elements 40
7.19 Administration and Public Areas 4t
Preface vi 7.20 Medical Records 42
Major Additions and Revisions viii 7.21 Central Services 42
Acknowledgments x 7.22 General Stores 42
7.23 Linen Services 42
1. Introduction 7.24 Facilities for Cleaning and Sanitizing Carts 43
1.1 General 1
1.25 EmployeeFacilities 43
1.2 Renovation 1
1.26 HousekeepingRooms 43
1.3 Design Standards for the Disabled 2 7.27 Engineering Service and Equipment Areas 43
1.4 Provisions for Disasters 2 7.28 General Standards for Details and Finishes 44
1.5 Codes and Standards 3
7.29 Design and Construction, Including
Fire-Resistant Standards 46
2. Energy Conservation 1.30 Special Systems 47
2.1 General 1.31 Mechanical Standards 48
1.32 Electrical Standards 54
3. Site
3.1 Location 7 8. Nursing Facilities
3.2 Facility Site Design 1 8.1 General Conditions 62
3.3 EnvironmentalPollutionControl 7
8.2 Resident Unit 62
8.3 Resident Suppofi Areas 64
4. Equipment 8.4 Activities 64
4.1 General 8
8.5 RehabilitationTherapy 65
4.2 Classiflcation 8
8.6 Personal Services (Barberpeauty) Areas 65
4.3 Major Technical Equipment 9 8.7 Subacute Care Facilities 65
4.4 Equipment Shown on Drawings 9 8.8 Alzheimer's and Other Dementia Units 65
4.5 ElectronicEquipment 9 8.9 Dietary Facilities 65
8.10 Administrative and Public Areas 66
5. Construction 8.11 Linen Services 66
5.1 Planning and Design 10
8.12 HousekeepingRooms 67
5.2 Phasing 10
8.13 Engineering Service and Equipment Areas 67
5.3 Commissioning 10
8.14 General Standards for Details and Finishes 67
5.4 NonconformingConditions 10
8.15 Finishes 68
8.16 ConstructionFeatures 69
6. Record Drawings and Manuals 8.17 Reserved 69
6.1 Drawings 11
8.18 Reserved 69
6.2 Equipment Manuals 11
8.19 Reserved 69
6.3 Design Data 11
8.20 Reserved 69
8.21 Reserved 69
7. General Hospital 8.22 Reserved 69
l.l GeneralConsiderations 11
8.23 Reserved 69
7.2 Nursing Unit (Medical and Surgical) l2 8.24 Reserved 69
7.3 Critical Care Units t4 8.25 Reserved 69
7.4 Newbom Nurseries 18
8.26 Reserved 69
7.5 Pediatric and Adolescent Unit t9 8.21 Reserved 69
1.6 Psychiatric Nursing Unit 20 8.28 Reserved 69
8.29 Reserved 69 10. 14 Employee Facilities 101
8.30 Special Systems 69 10.15 Nursing Unit (for Inpatients) 101
8.31 Mechanical Standards 10 10. 16 Sterilizing Facilities 103
8.32 Electrical Standards 12 10.17 Physical Therapy Unit 103
10.18 Occupational Therapy Unit 103
9. Outpatient Facilities 10.19 Prosthetics and Orthotics Unit 103
9.1 General 10.20 Speech and Hearing Unit 103
9.2 Common Elements for Outpatient Facilities 78 10.21 Dental Unit 103
9.3 Primary Care Outpatient Facilities 80 10.22 Imagtng Suite r04
9.4 Small Primary (Neighborhood) 10.23 Pharmacy Unit r04
Outpatient Facility 81 10.24 Details and Finishes 104
9.5 Outpatient Surgical Facility 83 10.25 Design and Construction, Including
9.6 FreestandingEmergencyFacility 85 Fire-Resistant Standards 106
9.7 FreestandingBirthingFacility 87 10.26 Reserved 106
9.8 FreestandingOutpatientDiagnostic 10.27 Reserved 106
and Treatment Facility 88 10.28 Reserved 106
9.9 Endoscopy Suite 89 10.29 Reserved 106
9.10 Cough-Inducing and Aerosol-Generating 10.30 Special Systems r06
Procedures 89 10.3 1 Mechanical Standa.rds to7
9.11 Reserved 89 10.32 Electrical Standards 111
9.12 Reserved 89
9.13 Reserved 90 11. PsychiatricHospital
9.14 Reserved 90 11.1 General Conditions 113
9.15 Reserved 90 11.2 General Psychiatric Nursing Unit tt4
9.16 Reserved 90 11.3 Child Psychiatric Unit 116
9.17 Reserved 90 11.4 Geriatric, Alzheimer's, and Other
9.18 Reserved 90 Dementia Unit 116
9.19 Reserved 90 11.5 Forensic Psychiatric Unit 116
9.20 Reserved 90 1 1.6 RadiologySuite 116
9.21 Reserved 90 11.1 Nuclear Medicine ll7
9.22 Reserved 90 11.8 Laboratory Suite lll
9.23 Reserved 90 11.9 Rehabilitation Therapy Department lll
9.24 Reserved 90 11.10 Pharmacy 118
9.25 Reserved 90 11.11 Dietary Facilities 118
9.26 Reserved 90 lt.t2 Administration and Public Areas 1 18
9.21 Reserved 90 11.13 Medical Records 1 18
9.28 Reserved 90 tt.t4 Central Services 118
9.29 Reserved 90 11.15 General Storage 118
9.30 Special Systems 90 I 1.16 Linen Services 119
9.31 MechanicalStandards 9t tl.t7 Facilities for Cleaning and Sanitizing Carts 119
9.32 Electrical Standards 96 11.18 Employee Facilities ll9
I 1.19 Housekeeping Room 119
10. RehabilitationFacilities 11.20 Engineering Service and Equipment Area 119
10.1 General Considerations 98 n.2t Waste Processing Services ll9
lO.2 Evaluation Unit 98 1.22 General Standards for Details and Finishes 119
10.3 Psychological Services Unit 98 fi.23 Design and Construction, Including
10.4 Social Services Unit 99 Fire-Resistant Standards 119
10.5 Vocational Services Unit 99 11.24 Reserved tt9
10.6 Dining, Recreation, and Day Spaces 99 11.25 Reserved 119
10.7 DietaryDepartment 99 11.26 Reserved 119
10.8 Personal Care Unit for Inpatients 100 11.27 Reserved tt9
10.9 Activities for Daily Living Unit 100 11.28 Reserved 119
10.10 Administration and Public Areas 100 11.29 Reserved tt9
10.11 Engineering Service and Equipment Areas 100 11.30 Special Systems 119
10,12 Linen Services 101 11.31 Mechanical Standards 120
10.13 Housekeeping Room(s) 101 11.32 Electrical Standards 124

