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Codes & Requirements

This section contains an overview of some of the building codes most pertinent to the projects you will be undertaking. It is not necessarily an exhaustive list. Note also that not all the codes and regulations listed here will be applicable to all hospitals in all situations. They’re listed here for reference purposes only. Note also that there will be some codes below listed that will conflict with each other.

Since you may find it helpful to be aware of potential funding, grant, and incentive opportunities as you review the below codes, feel free to cross-reference these listings with those found in Step 6: Secure Funding.

NYS Hospital Codes Overview

Title: Article 1 – General Provisions¹ | New York Codes, Rules and Regulations (ny.gov)

Title: Article 2 – Medical Facility Construction² | New York Codes, Rules and Regulations (ny.gov)

NYS Hospital Codes: Applicability & Standards

Section 711.1 Applicability³

(a) This Part sets forth minimum construction and physical environment standards applicable to all health facilities subject to Public Health Law Article 28, including but not limited to, general hospitals, nursing homes and ambulatory care facilities. (b) An applicant seeking approval to construct a new health facility or alter or renovate an existing health facility shall submit to the department a completed application and functional program. The applicant shall ensure that all terms and acronyms are clearly defined and consistently used in the application and functional program. The functional program, which is a detailed architectural and design plan for the health facility, shall include a description of the following:
  1. the scope and purpose of the proposed construction project and other basic information relating to fulfillment of the applicant’s objectives;
  2. the services necessary for the complete operation of the health facility, the size and function of each space, any special design features, the projected occupant load, and numbers and types of staff, patients, residents, visitors and vendors;
  3. the types and projected numbers of procedures to be performed in each treatment area and circulation patterns for staff, patients or residents, and the public;
  4. the projected demand or utilization, staffing patterns, departmental relationships, space requirements, and circulation patterns that are a function of infection control requirements and for clean and soiled materials;
  5. equipment requirements, including building service equipment and fixed and moveable equipment; and,
  6. potential future expansion that may be needed to accommodate increased demand.
(c) Once approved by the department, the functional program and the approved plans and specifications developed from it shall be used in the development, design and construction of the project and serve as the basis for all subsequent construction approvals regarding the specific project. The applicant or health facility operator shall retain and make available to the department, upon the department’s request, the functional program, all government approved plans and specifications developed from it and any other design data to facilitate alterations, and program changes.

711.2 Pertinent technical standards⁴. All health facilities shall comply with the pertinent provisions of the standards and codes referred to in this section and with local laws relating to zoning, sanitation, fire safety and construction, where such local laws represent standards in addition to those required by this Part. Reference throughout this chapter to codes and standards shall be those editions listed in this section. If a conflict occurs between the following codes and standards or between them and regulations elsewhere in this chapter, then compliance with the more restrictive regulation is required. If federal regulatory requirements conflict with the codes and standards referred to in this section, the department may waive compliance with such standards and codes, provided that a health facility fully complies with said federal regulatory requirements.

(a) The following National Fire Protection Association (NFPA) Codes and Standards are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. These codes and standards are available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. The codes and standards are published by the National Fire Protection Association, and copies are also available from the National Fire Protection Association, 1 Batterymarch Park, P.O. Box 9101, Quincy, MA 02269-9101, 1-800-344-3555 or www.nfpa.org. The various codes and standards are available from the NFPA either as individual publications or as contained within the Compilation of NFPA National Fire Codes, 1999 edition.

