Between the Lines with FGI
Curious about the health care physical environment? Join John Williams and Marissa Lamperis Kastrinos for serial fun on a serious topic as they discuss the FGI Code for Planning and Design and compliance issues with some of the world’s top thinkers and designers. Explore the history of the minimum standards and intent between the lines of the code.
info_outline
S3 E3 — The Code Ahead: A Preview to the 2026 FGI Residential Code
01/30/2026
S3 E3 — The Code Ahead: A Preview to the 2026 FGI Residential Code
In this episode of Between the Lines with FGI, John Williams and Marissa Lamperis Kastrinos introduce the first installment of a three-part series that focuses on each of the documents in the 2026 FGI Codes, starting with the Residential document. Marissa and John welcome Addie Abushousheh, Gaius G. Nelson, and John Shoesmith, the chairs of the Residential Document Group of the 2026 Health Guidelines Revision Committee (HGRC), who provide an inside look at the key changes to the 2026 FGI Code for Planning and Design of Residential Care and Support Settings, as well as their inspiration for leading these changes. The 2026 FGI Residential Code provides baseline requirements for the planning, design, and construction of nursing homes, hospice facilities, assisted living settings, residential behavioral and mental health treatment facilities, long-term residential substance use disorder facilities, settings for individuals with intellectual and/or developmental disabilities, adult day care and adult day health care facilities, wellness centers, and outpatient rehabilitation therapy facilities. This episode discusses additions and revisions to the 2026 FGI Residential Code, including clearer language addressing dining spaces, resident room capacity, and small-scale environments. This trio of experts shed light on the revision process of the FGI Codes/Guidelines through the HGRC and industry perspectives that shaped the outcomes. They discuss the major shift in how information is delivered through FGI’s new approach to providing both code requirements and advisory guidance. Sponsored by: Optimizing health care facilities Link to show notes: Take a deeper dive into the 2026 FGI Residential Code An on-demand webinar is available at FGI University that breaks down the specific updates mentioned in this episode, plus additional context and practical takeaways, directly from the chairs of the Residential Document Group of the 2026 Health Guidelines Revision Committee (HGRC). Earn CEUs Anytime with FGI University and Between the Lines with FGI: Gain even more insight with the extended version of this episode while earning continuing education units (CEUs)! Head over to FGIUniversity.org our educational platform for the FGI Codes/Guidelines, and explore CEU- and HSW-approved audio courses designed to make earning credits effortless—perfect for learning on the go. To make it even better, use promo code BTL10 at checkout to get 10% off any Between the Lines with FGI course and the on-demand webinar for the 2026 FGI Residential Code. Listen, learn, and save today. AIA self-reporting: FGI is a registered provider of AIA-approved continuing education under Provider Number 38744124. All registered AIA CES Providers must comply with the AIA Standards for Continuing Education Programs. Any questions or concerns about this provider or this learning program may be sent to AIA CES (cessupport@aia.org). This learning program may be self-reported for LU credit through the AIA Continuing Education System. As such, it does not include content that may be deemed or construed to be an approval or endorsement by the AIA. To receive AIA self-reported LUs, learners must complete and self-report two of these entire learning programs for 1 LU. Learn more about AIA self-reporting LUs: Connect with us on Author: Facility Guidelines Institute
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/39880890
info_outline
S3 E2 – The Code We Live In: A Family’s Journey Through Hospital Design
12/05/2025
S3 E2 – The Code We Live In: A Family’s Journey Through Hospital Design
In this episode of Between the Lines with FGI, John Williams and Marissa Lamperis Kastrinos welcome back our beloved co-host, Bridget McDougall, as she continues to navigate an unexpected and challenging chapter in her family’s life: caring for her 8-year-old son following the sudden onset of acute psychiatric symptoms. Bridget’s journey included repeated crises, multiple hospitalizations, and countless hours in health care spaces—giving her a unique, firsthand perspective on how the built environment can aid or hinder healing. While the conversation focuses on the intersection of the FGI Codes/Guidelines, design, and patient experience, we begin with a brief look at what led her family to seek care. Join Marissa, John, and Bridget as they explore why design matters in moments of vulnerability and how health care spaces shape recovery. Sponsored by: Optimizing health care facilities
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/39279740
info_outline
S3 E1 – Safe by Design: Proactive Maintenance for Code and Care
10/24/2025
S3 E1 – Safe by Design: Proactive Maintenance for Code and Care
In the Season 3 opener of Between the Lines with FGI, cohosts John Williams and Marissa Lamperis Kastrinos sit down with Jonathan Flannery, MHSA, CHFM, FASHE, FACHE, senior associate director, American Society for Health Care Engineering (ASHE) and Mark Mochel, MBA, CHFM, SASHE, ACABE, strategic account executive at Brightly, A Siemens Company, to unpack one of health care’s most overlooked challenges—deferred maintenance. Together, they explore how proactive infrastructure investment can enhance patient safety, reduce long-term costs, and foster collaboration across design, construction, and operations. With real-world stories and strategic insights, listeners will learn how facility managers, architects, and clinical leaders can turn maintenance planning into a vital component of care delivery. Sponsored by: Optimizing health care facilities : Software to create more secure, efficient, & compliant facilities. Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/38727470
info_outline
S3 Kickoff - What’s New with Joint Commission: Recorded at HFIC!