lriil
12. Mobile, Tiansportable, and Relocatable Units Tables
L2.l General 126
12.2 Reserved 128
12.3 Reserved 128 1. Sound Transmission Limitations
12.4 Reserved 128 in General Hospitals 57
12.5 Reserved 128
12.6 Reserved 128 2. Ventilation Requirements for Areas
12.7 Reserved 128 Affecting Patient Care in Hospitals
12.9 Reserved r28 and Outpatient Facilities 58
12.9 Reserved 128
12.10 Reserved 128 3. Filter Efficiencies for Central Ventilation
12.11 Reserved t28 and Air Conditioning Systems in
12.12 Reserved 128 General Hospitals 60
12.13 Reserved t28
12.14 Reserved r28 4. Hot Water Use--General Hospital 60
12.15 Reserved t28
12.16 Reserved t29 5. Station Outlets for Oxygen, Vacuum
12.17 Reserved 129 (Suction), and Medical Air Systems 61

12.18 Reserved t29

12.19 Reserved 129 6. Pressure Relationships and Ventilation
12.20 Reserved 129 of Certain Areas of Nursing Facilities 74
12.21 Reserved 129
12.22 Reserved 129 7. Filter Efficiencies for Central
12.23 Reserved r29 Ventilation and Air Conditioning
12.24 Reserved t29 Systems in Nursing Facilities 76
12.25 Reserved 129
12.26 Reserved t29 8. Hot Water Use-Nursing Facilities 76
12.27 Reserved 129
12.28 Reserved t29 9. Flame-Spread and Smoke-Reduction
12.29 Reserved 129 Limitations on Interior Finishes 97
12.30 Reserved 129
12.31 Mechanical Standards 129 10. Filter Efficiencies for Central
12.32 ElectriLcal Standards t29 Ventilation and Air Conditioning
Systems in Outpatient Facilities s7
13. Hospice Care 131
11. Filter Efficiencies for Central
Appendix A 132 Ventilation and Air Conditioning
Systems in Psychiatric Hospitals r25

This is the latest in a 45-year series of guidelines to aid
in the design and construction of hospital and medical
facilities.
The original General Standards appeared inthe Federal
Register on February 14, 1947, as part of the implement-
ing regulations for the Hill-Burton program. The stan-
dards were revised from time to time as needed. In 1973,
the document was retitled Minimum Requirements of
Construction and Equipment for Medical Facilities to
emphasize that the requirements were generally mini-
mum, rather than recommendations of ideal standards.
Sections 603(b) and 1620(2) of the Public Health Service
Act require the Secretary of the Department of Health
and Human Services (HHS) to prescribe by regulation
general standards of construction, renovation, and equip-
ment for projects assisted under Title VI and Title XVI,
respectively, of the act. Since Title VI and Title XVI
grant and loan authorities have expired, there is no need
to retain the standards in regulation.
In 1984, HHS removed from regulation the requirements
relating to minimum standards of construction, renova-
tion, and equipment of hospitals and other medical facili-
ties, as cited in the Minimum Requirements, DHEW
Publication No. (HRA) 81-14500. To reflect the nonreg-
ulatory status, the title was changed to Guidelines for
Construction and Equipment of Hospital and Medical
Facilities. For this 1996-9l edition, the ritle has been
amended to read Guidelines for Design and Construction
of Hospital and Health Care Facilities to reflect the
scope, content, and usage ofthis document.
These Guidelines are evolving in order to provide guid-
ance to providers, designers, and regulators in a continu-
ally changing environment. It is recognized that many
health care services may be provided in facilities not
subject to licensure or regulation, and it is intended that
these Guidelines be suitable for use by all health care
providers. It is further intended that, when used as regu-
Preface
lations, some latitude be granted in complying with these
Guidelines, so long as the health and safety of the occu-
pants of the facility are not compromised.
The Guidelines will be used by HHS to assess Depart-