  1. NFPA 101, Life Safety Code, 2000 edition.
  2. NFPA 101A, Guide on Alternative Approaches to Life Safety, 1998 edition.
  3. NFPA 10, Standard for Portable Fire Extinguishers, 1998 edition.
  4. NFPA 13, Standard for the Installation of Sprinkler Systems, 1999 edition.
  5. NFPA 14, Standard for the Installation of Standpipe, Private Hydrants and Hose Systems, 2000 edition.
  6. NFPA 25, Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems, 1998 edition.
  7. NFPA 30-1996–Flammable and Combustible Liquids Code.
  8. NFPA 31, Standard for the Installation of Oil-Burning Equipment, 1997 edition.
  9. NFPA 45-1996-Standard on Fire Protection for Laboratories Using Chemicals.
  10. NFPA 54, National Fuel Gas Code, 1999 edition.
  11. NFPA 58, Liquefied Petroleum Gases Code, 1998 edition.
  12. NFPA 70, National Electrical Code, 1999 edition.
  13. NFPA 72, National Fire Alarm Code, 1999 edition.
  14. NFPA 80, Standard for Fire Doors and Fire Windows, 1999 edition.
  15. NFPA 82, Standard on Incinerators and Waste and Linen Handling Systems and Equipment, 1999 edition.
  16. NFPA 90A, Standard for the Installation of Air Conditioning and Ventilating Systems, 1999 edition.
  17. NFPA 90B, Standard for the Installation of Warm Air Heating and Air-Conditioning Systems, 1999 edition.
  18. NFPA 91, Standards for Exhaust Systems for Air Conveying of Vapors, Gases, Mists and Noncombustible Particulate Solids, 1999 edition.
  19. NFPA 96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations, 1998 edition.
  20. NFPA 99, Standard for Health Care Facilities, 1999 edition.
  21. NFPA 110, Standard for Emergency and Standby Power Systems, 1999 edition.
  22. NFPA 111, Standard on Stored Electrical Energy Emergency and Standby Power Systems, 1996 edition.
  23. NFPA 211, Standard for Chimneys, Fireplaces, Vents, and Solid Fuel-Burning Appliances, 2000 edition.
  24. NFPA 220, Standard on Types of Building Construction, 1999 edition.
  25. NFPA 221, Standard for Fire Walls and Fire Barrier Walls, 1997 edition.
  26. NFPA 241-1996–Standard for Safeguarding Construction, Alteration, and Demolition Operations.
  27. NFPA 251, Standard Methods of Tests of Fire Endurance of Building Construction and Materials, 1999 edition.
  28. NFPA 252, Standard Methods of Fire Tests of Door Assemblies, 1999 edition.
  29. NFPA 253, Standard Method of Test for Critical Radiant Flux of Floor Covering Systems Using a Radiant Heat Energy Source, 2000 edition.
  30. NFPA 255, Standard Method of Test of Surface Burning Characteristics of Building Materials, 2000 edition.
  31. NFPA 256, Standard Methods of Fire Tests of Roof Coverings, 1998 edition.
  32. NFPA 257, Standard on Fire Test for Windows and Glass Block Assemblies, 2000 edition.
  33. NFPA 260, Standard Methods of Tests and Classification System for Cigarette Ignition Resistance of Components of Upholstered Furniture, 1998 edition.
  34. NFPA 261, Standard Method of Tests for Determining Resistance of Mock-Up Upholstered Furniture Material Assemblies to Ignition by Smoldering Cigarettes, 1998 edition.
  35. NFPA 265, Standard Methods of Fire Tests for Evaluating Room Fire Growth Contribution of Textile Wall Coverings, 1998 edition.
  36. NFPA 266, Standard Method of Test for Fire Characteristics of Upholstered Furniture Exposed to Flaming Ignition Source, 1998 edition.
  37. NFPA 267, Standard Method of Test for Fire Characteristics of Mattresses and Bedding Assemblies Exposed to Flaming Ignition Source, 1998 edition.
  38. NFPA 286, Standard Methods of Fire Tests for Evaluating Room Fire Contribution of Wall and Ceiling Interior Finish, 2000 edition.
  39. NFPA 418, Standard for Heliports, 1995 edition.
  40. NFPA 701, Standard Methods of Fire Tests for Flame Propagation of Textiles and Films, 1999 edition.
  41. NFPA 703, Standard for Fire Retardant Impregnated Wood and Fire Retardant Coatings for Building Materials, 2000 edition.

(b) The following codes and standards are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. These codes and standards are available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. Copies are also available from the publisher or issuing organization at the address listed.

  1. ANSI/ASHRAE Standard 52.2-1999, Method of Testing Air-Cleaning Devices for Removal Efficiency by Particle Size, 1999 edition. American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc., 180 Technology Parkway, Peachtree Corners, GA  30092.
  2. Compressed Gas Association, Inc. (CGA) Pamphlet E-10, Maintenance of Medical Gas and Vacuum Systems in Health Care Facilities, third edition, 2007. Compressed Gas Association, Inc., 4221 Walney Road, Chantilly, VA, 20151-2923, www.cganet.com.
  3. National Council on Radiation Protection and Measurements (NCRP) Report No. 102–Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50MeV (1989). National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.
  4. National Council on Radiation Protection and Measurements (NCRP) Report No. 147–Structural Shielding Design for Medical X-Ray Imaging Facilities, 2004 edition. National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.
  5. National Council on Radiation Protection and Measurements (NCRP) Report No. 144–Radiation Protection for Particle Accelerator Facilities, 2003 edition. National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.
  6. 1996-97 Guidelines for Design and Construction of Hospital and Health Care Facilities, 1996 edition. The American Institute of Architects Academy of Architecture for Health, with assistance from the U.S. Department of Health and Human Services, the American Institute of Architects Press, 1735 New York Avenue, N.W., Washington, D.C. 20006. The standards set forth in this paragraph are applicable to construction projects completed pursuant to Subparts 712-2 and 713-2 and other applicable provisions in this Chapter. Such projects must, at minimum, maintain compliance with these standards.
  7. Guidelines for Design and Construction of Health Care Facilities, 2010 edition. The American Society for Healthcare Engineering, with assistance from the U.S. Department of Health and Human Services, One North Franklin Street, Chicago, Illinois, 60606, and at www.ashe.org.

(c) Design standards for the disabled. The Americans with Disabilities Act of 1990 (ADA) extends comprehensive civil rights protection to persons with disabilities. Health care facilities must comply with the ADA and the regulations which implement it. Title 28 of the Code of Federal regulations, Public Health Parts 35, Non-Discrimination on the Basis of Disability in State and Local Government Services, and Part 36, Non-Discrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities, including Appendix A, “Standard for Accessible Design”, 2004 edition. These regulations are published by the Office of the Federal Register National Archives and Records Administration. Copies may be obtained from the Superintendent of Documents, United States Government Printing Office, Washington D.C. 20402.

