By Jeff Wardon, Jr., Assistant Editor

Restrooms are now a focal point in healthcare facility planning as regulations, infection-control standards and water management requirements continue to evolve. Guidance from organizations such as The Joint Commission, CMS, CDC, ASHRAE and the Facility Guidelines Institute is pushing restrooms to be considered earlier in the design process and more holistically as part of a facility’s strategies. 

In this manufacturer roundtable, Healthcare Facilities Today spoke with restroom fixture manufacturers about how emerging codes and standards are shaping restroom layouts, fixture selection, material durability and plumbing system design. 

How are emerging regulations, building codes or infection-control standards influencing the way restroom environments are planned and equipped in hospitals and clinics? 

“Regulations and infection-control standards are increasingly shaping restroom design decisions early in the planning process. Accessibility codes, infection-prevention guidance and water safety requirements are prompting closer coordination between design teams, facility managers and infection-control professionals. 

The Joint Commission’s 2024 infection-control updates streamline standards, highlighting essential practices like hand hygiene and cleanliness. This means restroom planning should include elements such as multiple accessible handwashing stations, layouts that support monitoring and auditing of cleanliness and integration with overall infection-control efforts rather than treating restrooms as stand-alone spaces. 

CMS infection control guidance also reinforces the need for robust infection-prevention programs and environmental controls. These types of initiatives help ensure restrooms support proper hand hygiene and safe water management to minimize microbial contamination. 

There is also growing attention to fixture selection, placement, clearances and materials. Surfaces need to be easily cleaned and disinfected without harboring moisture or bacteria. In addition, concerns around water stagnation and system flushing are influencing how healthcare facilities think about restroom usage patterns and system design. As codes and standards continue to evolve, facilities are prioritizing solutions that are adaptable and resilient to future regulatory changes.” 

— Cassie Keeler, product manager of handwashing products, Bradley Company   

“Regulatory guidance has reinforced a shift toward formal, documented water management programs rather than isolated compliance measures. Expectations from CMS, The Joint Commission, CDC and ASHRAE emphasize planning, validation and accountability across the entire building water system. 

As a result, restroom environments are being considered earlier in the design process and evaluated as part of the broader plumbing system. Factors such as water age, stagnation risk, aerosol generation from the fitting and accessibility for inspection and maintenance are influencing both fixture selection and plumbing layouts. 

Water management expectations have evolved significantly over the last decade. Today, it is not enough to say a program exists—facilities are expected to document and demonstrate that it’s working, consistently and defensibly. Rather than relying on a single control strategy, healthcare facilities are increasingly adopting multi-layered approaches that align design, operations and ongoing monitoring.” 

— Greg Hunt, commercial product manager, Chicago Faucets   

“Evolving regulations and infection-control standards continue to shape how restrooms in hospitals and clinics are planned and equipped. Much of the focus centers on working to meet Facility Guidelines Institute (FGI) hand washing recommendations to reduce splashing, along with plumbing system design standards to reduce water stagnation and improved temperature control.  

These basic design considerations to promote regular flow of fresh chlorinated water are now built into the majority of water management plans, which are now a cornerstone of healthcare safety programs. As a result, we are seeing a design move toward materials and internal components that withstand disinfectants, thermal treatments and chemically aggressive water conditions. As healthcare plumbing systems undergo more frequent high-temperature or chemically enhanced line flush protocols, fixtures must align with these operational realities. 

Touchless technology is increasingly viewed as a baseline expectation to limit surface contact and reduce the spread of pathogens. Above and beyond that, more facilities are actively looking for systems that support programmable or automated line flushing to help them mitigate biofilm formation in low-use areas and ensure consistent water turnover throughout their plumbing systems. 

These shifts are driving restroom environments that are more hygienic, smarter and more resilient under rigorous infection-control protocols.” 

— Dan Danowski, product manager, Zurn Elkay  

“Emerging regulations are forcing a more rigorous, proactive approach to restroom design, with a primary focus on infection control and universal access. Standards such as ASSE 1070 for anti-scald protection are becoming increasingly recommended for facilities such as healthcare, and touch-free fixtures are helping to further minimize cross-contamination.  

Furthermore, a heightened awareness of waterborne pathogens is driving the need for systems that can prove compliance with water management plans through automated line flushing. These standards are collectively pushing manufacturers to innovate beyond basic compliance toward creating inherently safer and more hygienic environments.” 

— Morgan Kish, director of product management, Sloan 

Jeff Wardon, Jr., is the assistant editor of the facilities market.