Healthcare Pest Reference A National Authoritative Reference

FGI Guidelines for Design and Construction — Pest Exclusion in Healthcare Facility Design

Source Record
Authority Type
Recognized Authority
Citation
Facility Guidelines Institute (FGI), Guidelines for Design and Construction of Hospitals; Guidelines for Design and Construction of Outpatient Facilities; Guidelines for Design and Construction of Residential Health, Care, and Support Facilities. 2022 Edition.
Primary Source
https://fgiguidelines.org/
Source Tier
Tier 1
Confidence
MEDIUM
Paywalled
Yes — institutional access recommended for litigation-grade use
Verbatim Available
No — predecessor or paraphrase only
Last Verified
May 25, 2026
Verified by Trenton L. Frazer, BCE #B3413 · Board Certified Entomologist · verification methodology

Citation

Facility Guidelines Institute (FGI). 2022 Edition Guidelines comprising three documents: Guidelines for Design and Construction of Hospitals; Guidelines for Design and Construction of Outpatient Facilities; and Guidelines for Design and Construction of Residential Health, Care, and Support Facilities. FGI publishes a new edition every four years; the 2022 edition is the current standard as of the verification date. The 2026 edition is under development with planned publication later in 2026.

What It Says (Operative Provisions Relevant to Pest Management)

FGI Guidelines are the U.S. standard for healthcare facility design and construction, adopted by reference in the hospital licensing rules of approximately 40 U.S. states. The guidelines address pest exclusion through architectural and mechanical design requirements at the facility envelope and at critical pest-vulnerable interior spaces.

Building envelope pest exclusion:

FGI specifies design requirements for the healthcare facility envelope that simultaneously serve infection control, energy efficiency, and pest exclusion:

Kitchen and dietary area design:

FGI specifies design requirements for hospital kitchens, cafeterias, and food storage areas that incorporate pest exclusion:

Sterile processing and pharmacy compounding design:

FGI specifies design requirements for sterile processing departments, pharmacy compounding areas, and other critical clean spaces:

Mechanical and electrical room design:

FGI specifies pest exclusion requirements for mechanical rooms, electrical rooms, telecommunications closets, and other support spaces commonly affected by pest activity:

Loading dock design:

FGI specifies loading dock design that addresses pest exclusion at one of the highest-risk pest entry zones in any healthcare facility:

What It Means in Plain Language

FGI Guidelines are the architectural and engineering standard that determines how U.S. healthcare facilities are designed and built. The guidelines are not directly enforceable as federal regulation, but they are adopted by reference in state hospital licensing rules (approximately 40 states), referenced by The Joint Commission and DNV-GL as standard of care for facility design, and referenced by Authorities Having Jurisdiction (AHJs) during facility permitting and construction inspection.

The practical implication for pest management programs serving healthcare facilities:

  1. Pest exclusion is built into facility design. A healthcare facility constructed under FGI Guidelines has architectural pest exclusion features that pest management programs can leverage. A facility constructed without FGI compliance (or under older FGI editions) may have architectural deficiencies requiring elevated operational pest management to compensate.
  2. Renovation and addition work must maintain pest exclusion design. Every renovation, addition, or major repair project in an FGI-compliant facility must maintain pest exclusion features. Pest management programs should be consulted during renovation planning to ensure architectural pest exclusion is preserved or improved.
  3. Loading docks, kitchens, and mechanical rooms are the highest-leverage pest exclusion zones. FGI guidelines specifically address these zones because they are documented as the highest-frequency pest entry points in healthcare facilities. Pest management programs that focus on these zones address the architectural-level pest exclusion failures most likely to undermine the broader pest management effort.
  4. Sterile spaces have specialized architectural pest exclusion. Operating rooms, sterile processing, pharmacy compounding, and other critical clean spaces have FGI-specified architectural pest exclusion features that must be maintained throughout the facility lifecycle. Loss of these features through deferred maintenance constitutes both an infection control failure and a pest exclusion failure.

Who It Applies To

FGI Guidelines apply by reference to:

The specific FGI volume depends on facility type:

Documentation Evidence Required

For pest management documentation supporting FGI-aligned facility operations:

How Surveyors Evaluate It

State health department surveyors evaluate FGI compliance directly in states that adopt FGI by reference. Joint Commission and DNV-GL surveyors reference FGI Guidelines as standard of care during facility tours. AHJs evaluate FGI compliance during construction permitting and inspection.

Surveyors evaluating pest management in the context of FGI compliance look for:

Common findings: deteriorated door seals at exterior openings, damaged window screens, unsealed wall and floor penetrations in mechanical rooms, deteriorated dock seals, and renovation projects that compromised original architectural pest exclusion features.

Confidence Notes

MEDIUM confidence. FGI Guidelines verbatim text is paywalled (sold through ASHE at approximately $200-$400 per volume). Operational requirements summarized on this page are derived from publicly available FGI overview materials, state hospital licensing regulations that adopt FGI by reference (verifiable through state administrative code), ASHE/HFM published articles, and architectural industry analysis. The 2022 edition is the current standard as of the verification date; the 2026 edition is under development. State adoption status varies and should be verified against individual state hospital licensing rules.