711.3 Site Conditions⁵

(a) Each health facility shall be easily accessible to patients or residents, staff and visitors and to service vehicles such as fire protection apparatus. Health facility grounds shall have paved roads and walkways to provide access to all public and service entrances, including loading docks. Emergency department entrances shall be conspicuously marked to facilitate access from public roads and streets. Access to emergency entrances shall not conflict with other vehicular or pedestrian traffic.

(b) Health facilities shall be located with due regard to the accessibility by public transportation for patients, staff and visitors and the availability of competent medical and surgical consultation.

(c) Off-street parking shall be made available for patients, staff and visitors. In urban areas where a health facility is accessible by public transportation, the commissioner may waive the requirement for off-street parking, if compliance with this requirement is burdensome or unnecessary because adequate parking exists to accommodate patients, staff and visitors.

(d) In earthquake prone regions, health facilities that are subdivided into separate structural units by seismic joints, each unit shall be provided with an exit stairway to permit evacuation from the building without traversing the seismic joints. Special care shall be taken to anchor fixed equipment, suspended ceilings, light fixtures and similar items to minimize hazard to occupants and damage to the equipment and building during an earthquake. Storage shelves and racks holding breakable or fragile supplies shall be designed to retain their contents when subject to the lateral forces of an earthquake.

(e) If a health facility is located in a flood plain, the commissioner may require that the health facility comply with any, or all, of the following:

  1. Health facility footings, foundations, and structural frame shall be designed to be stable under flood conditions.
  2. A helicopter landing pad shall be located on the facility roof and shall be structurally sound and suitable for safe helicopter evacuations of patients and staff.
  3. The health facility shall be designed and capable of providing services necessary to maintain the life and safety of patients and staff if floodwaters reach the one-hundred year flood crest level and shall include the following:

(i) electrical service, emergency power supply, heating, ventilating and sterilizers;

(ii) main internal communication capability, including nurses’ call systems and the fire alarm system;

(iii) dietary service;

(iv) an acceptable alternate to the normal water supply system;

(v) an acceptable emergency means of storage and/or disposal of sewage, biological waste, and garbage;

(vi) emergency department service; and,

(vii) x-ray service.

  1. No floor level or basement shall be located below the 100-year flood crest level, unless specifically approved by the commissioner. On those floor levels or basements that the commissioner approves to be below the 100-year flood crest level:

(i) all new partitions shall be constructed without void such as solid concrete, solid concrete block, or other solid material;

(ii) no new carpeting shall be installed; and

(iii) the following services and equipment shall not be provided or located in such area:

(a) medical records storage area;

(b) medical records library;

(c) surgical suite; and

(d) such other services and fixed equipment that the commissioner may determine, taking into consideration patient safety and cost of replacement.

  1. Storage of available building plans of the existing buildings shall be above the 100-year flood crest level.

Reference Standards

Applicable Code Packages – ICC Digital Codes

(International Code Council)

  • 2020 Building Code of New York State
  • 2020 Fire Code of New York State
  • 2020 Energy Conservation Code of New York State
  • 2020 Mechanical Code of New York State
  • 2020 Plumbing Code of New York State
  • 2020 Fuel Gas Code of New York State
  • 2020 Existing Building Code of New York State
  • 2020 Property Code of New York State

Health Equity Impact Assessments (HEIA)

On June 22, 2023 and new Health Equity Impact Assessment Regulation went into effect in the State of New York. Under the regulation, certain applications under Public Health Law Section 2802-b must include a Health Equity Impact Assessment to demonstrate how a proposed project affects the accessibility and delivery of health care services to enhance health equity and contribute to mitigating health disparities in the facility’s service area, specifically for medically underserved groups⁶. For related grant or funding opportunities, see Step 6: Securing Funding.

New York City Construction Codes - NYC Codes - Buildings

2022 Construction Codes

  • General Administrative Provisions
  • Building Code
  • Fuel Gas Code
  • Mechanical Code
  • Plumbing Code
  • Electrical Code

Table of Contents

PREFACE
ACKNOWLEDGEMENTS
TITLE 28-ARTICLE 1001

CHAPTER 1 – ADMINISTRATION

RESIDENTIAL PROVISIONS
CHAPTER R2 – DEFINITIONS
CHAPTER R3 – GENERAL REQUIREMENTS
CHAPTER R4 – RESIDENTIAL ENERGY EFFICIENCY
CHAPTER R5 – EXISTING BUILDINGS
CHAPTER R6 – REFERENCED STANDARDS

COMMERCIAL PROVISIONS
CHAPTER C2 – DEFINITIONS
CHAPTER C3 – GENERAL REQUIREMENTS
CHAPTER C4 – COMMERCIAL ENERGY EFFICIENCY -***New NYS Code Interpretation Table C404.2***
CHAPTER C5 – EXISTING BUILDINGS
CHAPTER C6 – REFERENCED STANDARDS
APPENDIX CA – MODIFIED ENERGY STANDARD FOR BUILDINGS, EXCEPT FOR
LOW-RISE RESIDENTIAL BUILDINGS

The 2014 Building Code
The 2014 Construction Codes applied to the applications filed from December 31, 2014 through November 6, 2022 and governed the construction, alteration, modification, addition, replacement, repair, equipment, use and occupancy, location, maintenance, removal, and demolition of buildings and structures in New York City.