ment of Housing and Urban Development Section242
applications for hospital mortgage insurance and the
Indian Health Service construction projects. The Guide-
lines may also be used by other entities, such as state
licensure agencies. For this reason, regulatory language
was retained. The 1996-97 edition of the Guidelines fol-
lows these principles. Explanatory and guide material is
included in appendix A, which is not mandatory.
The Health Care Finance Administration (HCFA) and
the Health Resources Services Administration (HRSA),
which are both in the Department of Health and Human
Services, are supporting the efforts of the 1996-97
Guidelines both financially and with support staff. HCFA
has the responsibility for the reimbursement and opera-
tion of the Medicare and Medicaid programs. Hospital
construction and costs are directly related to the charge
of HCFA's mission. Although HCFA is not adopting the
Guidelines as regulations, the agency does concur with
the design and construction recommendations.
This edition of the Guidelines reflects the work of advi-
sory groups from private, state, and federal sectors, rep-
resenting expertise in design, operation, and construction
of health facilities. Advisory group members reviewed
the 1992-93 edition of the Guidelines liIte by line, revis-
ing details as necessary to accommodate current health
care procedures and to provide a desirable environment
for patient care at a reasonable facility cost.
The Guidelines standards are performance oriented for
desired results. Prescriptive measurements, where given,
have been carefully considered relative to generally rec-
ognized standards and do not require detail specification.
For example, experience has shown that it would be
extremely difficult to design a patient bedroom smaller
thaa the size suggested and have space for functions and
procedures that are normally expected.
Authorities adopting the Guidelines standards should
encourage design innovations and grant exceptions
where the intent of the standards is met. These standards
assume that appropriate architectural and engineering
practice and compliance with applicable codes will be
observed as part of normal professional service and
require no separate detailed instructions.
UI
 ln some facility areas or sections, it may be desirable to This publication supersedes DHHS publication Nol
exceed the Guidelines standards for optimum function. (HRS-M-HF) 84-1, DHEW Publication No. (HRA)
For example, door widths for inpatient hospital rooms 79-14500, DHEW Publication No. (HRA) 76-4000,
are noted as 3 feet 8 inches (1.11 meters), which satisfies the 1992-93 edition of the Guidelines.
most applicable codes, to permit passage of patient beds.
However, wider widths of 3 feet 10 inches ( 1. l6 meters) Inquiries or questions onthe Guidelines may be
or even 4 feet (I.22 meters) may be desirable to reduce addressed to the following groups:
damage to doors aad frames where frequent movement American Institute of Architects
of beds and large equipment may occur. The decision to Academy of Architecture for Health
exceed the standards should be made by the individuals 1735 New York Avenue, N.W.
involved. Washington, D.C. 20006
In many ways, the Guidelines may be considered a con- Health Resources and Services Administration
sensus document. There have been at least two national Division of Facilities Loans
reviews by all interest groups, and by state and federal 5600 Fishers Lane, Room 1 lA-14
entities. While the Guidelines started as a federal docu- Rockville, Maryland 20857
ment, the American Institute of Architects has made it
a national document to improve the health of the nation. Office of Engineering Services
Region II
Room 3309
26FederalPlaza
New York, New York 10278