08/15/2025
S3 Kickoff - What’s New with Joint Commission: Recorded at HFIC!
In this episode of Between the Lines with FGI, cohosts John Williams and Marissa Lamperis Kastrinos are joined by ASHE’s Leah Hummel and Chad Beebe for a conversation recorded live at HFIC. The discussion focuses on the Joint Commission’s upcoming consolidation of standards, set to take effect in 2026, and what these changes mean for health care facilities. Leah and Chad explain the addition of the new National Performance Goals chapter, the Commission’s unique ability to respond quickly to critical safety concerns, and how high-profile incidents can influence survey priorities. They also introduce ASHE’s new survey readiness course, which aligns current and future Joint Commission standards with NFPA, CMS, and other accrediting body requirements. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/37802810
info_outline
S2 E8 – MRI Quench Pipes: Engineering Challenges and Safety Solutions
05/09/2025
S2 E8 – MRI Quench Pipes: Engineering Challenges and Safety Solutions
In this episode, Toby Gilk returns to discuss the intriguing and complex world of MRI technology. Learn about the role of superconductivity in MRI machines, the potential hazards of quench pipes, and the importance of proper design to prevent catastrophic failures. Toby explains how superconductivity allows MRI machines to operate efficiently without continuous power but also introduces risks if not managed correctly. Hear about real-world examples of quench pipe failures and the engineering solutions that mitigate these dangers, and gain insights into the latest advancements in MRI technology and how they impact safety protocols in healthcare facilities. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/36440470
info_outline
S2 E7 – Plumbing Standards and Health Care Facility Design
04/04/2025
S2 E7 – Plumbing Standards and Health Care Facility Design
In this episode of Between the Lines with FGI, host John Williams interviews Christoph Lohr, vice president of technical services and research at IAPMO and the plumbing task group chair for the 2026 Health Guidelines Revision Committee (HGRC). Their discussion explores the complexities and challenges of plumbing systems in health care facilities, emphasizing the importance of water quality and safety. Christoph also highlights the collaborative efforts between IAPMO and FGI to improve plumbing standards and codes. Listeners will gain insights into the critical role of plumbing in health care and the ongoing efforts to enhance system resiliency and efficiency. Sponsored by: Optimizing health care facilities Link to show notes: https://fgiguidelines.org/podcast/s2-e7-plumbing-standards-and-health-care-facility-design/ Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/35907045
info_outline
S2 E6 – Accommodating Individuals of Size in Health Care
03/07/2025
S2 E6 – Accommodating Individuals of Size in Health Care
In this episode of Between the Lines with FGI, cohosts John Williams and Bridget McDougall sit down with Dr. Marie Martin from the U.S. Department of Veterans Affairs to discuss the critical topic of safe patient handling and mobility. Dr. Martin shares her journey and insights into the development of guidelines and practices that ensure the safety and well-being of both patients and caregivers. Learn about the importance of accommodating individuals of all sizes in health care environments and the innovative solutions being implemented to address these needs. This episode is packed with valuable information for anyone interested in health care design and patient safety. Tune in for an engaging and educational conversation! Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/35468530
info_outline
S2 E5 – Surfaces in Health Care Settings + Evidence-Based Design
12/06/2024
S2 E5 – Surfaces in Health Care Settings + Evidence-Based Design
This episode of Between the Lines with FGI focuses on optimizing surface materials in health care and residential care design. Cohosts John Williams and Bridget McDougall discuss the importance of surface materials in health care settings with Laurie Waggener, the Director of Research for Healthcare at Page. Laurie explains her role in ensuring evidence-based architectural processes and shares insights on the impact of surface materials on patient care, including durability, maintenance, and safety. The discussion also covers the use of UVC radiation for disinfection, the importance of consensus decisions with clients, and how the COVID-19 pandemic influenced surface testing. The conversation underscores the need for materials that balance aesthetics, functionality, and safety in health care environments. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/34267845
info_outline
S2 E4 – MRI Safety and the Built Environment