The 2008 Building Code
The 2008 Building Code applies to the construction, alteration, modification, addition, replacement, repair, equipment, use and occupancy, location, maintenance, removal, and demolition of buildings and structures in the City.

The 1968 Building Code
The 1968 Building Code has amendments to July 2008. Included in the Code are instructions on how to add, discard, and replace pages to the current Building Code.

The 1938 Building Code
The 1938 Building Code was edited and amended to December 6, 1968 also has Building Laws relating to buildings built before the edited and amended date.

You can purchase any of the Past Codes at the CityStore or you can visit the CityStore in person by going to the:
Manhattan Municipal Building
1 Centre Street – North Plaza
New York, New York 10007

Hours of Operation:
Monday-Friday
10:00 am to 5:00 pm

Helpful Links

Housing Maintenance Code
The New York City Housing Maintenance Code covers the responsibilities of owners, tenants, and the City for maintaining health, safety, repair, and maintenance in dwellings.

Fire Code
The New York City Fire Code regulates fire safety in the operation and maintenance of all buildings, and establishes design requirements for a wide range of building installations. The Fire Code is a companion Code to the New York City Construction Codes and Zoning Resolution, with extensive cross-references to the Building, Mechanical and Electrical Codes.

Multiple Dwelling Law
The New York State Multiple Dwelling Law is state law governing design and construction standards for multiple dwellings in the state of New York, including New York City. It covers everything from the placement of fire exists to prohibitions against such arcana as having a commercial fat-boiling facility in your apartment.

Helpful Links

Facilities Guideline Institute

Adoption Map

Guideline Interpretations

Facilities Guideline Institute

ASHRAE Healthcare Resources

ASHRAE Healthcare Resources

CMS Life Safety Code & Health Care Facilities Code Requirements

CMS LIfe Safety Code & Health Care Faciities Code Requirements

CMS State of Operations Manual Survey

October 2022

R209SOMA (cms.gov)

NYC Construction Codes

Table of Contents

  1. GENERAL ADMINISTRATIVE PROVISIONS
  2. PLUMBING CODE
  3. MECHANICAL CODE
  4. FUEL GAS CODE
  5. BUILDING CODE

*A newer version of Internet Explorer (v.11+), Firefox (v.56+), Chrome (v.98+) or Safari (v.10+) is required to view these documents.*

The 2022 Construction Codes go into effect on November 7, 2022.

GENERAL ADMINISTRATIVE PROVISIONS:
CHAPTER 1 – ADMINISTRATION
CHAPTER 2 – ENFORCEMENT
CHAPTER 3 – MAINTENANCE OF BUILDINGS
CHAPTER 4 – LICENSING AND REGISTRATION OF BUSINESSES, TRADES AND OCCUPATIONS ENGAGED IN BUILDING WORK
CHAPTER 5 – MISCELLANEOUS PROVISIONS

PLUMBING CODE:
CHAPTER 1 – ADMINISTRATION
CHAPTER 2 – DEFINITIONS
CHAPTER 3 – GENERAL REGULATIONS
CHAPTER 4 – FIXTURES, FAUCETS AND FIXTURE FITTINGS
CHAPTER 5 – WATER HEATERS
CHAPTER 6 – WATER SUPPLY AND DISTRIBUTION
CHAPTER 7 – SANITARY DRAINAGE
CHAPTER 8 – INDIRECT/SPECIAL WASTE
CHAPTER 9 – VENTS
CHAPTER 10 – TRAPS, INTERCEPTORS AND SEPARATORS
CHAPTER 11 – STORM DRAINAGE
CHAPTER 12 – SPECIAL PIPING AND STORAGE SYSTEMS
CHAPTER 13 – NONPOTABLE WATER SYSTEMS
CHAPTER 14 – SUBSURFACE LANDSCAPE IRRIGATION SYSTEMS
CHAPTER 15 – REFERENCED STANDARD
APPENDIX A – RESERVED
APPENDIX B – RESERVED
APPENDIX C – STRUCTURAL SAFETY
APPENDIX D – RESERVED
APPENDIX E – SIZING OF WATER PIPING SYSTEM

MECHANICAL CODE:
CHAPTER 1 – ADMINISTRATION
CHAPTER 2 – DEFINITIONS
CHAPTER 3 – GENERAL REGULATIONS
CHAPTER 4 – VENTILATION
CHAPTER 5 – EXHAUST SYSTEMS
CHAPTER 6 – DUCT SYSTEMS
CHAPTER 7 – COMBUSTION, VENTILATION AND DILUTION AIR
CHAPTER 8 – CHIMNEYS AND VENTS
CHAPTER 9 – SPECIFIC APPLIANCES AND EQUIPMENT
CHAPTER 10 – BOILERS, WATER HEATERS AND PRESSURE VESSELS
CHAPTER 11 – REFRIGERATION
CHAPTER 12 – HYDRONIC PIPING
CHAPTER 13 – FUEL-OIL PIPING AND STORAGE
CHAPTER 14 – SOLAR SYSTEMS
CHAPTER 15 – REFERENCED STANDARDS
APPENDIX A – CHIMNEY CONNECTOR PASS-THROUGHS
APPENDIX B – RESERVED
APPENDIX C – FUEL OIL STORAGE TANK VENTING OPTIONS

