For every edition before this one, the FGI Guidelines were a single blended book: enforceable minimum requirements and advisory appendix commentary bound together, and the reader had to know which paragraphs could be cited against a project and which were simply advice. In the 2026 revision cycle, the Facility Guidelines Institute separated the two. The minimums now stand alone as the FGI Codes, and the guidance lives in companion FGI Handbooks. If you size rooms or write functional programs, the split changes which book you open for which question — even though most of the numbers themselves barely moved.
What exactly split in the 2026 FGI documents?
The enforceable half is now called the FGI Codes for Planning and Design. FGI describes the Codes as the minimum requirements that support regulatory compliance and facility safety, written to be adopted and enforced by government agencies and quality assurance entities. As before, there are three volumes: Hospitals, Outpatient Settings, and Residential Care and Support Settings.
The advisory half is now the FGI Handbooks for Planning and Design. Everything that used to sit in the Guidelines’ appendices — supplemental technical and design guidance, rationale, illustrations, and examples — was removed from the requirements document and relocated to the Handbooks. SpaceMed, which publishes the best-known space-planning companion to the FGI documents, describes the Handbook material as guidance that can inform decision-making “without carrying regulatory weight.”
Which book can a surveyor cite?
A surveyor, plan reviewer, or licensing inspector can only cite what your authority having jurisdiction (AHJ) has adopted — and what gets adopted is the Code. The Handbook was never designed to be adopted, and its diagrams, examples, and commentary create no enforceable minimum on their own. A finding traces to a Code paragraph in the volume for your setting — hospital or outpatient — not to a Handbook page.
That cuts in both directions. A design team can no longer be held to a Handbook recommendation as though it were a requirement, which ends a long-running source of scope creep: the worked example is not the minimum. But a team also cannot defend a below-minimum room by pointing at Handbook discussion. If the Code states a minimum clear floor area, the Handbook’s context explains why the number exists; it does not negotiate the number down.
If the minimum sizes stayed in the Code, what moved to the Handbook?
This is the point planners most often get wrong about the split: the space requirements did not leave the enforceable book. SpaceMed’s review of the 2026 documents concludes there are minimal changes to the types, numbers, and minimum sizes of spaces in the new Codes. Minimum clear floor areas, required rooms, and required elements remain Code text — and when the 2026 Code changed a number, it changed it inside the Code. SpaceMed’s summary notes the rehabilitation patient room minimum rising from 140 to 150 net square feet, a single-patient behavioral health observation room from 80 to 100, and a new optional discharged patient lounge at a minimum of 30 net square feet per patient.
What moved to the Handbook is everything around the number: why it is what it is, how experienced planners apply it, what good layouts look like, and the supplemental technical guidance that used to pad the appendices. In 2022, the reasoning sat next to the requirement, and the two blurred. In 2026, a planner who wants the minimum opens the Code; a planner who wants to understand the minimum — or to plan well above it — opens the Handbook. The Code tells you the smallest legal room. The Handbook is where the profession’s thinking about the right-sized room now lives.
The two books will also age differently. The Code is fixed for its four-year cycle, the way an adopted code always is. The Handbooks are a digital series, and ASHE’s Health Facilities Management, reporting on the launch, describes the guidance as dynamic — able to grow and evolve over time rather than waiting for the next edition. Your minimums hold still until the 2030 cycle; the guidance interpreting them may not.
What changes when your state adopts the 2026 documents?
Adoption is now visibly a book-by-book act. A state adopts a Code volume for a setting; it does not adopt the Handbook, because there is nothing in the Handbook to enforce. A requirement can therefore bind a project completely stripped of its published rationale — the “why” is a separate purchase the state never makes on your behalf. Teams that learned the old Guidelines as one book should brief owners on this early: compliance is now defined by a leaner document than the one that explains itself.
Georgia shows how this already works in practice. Georgia’s Department of Community Health has accepted the 2026 Hospital and Outpatient Codes, with enforcement beginning August 31, 2026 — while for residential care and support settings it encourages the 2026 document as best practice rather than enforcing it. One state, three volumes, two different legal weights. That per-volume pattern is the new normal — and it is what HFH’s FGI State Adoption Tracker now records state by state.
FGI’s own explainer material flags one more wrinkle: states whose rules automatically adopt the current FGI edition — “evergreen” adoption — must adjust to the new structure to avoid legal and enforcement problems. In an evergreen state, the split can arrive on FGI’s schedule rather than your legislature’s, and a rule written to adopt “the Guidelines” now points at documents that no longer exist under that name. Which mechanism your state uses determines when the split becomes your problem — which is why the edition question, covered in Which edition of the FGI Guidelines does my state enforce?, has to be answered per project, not assumed.
What should planners do differently?
Cite the Code for compliance, and say so. Every minimum in a program or drawing set should trace to a Code volume and section. If a number cannot be found in the Code, it is not a minimum — it is a recommendation or a preference, and it should be labeled as one before it hardens into a contract obligation.
Plan from the Handbook, and budget for it. The design intelligence — rationale, examples, diagrams, planning considerations — now lives in a separate digital companion sold alongside the Codes. A team working only from the Code will be compliant and under-informed: they will know the smallest permitted observation room and nothing about why it grew. Treat Handbook access as project infrastructure.
Use the Code’s new leanness where FGI intended it. Some 2026 Code text got deliberately shorter. SpaceMed notes the lengthy 2022 telemedicine room requirements were replaced with a single sentence: where telemedicine services will be provided, spaces shall be designed for acoustical and visual privacy. Performance language like that is the Code trusting the planner’s judgment — designs will be judged on whether the privacy outcome is real, not on whether a checklist was copied.
Watch how your state adopts each volume. Check, per project, which Code volume your AHJ has adopted, for which settings, and from what effective date — and do not assume the hospital answer matches the outpatient answer, as Georgia shows. HFH’s FGI 2022 vs 2026 differences piece covers the edition-level changes in full; this split is the structural one underneath them.
Expect the guidance to move between cycles. Build a mid-project check into long design timelines: re-verify the Handbook guidance you cited at kickoff before construction documents are issued. The requirement will not have changed; the profession’s published thinking about meeting it may have.
The split does not change what a compliant hospital or outpatient facility is, very much. It changes where the authority sits, where the thinking sits, and how honestly a project team has to label each one. Keep the two books straight — Code for the floor you cannot go below, Handbook for the reasoning that keeps you off it — and the 2026 documents are easier to use than the blended Guidelines ever were.
Go deeper: The FGI Guidelines guide for healthcare facility design · Do states adopt the FGI Guidelines as building code?
Sources: Facility Guidelines Institute, editions and revision-process pages (fgiguidelines.org); ASHE, Health Facilities Management, “The 2026 FGI Codes and FGI Handbooks Are Now Available”; SpaceMed, “Changes to the 2026 FGI Documents Impacting Space Planning”; Georgia Department of Community Health, Office of Health Planning Design and Construction — acceptance of the 2026 FGI Codes, enforcement from August 31, 2026.