11/01/2024
S2 E4 – MRI Safety and the Built Environment
After listening to this episode, you’ll understand why guest Tobias (Toby) Gilk says, “The physics associated with MRI scanners is so otherworldly and so profoundly different from our daily experience interacting with the world that everything seems magic associated with this particular imaging modality.” The profound differences with MRI don’t stop with just the physics; there are a host of built environment considerations for the spaces that house MRIs as well as operational implications for patient and staff safety. Toby gives a quick lesson on how MRIs work, shares a story of how tragedy led to codified safety measures, and answers John and Bridget’s questions about the whys behind the codes. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/33569127
info_outline
S2 E3 – Changes Ahead: Intellectual Property Rights and the Future of the Guidelines
10/04/2024
S2 E3 – Changes Ahead: Intellectual Property Rights and the Future of the Guidelines
There’s a seismic shift happening in the codes and standards development legal landscape as courts back away from the longstanding precedent of protecting copyrights. As a result, some entities now post what was protected content, seemingly in partnership with standards development organizations, in order to sell their own products. In reality, standards development organizations like FGI have no oversight on how their code content is used outside of its own platforms and publications. CEO Heather Livingston discusses FGI’s unusual approach to making sure that everyone involved in health and residential care design and construction has access to accurate and complete code requirements straight from the source. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/33266782
info_outline
S2 E2 – Built Environment Impacts on Operations and the Patient Experience
09/06/2024
S2 E2 – Built Environment Impacts on Operations and the Patient Experience
Woven into any patient’s health care experience is the environment in which they are treated. Questions about cleanliness and quietude appear on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey; the results of which determine how much funding is provided (or removed) from health care facilities by CMS. In this episode, recorded at ASHE’s Health Care Facilities Innovation Conference last month (July 2024), guests Jeff O’Neill and Kathy Easter, both of Robert Wood Johnson University Hospital, engage in discussion about where the patient experience and the Guidelines (soon to be the FGI Facility Code) intersect. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/32659972
info_outline
S2 E1 – What’s New in the 2026 FGI Facility Code Drafts
08/02/2024
S2 E1 – What’s New in the 2026 FGI Facility Code Drafts
This is your chance to weigh in! The change in title from the 2022 Guidelines for Design and Construction documents to the 2026 FGI Facility Code documents is one of several changes you will see during the 2026 draft public comment period (now through September 30, 2024). For this episode, John Williams and Leah Hummel sit down with Bridget McDougall for an overview of the draft changes discussed as part of a presentation they gave at the Health Care Facilities Innovation Conference in Anaheim, CA. From new chapters to revised requirements, hear about the language that you have an opportunity to comment on before the next edition is published in early 2026. Note: This episode was recorded on July 20, 2024, while at ASHE’s Health Care Facilities Innovation Conference in Anaheim, CA. Sponsored by: Optimizing health care facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/32389532
info_outline
BONUS: Between the Lines – with ASHE
07/25/2024
BONUS: Between the Lines – with ASHE
Not an ASHE member? Didn’t attend the HCFI conference? This episode is also for you! In this bonus episode (recorded at the Health Care Facilities Innovation Conference in Anaheim, California on July 21, 2024), hosts John Williams and Bridget McDougall sit down with Leah Hummel, senior associate director of the American Society for Health Care Engineering’s (ASHE) advocacy team, to discuss the importance of reviewing and commenting on the 2026 draft FGI Facility Code documents. Leah and John touch on the presentations they’re giving at the conference, and Leah talks about the one thing she’s always stressing to ASHE members regarding FGI and the code documents. NOTE: Look for the first episode of Season 2 (released Friday, August 2, to hear an overview of the changes in the 2026 draft! Sponsored by: : Optimizing Health Care Facilities Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/32278412
info_outline
E10 – Designing Care Spaces with Our Future Selves in Mind: Jane Rohde
06/14/2024
E10 – Designing Care Spaces with Our Future Selves in Mind: Jane Rohde