FUEL GAS CODE:
CHAPTER 1 – ADMINISTRATION
CHAPTER 2 – DEFINITIONS
CHAPTER 3 – GENERAL REGULATIONS
CHAPTER 4 – GAS PIPING INSTALLATIONS
CHAPTER 5 – CHIMNEYS AND VENTS
CHAPTER 6 – SPECIFIC APPLIANCES
CHAPTER 7 – GASEOUS HYDROGEN SYSTEMS
CHAPTER 8 – REFERENCED STANDARDS
APPENDIX A – RESERVED
APPENDIX B – RESERVED
APPENDIX C – RESERVED
APPENDIX D – RESERVED
APPENDIX E – METERS AND GAS SERVICE PIPING
APPENDIX F – RESERVED
APPENDIX G – HIGH PRESSURE NATURAL GAS INSTALLATIONS

BUILDING CODE:
CHAPTER 1 – ADMINISTRATION
CHAPTER 2 – DEFINITIONS
CHAPTER 3 – USE AND OCCUPANCY CLASSIFICATION
CHAPTER 4 – SPECIAL DETAILED REQUIREMENTS BASED ON USE AND OCCUPANCY
CHAPTER 5 – GENERAL BUILDING HEIGHTS AND AREAS; SEPARATION OF OCCUPANCIES
CHAPTER 6 – TYPES OF CONSTRUCTION
CHAPTER 7 – FIRE AND SMOKE PROTECTION FEATURES
CHAPTER 8 – INTERIOR FINISHES
CHAPTER 9 – FIRE PROTECTION SYSTEMS
CHAPTER 10 – MEANS OF EGRESS
CHAPTER 11 – ACCESSIBILITY
CHAPTER 12 – INTERIOR ENVIRONMENT
CHAPTER 13 – ENERGY EFFICIENCY
CHAPTER 14 – EXTERIOR WALLS
CHAPTER 15 – ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
CHAPTER 16 – STRUCTURAL DESIGN
CHAPTER 17 – SPECIAL INSPECTIONS AND TESTS
CHAPTER 18 – SOILS AND FOUNDATIONS
CHAPTER 19 – CONCRETE
CHAPTER 20 – ALUMINUM
CHAPTER 21 – MASONRY
CHAPTER 22 – STEEL
CHAPTER 23 – WOOD
CHAPTER 24 – GLASS AND GLAZING
CHAPTER 25 – GYPSUM BOARD, GYPSUM PANEL PRODUCTS AND PLASTER
CHAPTER 26 – PLASTIC
CHAPTER 27 – ELECTRICAL
CHAPTER 28 – MECHANICAL SYSTEMS
CHAPTER 29 – PLUMBING SYSTEMS
CHAPTER 30 – ELEVATORS AND CONVEYING SYSTEMS
CHAPTER 31 – SPECIAL CONSTRUCTION
CHAPTER 32 – ENCROACHMENTS INTO THE PUBLIC RIGHT-OF-WAY
CHAPTER 33 – SAFEGUARDS DURING CONSTRUCTION OR DEMOLITION
CHAPTER 34 – RESERVED
CHAPTER 35 – REFERENCED STANDARDS
APPENDIX A – RESERVED
APPENDIX B – RESERVED
APPENDIX C – RESERVED
APPENDIX D – FIRE DISTRICTS
APPENDIX E – SUPPLEMENTARY ACCESSIBILITY REQUIREMENTS
APPENDIX F – RODENT-PROOFING
APPENDIX G – FLOOD-RESISTANT CONSTRUCTION
APPENDIX H – OUTDOOR SIGNS
APPENDIX I – RESERVED
APPENDIX J – RESERVED
APPENDIX K – MODIFIED INDUSTRY STANDARDS FOR ELEVATORS AND CONVEYING SYSTEMS
APPENDIX L – RESERVED
APPENDIX M – SUPPLEMENTARY REQUIREMENTS FOR ONE- AND TWO-FAMILY DWELLINGS
APPENDIX N – ASSISTIVE LISTENING SYSTEMS PERFORMANCE STANDARDS
APPENDIX O – RESERVED
APPENDIX P – RESERVED
APPENDIX Q – MODIFIED NATIONAL STANDARDS FOR AUTOMATIC SPRINKLER, STANDPIPE, FIRE PUMP, FIRE ALARM, AND SMOKE CONTROL SYSTEMS
APPENDIX R – ACOUSTICAL TILE AND LAY-IN PANEL CEILING SUSPENSION SYSTEMS
APPENDIX S – SUPPLEMENTARY FIGURES FOR LUMINOUS EGRESS PATH MARKINGS

Requirements for State Owned/Operated Facilities

EO22 (Executive Order 22)

EO22 effects the thousands of State owned and operated facilities across New York State by directing State Agencies to adopt a Sustainability and Decarbonization Program.