uil Preface

ADDITIONS
rsl0Ns
To reflect the scope, content, and usage ofthis document,
the previous title has been amende d, to Guidelines
for
Design and Construction of Hospitql and Health Care
Faciliries for this 1996-97 edition.
The format and technical content, in general, follow the
previous document, Guidelines
for Construction and
Equipment of Hospital and Medical Facilities, lgg2_g3
Edition. The exception to this is that elevators will
always be section 30.B (i.e., j.30.8, g.30.B, 9.30.8,
etc.); waste processing will be 30.C, HVAC 3l.A
through D, plumbing 3 1.E, electric al 32.Athrough F,
nurses call 32.G, emergency electrical service 32.H,
fire
alarm system 32.J, and telecommunications 32.J. Appen-
dix B has been eliminated. All significant changes are
identified by a vertical 1ine in the margin. An asterisk (*)
preceding a number or letter designating a paragraph
indicates explanatory material about that paragraph
can
be found in appendix A.
Many editorial changes were made to correct errors or
inconsistencies or to clarify the intent. Listed below
are
major additions and revisions made to this edition of the
Guidelines.
1. Infection control
Significant changes have been incorporated into these
Guidelines with regard to infection control, types of iso_
lation requirements, and ventilation. to ev"ry extent pos_
sible, these changes conform to the most current Centers
for Disease Control and prevention ..Guidelines for pre_
venting the Transmission of Mycobacterium Tuberculo_
sis in Health Care Facilities,'and.,Guidelines
for
Prevention of Nosocomial pneumonia, 1994.,, Tfuee
patient segregation categories have been identified:
. Airbome infection isolation room
. Protective environment room
. Immunosuppressed host in airborne infection isolation
A new process called ..infection control risk assess_
ment" is introduced to describe how an organization
determines the risk for transmission of various infec_
tious pathogens. This process is an essential component
of any facility's functional or master programming,
Major Additions and Reyisions
vilt
I
since there may be signiflcant differences in population.
This organizational committee should be a muliidiscipli_
nary panel with expertise in areas of infectious disease,
facility design and construction, ventilation and epi_
demiology, etc. The purpose of this committee is to
coordinate the individual infection control needs ofthe
organization with the appropriate numbers and types of
isolation rooms and procedure rooms. It is the intent of
this process to allow flexibility in meeting individual
organizational needs for creating a safer environment for
patients. staff, and visitors.
Anteroom space in either airbome infection isolation
or protective environment rooms is no longer required.
Anterooms are recommended only for those organiza_
tions with patients who are both immunosuppressed and
potential transmitters of airborne infection. Anterooms
are also required in those facilities in which the infection
control risk assessment dictates the need for special oper_
ating suites and delivery rooms.
Rooms with dual-purpose or switch-reversible airflow
mechanisms that allow rooms to be switched between
positive and negative pressure configurations are no
longer acceptable.
2. Section 5.1, Construction phasing, has been com_
pletely changed to reflect infectious hazards that may be
encountered during health care facility planning, design,
construction phasing, and commissioning, in addition to
occupant safety and comfort.
3. Section 1.3.A.3. The minimum area permitted in reno_
vation of existing critical care units has been increased
from 120 square feet (11.15 square meters) to 130 square
feet (12.09 square meters) for single-patient rooms (or