Jane Rohde is affectionately known in FGI circles as “the mother of the Residential Guidelines.” Her passion for residential health care facility design and advocacy for the aging and vulnerable populations led to the inclusion of residential health, care, and support facilities in the Guidelines documents beginning with the 2018 edition. In this episode, Jane explains how nursing homes, initially intended for short-term care, evolved into a care model that often widens the gap between “those who have and those who have not.” Jane further emphasizes the need for community-centric design, pointing to common design mistakes including poor acoustics in large spaces, inappropriate lighting disrupting circadian rhythms, and lack of contrast in colors leading to falls. Jane also shares why a detailed functional programming process, engaging community stakeholders to identify service gaps and needs, is “the nitty gritty” that she loves the most.” Sponsored by: The Facility Guidelines Institute: The keystone to health care planning, design, and construction Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/31714792
info_outline
E9 – Ding! Ding! A Toast to Residential Care Dining Spaces: Addie Abushousheh
05/24/2024
E9 – Ding! Ding! A Toast to Residential Care Dining Spaces: Addie Abushousheh
Addie Abushousheh shares her insights on the evolution of residential health, care, and support facility design and construction, particularly focusing on the role kitchen and dining spaces have in enhancing residents’ quality of life. Key points include shifts in language to empower residents, the importance of various kitchen types for autonomy, and the significance of dining areas for socialization and therapy. Addie highlights new language in the upcoming 2026 draft Guidelines for Design and Construction of Residential Health, Care, and Support Facilities document, emphasizing the intent to support choice for both those building these facilities and the people calling them home. Sponsored by: Specified Technologies, Inc. (STI): Your partner in barrier management solutions. Link to show notes Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/31403122
info_outline
E8 – The Sound of Silence: Mandy Kachur
05/10/2024
E8 – The Sound of Silence: Mandy Kachur
Unless you’re an expert in acoustics, it’s likely the acoustic-related requirements in the Guidelines read like a foreign language. Acoustic engineer Mandy Kachur joins hosts John and Bridget to not only talk about the impact noise can have on patient care, but also turn a complex topic into a digestible concept. Various acoustic tables in the Guidelines are explained, touching on speech privacy, speech intelligibility, exterior noise control, and sound isolation. Mandy also cautions designers about the easiest mistake to avoid before the threat of costly retrofits and explains how reducing noise in patient care spaces can be directly tied to reimbursement. Sponsored by: Specified Technologies, Inc.: Your partner in barrier management solutions. Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/31164062
info_outline
E7 – Is Part 1 of the Guidelines Optional? —John Williams and Bridget McDougall
04/12/2024
E7 – Is Part 1 of the Guidelines Optional? —John Williams and Bridget McDougall
In this week’s episode, Bridget and John discuss the intricacies of design and construction standards as they unravel both the misconceptions and the significance of Part 1 of the Guidelines for Design and Construction. Exploring topics ranging from risk assessments to equipment specifications, they offer valuable perspectives on navigating building codes, emphasizing the importance of thorough planning and collaborative discussions. Whether you're a seasoned professional or a curious observer, their conversation captivates and informs, leaving you with a deeper understanding of the complexities inherent in the planning, design, and construction of health care facilities. This episode is sponsored by Northstar Management Company: "Smart Builds Start With Us." Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/30701068
info_outline
E6 – It’s Electric! (Receptacles): Krista Biason
03/22/2024
E6 – It’s Electric! (Receptacles): Krista Biason
In this episode, Bridget and John enter the world of electrical receptacles in patient care areas with electrical engineer expert Krista Biason. They simplify complex regulations, dig into related Guidelines minimum requirements, and emphasize the importance of inclusive planning for functional, patient-centered spaces. Krista's expertise shines as she explains technical nuances, from distinguishing between critical and essential branches to discussing emerging technologies like USB charger outlets. The trio's candid exchanges inject humor, making the topic engaging, as they stress the need for flexible designs that balance functionality with adaptability. This episode is sponsored by Northstar Management Company: "Smart Builds Start With Us." Link to blog: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/30420383