1The Official Website of New York State, General Provisions
https://regs.health.ny.gov/content/article-1-general-provisions

2The Official Website of New York State, Medical Facility Construction
https://regs.health.ny.gov/volume-d-title-10/content/article-2-medical-facility-construction

3The Official Website of New York State, Applicability
https://regs.health.ny.gov/content/section-7111-applicability

4The Official Website of New York State, Pertinent Technical Standards
https://regs.health.ny.gov/content/section-7112-pertinent-technical-standards

5The Official Website of New York State, Site requirements
https://regs.health.ny.gov/content/section-7113-site-requirements

6New York Public Health Law, Section 2802-B
https://newyork.public.law/laws/n.y._public_health_law_section_2802-b

This section contains an overview of some of the building codes most pertinent to the projects you will be undertaking. It is not necessarily an exhaustive list. Note also that not all the codes and regulations listed here will be applicable to all hospitals in all situations. They’re listed here for reference purposes only. Note also that there will be some codes below listed that will conflict with each other.

Since you may find it helpful to be aware of potential funding, grant, and incentive opportunities as you review the below codes, feel free to cross-reference these listings with those found in Step 6: Secure Funding.

NYS Hospital Codes Overview

Article 1 – General Provisions

Title: Article 1 – General Provisions | New York Codes, Rules and Regulations (ny.gov)

Article 2 – Medical Facility Construction

Title: Article 2 – Medical Facility Construction | New York Codes, Rules and Regulations (ny.gov)

NYS Hospital Codes: Applicability & Standards

Article 711.1 – Applicability

Section 711.1 Applicability

(a) This Part sets forth minimum construction and physical environment standards applicable to all health facilities subject to Public Health Law Article 28, including but not limited to, general hospitals, nursing homes and ambulatory care facilities.

(b) An applicant seeking approval to construct a new health facility or alter or renovate an existing health facility shall submit to the department a completed application and functional program. The applicant shall ensure that all terms and acronyms are clearly defined and consistently used in the application and functional program. The functional program, which is a detailed architectural and design plan for the health facility, shall include a description of the following:

  1. the scope and purpose of the proposed construction project and other basic information relating to fulfillment of the applicant’s objectives;

  2. the services necessary for the complete operation of the health facility, the size and function of each space, any special design features, the projected occupant load, and numbers and types of staff, patients, residents, visitors and vendors;

  3. the types and projected numbers of procedures to be performed in each treatment area and circulation patterns for staff, patients or residents, and the public;

  4. the projected demand or utilization, staffing patterns, departmental relationships, space requirements, and circulation patterns that are a function of infection control requirements and for clean and soiled materials;

  5. equipment requirements, including building service equipment and fixed and moveable equipment; and,

  6. potential future expansion that may be needed to accommodate increased demand.

(c) Once approved by the department, the functional program and the approved plans and specifications developed from it shall be used in the development, design and construction of the project and serve as the basis for all subsequent construction approvals regarding the specific project. The applicant or health facility operator shall retain and make available to the department, upon the department’s request, the functional program, all government approved plans and specifications developed from it and any other design data to facilitate alterations, and program changes.

Article 711.2 – Pertinent Technical Standards

711.2 Pertinent technical standards. All health facilities shall comply with the pertinent provisions of the standards and codes referred to in this section and with local laws relating to zoning, sanitation, fire safety and construction, where such local laws represent standards in addition to those required by this Part. Reference throughout this chapter to codes and standards shall be those editions listed in this section. If a conflict occurs between the following codes and standards or between them and regulations elsewhere in this chapter, then compliance with the more restrictive regulation is required. If federal regulatory requirements conflict with the codes and standards referred to in this section, the department may waive compliance with such standards and codes, provided that a health facility fully complies with said federal regulatory requirements.

(a) The following National Fire Protection Association (NFPA) Codes and Standards are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. These codes and standards are available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. The codes and standards are published by the National Fire Protection Association, and copies are also available from the National Fire Protection Association, 1 Batterymarch Park, P.O. Box 9101, Quincy, MA 02269-9101, 1-800-344-3555 or www.nfpa.org. The various codes and standards are available from the NFPA either as individual publications or as contained within the Compilation of NFPA National Fire Codes, 1999 edition.

  1. NFPA 101, Life Safety Code, 2000 edition.

  2. NFPA 101A, Guide on Alternative Approaches to Life Safety, 1998 edition.

  3. NFPA 10, Standard for Portable Fire Extinguishers, 1998 edition.

  4. NFPA 13, Standard for the Installation of Sprinkler Systems, 1999 edition.

  5. NFPA 14, Standard for the Installation of Standpipe, Private Hydrants and Hose Systems, 2000 edition.

  6. NFPA 25, Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems, 1998 edition.

  7. NFPA 30-1996–Flammable and Combustible Liquids Code.

  8. NFPA 31, Standard for the Installation of Oil-Burning Equipment, 1997 edition.

  9. NFPA 45-1996-Standard on Fire Protection for Laboratories Using Chemicals.

  10. NFPA 54, National Fuel Gas Code, 1999 edition.

  11. NFPA 58, Liquefied Petroleum Gases Code, 1998 edition.

  12. NFPA 70, National Electrical Code, 1999 edition.

  13. NFPA 72, National Fire Alarm Code, 1999 edition.

  14. NFPA 80, Standard for Fire Doors and Fire Windows, 1999 edition.

  15. NFPA 82, Standard on Incinerators and Waste and Linen Handling Systems and Equipment, 1999 edition.

  16. NFPA 90A, Standard for the Installation of Air Conditioning and Ventilating Systems, 1999 edition.

  17. NFPA 90B, Standard for the Installation of Warm Air Heating and Air-Conditioning Systems, 1999 edition.

  18. NFPA 91, Standards for Exhaust Systems for Air Conveying of Vapors, Gases, Mists and Noncombustible Particulate Solids, 1999 edition.