cubicles) and from 100 square feet (9.29 square meters)
to 110 square feet (10.23 square meters) per bed in multi_
ple-bed space.
4. Sections 7.3.D.8 and 7.5.E, Examination and Treat_
ment Rooms. Omitting these elements in pediatric criti_
cal care units and in pediatric and adolescent units is no
longer permitted even if all patients are in private rooms.
5. Section 7.3.E.8. A new requirement has been added
that each patient space in a newbom intensive care unit
shall have a minimum of 100 square feet (9.29 square
meters).
6. Section 7.6.C has been changed to require at least one
airborne infection isolation room in the psychiatric unit.
7. Section 7.8.A2.a(3). permission to continue in use
existing three- or four-bed rooms in renovation projects
has been deleted. All rooms must have two beds or tewer.
8. Section 7.9.D3. Triage areas in the emergency
department must be designed and ventilated to reduce
exposure of staff, patients, and families to airborne
infectious diseases.
- :.;trrrns 1 .9.D3 and 7.10.G1. Waiting areas in the 18. Chapter 8 has been revised to reflect the changing
::.:r_ienc\ department and in the imaging suite have been mission and roles of nursing facilities. Sections on suba-
, :..:i urut &S oro&s that may require special measures to cute care and Alzheimer's have been added.
-: : - i : ihe risk of airbome infection transmission.
19. Section 8.2.C1. Nurses station has been changed to
. S:--tions 7.10.H1 through 7.10.H11, Cardiac staff work area and the text revised to permit altemative
--.:"::lerization Lab, have been moved from the appendix arrangements for centralized or decentralized caregiving.
. --re bodv of the Guidelines and modified from recom-
20. Table 6 has been changed to add requirements for:
:: jations to requirements.
. Protective environment and airbome infectious
. . Section 7.14, Renal Dialysis Unit, an entire new sec-
isolation.
:.:'.-,. has been added.
. Dining rooms and activity rooms.
- - Sections 1.30.82 and 10.30.81. The minimum size
, -: hospital and rehabilitation elevator cars has been 21. Table 8. Maximum and minimum temperature
.:,:reased from 5 feet (1.52 meters) wide and I feet6 requirements have been changed as follows:
::hes (f.29 meters) deep to 5 feet 8 inches (1.73 meters)
Resident care areas: from maximum 110'F (43"C) to
.i. j: and 9 feet (2.74 meters) deep. A renovation excep-
maximum 95 "-1 1 0"F (35"-43'C).
:-:,:: has been added.
Dietary: from minimum 120'F (49'C) to minimum 140"F
- .31.D24. A new requirement has been
-.. Section 1
(60"c).
.:Jed for rooms used for sputum induction, aerolized
lentamidine treatments, and other high-risk areas. Laundry: from minimum 160'F (71"C) to minimum
140"F (60"C).
l-1. Section .31.D25. A new paragraph has been added
1
p,ermitting fan coil and individual heating and cooling 22.Table 9, Illuminations Values for Nursing, has
ui',rts in certain areas of the hospital provided that all out- been deleted.
joor air requirements shall be supplied by a central ven-
23. Sections 8.7, Subacute Care Facilities, and 13, Hospice
:rlation system that meets the filtration requirements in
Care, both have suggested text in the appendix in order to
Table 3.
solicit public proposals to the Guidelines committee to
-5. Sections 7 .32.G,8.32.G,10.32.G, and 11.32.G, develop minimum guidelines for the next edition.
\urses Calling Systems, have been changed to permit
24. Throughout all sections, handwashing facilities are
the use ofnew technologies such as radio frequency
now required in all toilet rooms. Permission to omit them
S\ SICMS.
under certain circumstances has been deleted.
16. Table 2 has been changed to:
25. A form for public proposals for future changes to the
-{dd bronchoscopy and endoscopy requirements. Guideline s is included.