info_outline
E5 – Behavioral Health Crisis Units: Dr. Scott Zeller
03/08/2024
E5 – Behavioral Health Crisis Units: Dr. Scott Zeller
“We usually think of treatments being medications, devices, surgeries. But we need to realize that the environment can be a treatment, too.” Dr. Scott Zeller joins hosts Bridget and John to explore the importance of designing supportive spaces for individuals experiencing mental health crises. Learn about the innovative EmPATH model that led to the inclusion of the behavioral health crisis unit in the 2022 edition of the Guidelines. This episode is sponsored by Northstar Management Company: "Smart Builds Start With Us." Link to Blog https://fgiguidelines.org/podcast/e5-behavioral-health-crisis-units-scott-zeller/( Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/30261573
info_outline
E4 – Infection Preventionists as Collaborative Partners: Lela Luper
02/23/2024
E4 – Infection Preventionists as Collaborative Partners: Lela Luper
Infection preventionist Lela Luper joins hosts John and Bridget to explore the critical nexus of facility design and infection control in healthcare. From furr downs to fish tanks and everything in between, today’s episode illustrates the often-overlooked hidden dangers in the health and residential care physical environment. Lela underscores the value of including infection preventionists early in design conversations and highlights the importance of being a collaborative partner rather than a rigid enforcer. This episode is sponsored by Northstar Management Company: "Smart Builds Start With Us." Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/29974058
info_outline
E3 - But Wait! There’s More! The Functional Program: Tony Ruebsam
02/09/2024
E3 - But Wait! There’s More! The Functional Program: Tony Ruebsam
Tony Ruebsam, a self-described “cat herder” in the world of project management, warns John and Bridget that projects that get their start at the drawing board are missing a crucial step. Introduced to the functional program early in his career, Tony shares why he’s a firm believer in starting with the functional program before significant design drawings begin. This episode is sponsored by Northstar Management Company: "Smart Builds Start With Us." Link to show notes: Learn more about AIA self-reporting LUs: Connect with us on and
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/29803588
info_outline
E2 – Form Follows the Functional Program: Ken Cates
01/26/2024
E2 – Form Follows the Functional Program: Ken Cates
Every hospital, outpatient, and residential facility you’ve stepped foot in or driven past started with an idea. On today’s episode, Ken Cates, cofounder and principal of Northstar Management Company, talks about the importance of not leaping from idea straight to design (as is often the tendency) but instead utilizing the functional program as a way of gathering input from all stakeholders and clearly identifying the purpose of the space. This episode is sponsored by Northstar Management Company: "Smart Builds Start With Us." Connect with us on & Have an idea for an episode or a guest? Write to us at . Interested in having us mention your company on our podcast? Visit for information on episode sponsorship. _____________________________________________________
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/29599348
info_outline
E1 – The Genesis of the Guidelines: Doug Erickson
01/12/2024
E1 – The Genesis of the Guidelines: Doug Erickson
The early stories that live between the lines of the Guidelines include an intersection with Listerine (the antiseptic mouthwash) and a document that three individuals championed to keep alive in the mid-1980s. Doug Erickson, founder and former CEO of the Facility Guidelines Institute, joins John and Bridget for a casual conversation about the origins of the Guidelines and its impact on health and residential care settings. Have an idea for an episode or a guest? Write to us at . Connect with us on & __________________________________
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/29389623
info_outline
E0 - Introduction to Between the Lines with FGI
12/13/2023
E0 - Introduction to Between the Lines with FGI
Meet John Williams and Bridget McDougall from the Facility Guidelines Institute as they set the stage for engaging conversations regarding health and residential care design and construction. What are the Guidelines, exactly, and what are the stories behind them? Get ready to “read between the lines” with FGI. Connect with us on .
/episode/index/show/448fa33b-34fd-4ba5-bebb-d4ee32ee5eb7/id/29056718