  19. NFPA 96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations, 1998 edition.

  20. NFPA 99, Standard for Health Care Facilities, 1999 edition.

  21. NFPA 110, Standard for Emergency and Standby Power Systems, 1999 edition.

  22. NFPA 111, Standard on Stored Electrical Energy Emergency and Standby Power Systems, 1996 edition.

  23. NFPA 211, Standard for Chimneys, Fireplaces, Vents, and Solid Fuel-Burning Appliances, 2000 edition.

  24. NFPA 220, Standard on Types of Building Construction, 1999 edition.

  25. NFPA 221, Standard for Fire Walls and Fire Barrier Walls, 1997 edition.

  26. NFPA 241-1996–Standard for Safeguarding Construction, Alteration, and Demolition Operations.

  27. NFPA 251, Standard Methods of Tests of Fire Endurance of Building Construction and Materials, 1999 edition.

  28. NFPA 252, Standard Methods of Fire Tests of Door Assemblies, 1999 edition.

  29. NFPA 253, Standard Method of Test for Critical Radiant Flux of Floor Covering Systems Using a Radiant Heat Energy Source, 2000 edition.

  30. NFPA 255, Standard Method of Test of Surface Burning Characteristics of Building Materials, 2000 edition.

  31. NFPA 256, Standard Methods of Fire Tests of Roof Coverings, 1998 edition.

  32. NFPA 257, Standard on Fire Test for Windows and Glass Block Assemblies, 2000 edition.

  33. NFPA 260, Standard Methods of Tests and Classification System for Cigarette Ignition Resistance of Components of Upholstered Furniture, 1998 edition.

  34. NFPA 261, Standard Method of Tests for Determining Resistance of Mock-Up Upholstered Furniture Material Assemblies to Ignition by Smoldering Cigarettes, 1998 edition.

  35. NFPA 265, Standard Methods of Fire Tests for Evaluating Room Fire Growth Contribution of Textile Wall Coverings, 1998 edition.

  36. NFPA 266, Standard Method of Test for Fire Characteristics of Upholstered Furniture Exposed to Flaming Ignition Source, 1998 edition.

  37. NFPA 267, Standard Method of Test for Fire Characteristics of Mattresses and Bedding Assemblies Exposed to Flaming Ignition Source, 1998 edition.

  38. NFPA 286, Standard Methods of Fire Tests for Evaluating Room Fire Contribution of Wall and Ceiling Interior Finish, 2000 edition.

  39. NFPA 418, Standard for Heliports, 1995 edition.

  40. NFPA 701, Standard Methods of Fire Tests for Flame Propagation of Textiles and Films, 1999 edition.

  41. NFPA 703, Standard for Fire Retardant Impregnated Wood and Fire Retardant Coatings for Building Materials, 2000 edition.

(b) The following codes and standards are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. These codes and standards are available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. Copies are also available from the publisher or issuing organization at the address listed.

  1. ANSI/ASHRAE Standard 52.2-1999, Method of Testing Air-Cleaning Devices for Removal Efficiency by Particle Size, 1999 edition. American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc., 1791 Tullie Circle NE, Atlanta, GA 30329.

  2. Compressed Gas Association, Inc. (CGA) Pamphlet E-10, Maintenance of Medical Gas and Vacuum Systems in Health Care Facilities, third edition, 2007. Compressed Gas Association, Inc., 4221 Walney Road, Chantilly, VA, 20151-2923, www.cganet.com.

  3. National Council on Radiation Protection and Measurements (NCRP) Report No. 102–Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50MeV (1989). National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.

  4. National Council on Radiation Protection and Measurements (NCRP) Report No. 147–Structural Shielding Design for Medical X-Ray Imaging Facilities, 2004 edition. National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.

  5. National Council on Radiation Protection and Measurements (NCRP) Report No. 144–Radiation Protection for Particle Accelerator Facilities, 2003 edition. National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.

  6. 1996-97 Guidelines for Design and Construction of Hospital and Health Care Facilities, 1996 edition. The American Institute of Architects Academy of Architecture for Health, with assistance from the U.S. Department of Health and Human Services, the American Institute of Architects Press, 1735 New York Avenue, N.W., Washington, D.C. 20006. The standards set forth in this paragraph are applicable to construction projects completed pursuant to Subparts 712-2 and 713-2 and other applicable provisions in this Chapter. Such projects must, at minimum, maintain compliance with these standards.

  7. Guidelines for Design and Construction of Health Care Facilities, 2010 edition. The American Society for Healthcare Engineering, with assistance from the U.S. Department of Health and Human Services, One North Franklin Street, Chicago, Illinois, 60606, and at www.ashe.org.