Change protective isolation to protective environment

and increase total air changes from 6 to 12.

Change relative humidity in operating rooms and deliv-

ery rooms from 50-60 percent to 30-60 percent and tem-
perature range from 10"J5"F (21"-24"C) to 68"-73'F
(20'-23"C).
Change airbome infectious isolation room total air
changes from 6 to 12.

Increase patient room outdoor air changes from 1 to 2.

Increase labor/delivery/recovery and LDRP outdoor air

changes from 0 to 2.

Add a temperature requirement of 75"F (24'C) to general

laboratory, biochemistry, histology, microbiology,
nuclear medicine, pathology, and serology.

17. Table 3. The efficiency requirement for filter bed No.

t has been increased from25 percent to 30 percent.

tx Major Additions and Revisions

 Steering Group Ed Denton, AIA
Joseph G. Sprague, FAIA Kaiser Permanente
Chairman Scott J. Doellinger
HKS Architects. Inc. Design Group, Inc.
Douglas S. Erickson, FASHE John M. Dombrowski, P.E.
Vice Chaiman H. F. Lenz Company
American Hospital Association
Roger W. Gehrke
J. Armand Burgun, FAIA Idaho Department of Health
Chairman Emeritus and Welfare
Rodgers Burgun Shahine
Marjorie Geist, R.N., M.S.N.,
& Deschler
M.H.A.
Michelle Donovan, R.N. American College of Emergency
Ambulatory Care Advisory Physicians
Group, Inc.
Carole Gilmore, Lt. Col.
Daniel L. Hightower, R.A. U.S. Army Health Facility
U.S. Department of Health and Planning Agency
Human Services. NIH
The Academy of Architecture for Health (AAH) of the Warren N. Goodwin, AIA
Neil Kellman, M.D. Quorom Health Resouces, Inc.
American Institute of Architects (AIA) was privileged to California Office of Statewide
Rita A. Gore, R.N.
convene and work with an interdisciplinary committee to Health Planning and Development
New Jersey Depanment of Health
revise the Guidelines for Construction and Equipment of Todd S. Phillips, Ph.D., AIA
James R. Gregory
American Institute of Architects
Hospital and Medical Facilities. This is the third revi- Agency for Healthcare Administra-
Emilio M. Pucillo. R.A. tion, Florida
sion cycle for which the AIA/AAH has been honored to U.S. Depanment of Health and
Ken Gurtowski
serve in this capacity. They played a major role in the Human Seruices, HRSA, OES
Calumet Coach Company
preparation of this edition, entitled Guidelines David A. Rhodes, FAIA
for Design JMGR. Inc.
Jill Hall
and Construction of Hospital and Health Care Facilities. Institute for Family-Centered Care
Ralph Swain, Ph.D.
Maureen Harvey, R.N.
These revised Guidelines are the result of many hours Shands Hospital
of Society of Crirical Care Medicire
Mayer Zimmerman
concentrated work by dedicated professionals concerned Robert Hughes
U.S. Department of Health and
with the health care industry from private practice, pro- NIOSH
Human Services, HCFA
fessional organizations, and state and federal agencies. Thomas W. Jaegeq P.E.
Gage Babcock and Associates, Inc.
More than 2,000 proposals for change and comments on Guidelines Revision Committee
Dwight H. Jones, P.E.
proposed changes were received and processed at three James V Allred. AIA
Georgia Department of Human
U.S. Army Corps of Engineers
meetings held in Baltimore, San Diego, and Denver. Resources
Michael R. Amold, AIA
Approximately 65 members attended each meeting and Thomas M. Jung
Granary Associates
New York State Department
gave serious and full consideration to all written com_ Donald E. Baptiste of Health
ments and proposals. The AIA wishes to express its sin- Sturdy Memorial Hospital Inc.
Ode R. Keil. PE
cere gratitude to all who sent comments and to those Judene Bartley, M.S., M.PH. SMS
Harper Hospital
organizations whose representatives served on the Stuart L. Keill. M.D.
Chris Bettlach, P.E. American Psychiatric Association
Guidelines Revision Committee. Sisters of Mercy Health System- Carol Kershner
St. Louis
Episcopal Ministries to the Aging
James R. Biasco, P.E.
Steve M. Lakner
U.S. Department of Health and
Central DuPage Health System
Human Services, IHS
Roger J. Langlois
Leon B. Boland, P.E.
Connecticut Department
Wisconsin State Division of Health
of Public Health
Brenda Bouvier
Harold Laufman, M.D., Ph.D.
Association lor Professionals in
HLA Systems
Infection Control and Epidemiology
James l-efter
Mary Jo Breslin
University of Illinois
University of Maryland Medical
Systems Terence G. Lewis Sr.
Association of Massachusetts
George Byms, R.S., MPH
Homes for the Aging
U.S. Department of Health and
Human Services, IHS Stephen G. Lynn, M.D., FACEP
American College of Emergency
Joseph W. Carobene, CMHA
Physicians
Middle Tennessee MH Institute
Charles E. Maher
Jack Chamblee
Ochsner Medical Institutions
Healthsouth Corporation
Martin H. Cohen, FAIA
James Merrill
U.S. Department of Health
Forum for Health Care Planning
and Human Services, HCFA
Walter Collins, P.E.
Robert A. Michaels, Ph.D., CEP
Parsons Brinckerhoff, Facilities
RAM TRAC Health Risk Consul-
Services
tants of Schenectady, NY

