The Federal Guidelines Institute (FGI) concluded the second year of public comments on the recent draft of the 2026 FGI document for design and construction of residential health, care, and support facilities on September 30, 2024.
AHCA/NCAL submitted several comments on behalf of its membership in many areas. The top three areas of focus included:
- A proposal that would require 80 percent of units in newly constructed residential budlings (skilled nursing and assisted living) to be single units;
- A proposal that would require dining areas to be at least 25 square feet per person in size; and
- A proposal that would require outdoor space for residents to be at least 28 square feet per person in size.
For these three areas, AHCA/NCAL recommended that the proposed language be deleted, noting there is no data to support the change, the proposal would have a significant impact on high Medicaid facilities, and it may shut down new development. AHCA/NCAL also commented that these proposed parameters do not allow operators flexibility to meet market demands and, before advancing such guidelines, we recommend a national study be conducted producing information on how shifting guidelines would impact operators and residents before making significant changes to FGI.
Opinions and comments received from the public will be reviewed and voted on by the Health Guidelines Revision Committee (HGRC), which includes a representative from AHCA/NCAL. Revisions approved by the HGRC will appear in the next draft of the 2026 FGI Facility Code. The new FGI Facility Code is scheduled for release in early 2026.
About the FGI Guidelines for Design and Construction/FGI Facility Code Documents
The Facility Guidelines Institute (FGI) Facility Code provides guidelines for the design and construction of healthcare facilities, including residential and assisted living communities in the United States. A new edition of the FGI Guidelines/FGI Facility Code is published every four years based on a three-year revision cycle that offers opportunities for public comment. Visit the FGI website here.