Which edition of the FGI Guidelines does my state enforce?

Q: Which edition of the FGI Guidelines does my state enforce?

The specific edition your state has adopted into regulation — not necessarily the newest. 43 states have adopted FGI; many are on 2018 or 2022. The authority having jurisdiction (usually the state health department plan review office) is the definitive source; verify the edition before schematic design.

Q: How many states have adopted the FGI Guidelines?

43 states for regulating new construction and major renovations.

US map with states in varying shades for different adopted editions; magnifying glass over one state's regulation document — The AHJ’s answer beats every website — including this one.

Your state enforces the specific FGI edition it has adopted into regulation — not the newest edition. With 43 states adopting FGI for new construction and major renovations, the odds are high your project falls under FGI, but the edition varies: many states are on 2018 or 2022, and 2026 adoptions will roll out over the next few years. The authority having jurisdiction (AHJ) — usually the state health department’s plan review office — is the definitive source.

How to find your state’s edition

Check the state health department / licensing agency website — look for “plan review,” “construction standards,” or “physical environment” regulations referencing a specific FGI edition year.
Read the actual regulation — the adoption is usually a single line referencing “the [year] edition of the FGI Guidelines for Design and Construction of [Hospitals/Outpatient/Residential].” Note whether it says the edition “as amended” or a fixed year.
Call the plan reviewer — when the website is ambiguous (and it often is), a five-minute call beats a five-month redesign.
Check for local amendments — some jurisdictions adopt FGI with state-specific modifications that change individual requirements.

States with documented FGI adoption (examples)

FGI adoption is widespread. The following states are widely documented as referencing FGI Guidelines in their facility construction regulations — always verify the current edition with the AHJ, as adoptions update:

Texas — references FGI in hospital licensing standards
Florida — Agency for Health Care Administration references FGI
New York — Department of Health references FGI for facility construction
California — OSHPD/HCAI framework aligns with FGI-based requirements
Illinois, Pennsylvania, Ohio, Georgia, North Carolina, Virginia — documented FGI references in health facility regulations
Washington, Oregon, Colorado, Arizona — western states with FGI-based plan review

This is not exhaustive — 43 states have adopted FGI in some form. If your state isn’t listed, assume FGI applies until the AHJ tells you otherwise.

The edition-lag trap

The dangerous moment is the transition window: FGI publishes 2026, your state still enforces 2018, and your design team works from the newest book. Design to the enforced edition — and track the state’s adoption rulemaking so you know what’s coming.

The AHJ’s answer beats every website — including this one.

See how states adopt FGI into code and the FGI 2026 compliance guide.

FAQ

How many states have adopted the FGI Guidelines?
43 states have adopted FGI documents for regulating new construction and major renovations of healthcare facilities.

Does my state use the latest FGI edition?
Not necessarily — states adopt specific editions and update on their own rulemaking timelines. Verify with the AHJ.

What if my state hasn’t adopted FGI?
Accreditors (Joint Commission, DNV) may still require the current FGI edition for accredited facilities, and the AHJ may apply its own standards. Check both.