Acknowledgments

I
 Jhiratrtrldenberg, AIA
lE.-S. @mment of Health
mm Services, NIH
t- f*gg Moon, NCARB
@r4or College of Medicine,
fl&m
ftotucrt Mullan, M.D.
Ccms for Disease Control-NIOSH
&mis Murray
KJ[..S. md Associates, Ltd.
furis C. Nance, M.D.
-{mi:a College of Surgeons
fueh Nash, P.E.
{otittr Seckman Reid Inc.
hml \momura, P.E.
L .5" Departrnent of Health and
Fhmm Services, OES
Thmothy M. Peglow, P.E., CCE,
LASI{E
kFwte Hospital, Inc.
William Sciarillo, Sc.D.
and Association for the Care of
Children's Health
Lloyd H. Siegel, FAIA
U.S. Department of Veterans Affairs
David Sine, CSP
National Association of Psychiatric
Healthcare Systems
Grady Smith, Architect, AIA
Judith Smith
Smith Hager Bajo, Inc.
Maureen Smith
Centers for Disease Control
& Prevention
Joseph Strauss, AIA, CHC
Lammers + Gershon Assocs., Inc.
American Association of Healthcare
Consultants
Andrew J. Streifel, M.P.H.
University of Minnesota

Dooglas Pendergras Drexel Toland

Coiffa]escent Enterprises, Inc. Drexel Toland & Associates, Inc.

ZmA. Pihut, P.E. Marjorie Underwood, R.N.

Terrs Departrnent of Health Association for Professionals in
Infection Control and Epidemiology
Gim Pugliese, R.N., M.S.
Sultivan Kelly & Associates, Inc. Marjorie E. Vincent, R.N., MBA
Premier Ambulatory Systems
Chryl Riskin
[f\{R Associates Kathryn D. Wagner, Ph.D.
Kathryn D. Wagner, Ph.D.
Krrt Rockstroh, AIA
SBA/Eteffr an Bradley Associates, Inc. John A. Westcott
Northwestem Memorial Hospital
Chis Rousseau, P.E.
liewcomb & Boyd Consulting James H. Wilson
Fngrne€Is U.S. Department of Health and
Human Services, NIH
Arthu St. Andre, M.D.
E'ashington Hospital Center
Jmet Schultz, R.N.
AMSCO Intemational

Special thanks are due to the Health Care Finance

Administration and the Health Resources and Services
Administration of the U.S. Department of Health and
Human Services, which provided major funding for
the project.

Joseph G. Sprague, FAIA

Chairman
Guidelines Revision Committee

Acknowledgments

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