(c) Design standards for the disabled. The Americans with Disabilities Act of 1990 (ADA) extends comprehensive civil rights protection to persons with disabilities. Health care facilities must comply with the ADA and the regulations which implement it. Title 28 of the Code of Federal regulations, Public Health Parts 35, Non-Discrimination on the Basis of Disability in State and Local Government Services, and Part 36, Non-Discrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities, including Appendix A, “Standard for Accessible Design”, 2004 edition. These regulations are published by the Office of the Federal Register National Archives and Records Administration. Copies may be obtained from the Superintendent of Documents, United States Government Printing Office, Washington D.C. 20402.

Article 711.3 – Site Conditions

711.3 Site requirements.

(a) Each health facility shall be easily accessible to patients or residents, staff and visitors and to service vehicles such as fire protection apparatus. Health facility grounds shall have paved roads and walkways to provide access to all public and service entrances, including loading docks. Emergency department entrances shall be conspicuously marked to facilitate access from public roads and streets. Access to emergency entrances shall not conflict with other vehicular or pedestrian traffic.

(b) Health facilities shall be located with due regard to the accessibility by public transportation for patients, staff and visitors and the availability of competent medical and surgical consultation.

(c) Off-street parking shall be made available for patients, staff and visitors. In urban areas where a health facility is accessible by public transportation, the commissioner may waive the requirement for off-street parking, if compliance with this requirement is burdensome or unnecessary because adequate parking exists to accommodate patients, staff and visitors.

(d) In earthquake prone regions, health facilities that are subdivided into separate structural units by seismic joints, each unit shall be provided with an exit stairway to permit evacuation from the building without traversing the seismic joints. Special care shall be taken to anchor fixed equipment, suspended ceilings, light fixtures and similar items to minimize hazard to occupants and damage to the equipment and building during an earthquake. Storage shelves and racks holding breakable or fragile supplies shall be designed to retain their contents when subject to the lateral forces of an earthquake.

(e) If a health facility is located in a flood plain, the commissioner may require that the health facility comply with any, or all, of the following:

  1. Health facility footings, foundations, and structural frame shall be designed to be stable under flood conditions.

  2. A helicopter landing pad shall be located on the facility roof and shall be structurally sound and suitable for safe helicopter evacuations of patients and staff.

  3. The health facility shall be designed and capable of providing services necessary to maintain the life and safety of patients and staff if floodwaters reach the one-hundred year flood crest level and shall include the following:

(i) electrical service, emergency power supply, heating, ventilating and sterilizers;

(ii) main internal communication capability, including nurses’ call systems and the fire alarm system;

(iii) dietary service;

(iv) an acceptable alternate to the normal water supply system;

(v) an acceptable emergency means of storage and/or disposal of sewage, biological waste, and garbage;

(vi) emergency department service; and,

(vii) x-ray service.

  1. No floor level or basement shall be located below the 100-year flood crest level, unless specifically approved by the commissioner. On those floor levels or basements that the commissioner approves to be below the 100-year flood crest level:

(i) all new partitions shall be constructed without void such as solid concrete, solid concrete block, or other solid material;

(ii) no new carpeting shall be installed; and

(iii) the following services and equipment shall not be provided or located in such area:

(a) medical records storage area;

(b) medical records library;

(c) surgical suite; and

(d) such other services and fixed equipment that the commissioner may determine, taking into consideration patient safety and cost of replacement.

  1. Storage of available building plans of the existing buildings shall be above the 100-year flood crest level.

Applicable Code Packages – ICC Digital Codes (iccsafe.org)

  • 2020 Building Code of New York State

  • 2020 Fire Code of New York State

  • 2020 Energy Conservation Code of New York State

  • 2020 Mechanical Code of New York State

  • 2020 Plumbing Code of New York State

  • 2020 Fuel Gas Code of New York State

  • 2020 Existing Building Code of New York State

  • 2020 Property Code of New York State

Health Equity Impact Assessments (HEIA)

On June 22, 2023 and new Health Equity Impact Assessment Regulation went into effect in the State of New York. Under the regulation, certain applications under Public Health Law Section 2802-b must include a Health Equity Impact Assessment to demonstrate how a proposed project affects the accessibility and delivery of health care services to enhance health equity and contribute to mitigating health disparities in the facility’s service area, specifically for medically underserved groups. For related grant or funding opportunities, see Section 6: Securing Funding.

New York City Construction Codes - NYC Codes - Buildings

2022 Construction Codes

  • General Administrative Provisions

  • Building Code

  • Fuel Gas Code

  • Mechanical Code

  • Plumbing Code

  • Electrical Code

2020 Energy Conservation Code
Prior Codes
Code Tools

Facilities Guideline Institute

Adoption Map

Guideline Interpretations

Facility Guidelines Institute (fgiguidelines.org)

ASHRAE Healthcare Resources

ANSI/ASHRAE/ASHE Standard 170-2021 – Ventilation of Health Care Facilities

CMS LIfe Safety Code & Health Care Faciities Code Requirements

CMS State of Operations Manual Survey

October 2022

R209SOMA (cms.gov)

NYC Construction Codes

2022 NYC Construction codes

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