Construction/Remodeling Plan Review for Health Care Facilities

Notice of Requirements for Digital Submission of Documents

In accordance with Governor Evers Emergency Order 22, the Office of Plan Review and Inspection (OPRI) will require all documents to be submitted electronically effective April 14, 2020. Payment for fees associated with plan reviews must still be sent to OPRI’s Milwaukee office, which is listed on the application. Conditional approval will only be granted upon receipt of associated fees. 


The Department of Health Services (DHS) plan review submittals are required for the building, heating ventilation and air conditioning (HVAC) systems, and fire protection system projects for the following health care facilities:

  • Hospitals
  • Nursing homes
  • Facilities serving people with Developmental Disabilities (FDD)
  • Community-based residential facilities (CBRF)*
  • Hospice inpatient facilities
  • Other occupancies physically attached to a hospital, nursing home, CBRF, or hospice inpatient facility

*The Regulatory Authority For Health Care Construction Plan Review, P-00746 (PDF) outlines the scope of health care plan review provided by the Office of Plan Review and Inspection (OPRI).

Pre-design meetings for all health care projects promote compliance with the appropriate codes, familiarize the design team with Wisconsin inspection processes, and establish communication. It is highly recommended that a pre-design meeting be established with all stakeholders early in the planning stages of any health care project.

NOTE: Unique systems not reviewed by DHS include: plumbing systems, private onsite waste treatment, elevators, boilers, and mechanical refrigeration systems. The Department of Safety and Professional Services (DSPS) review these systems. Information is available on the DSPS Plan Review webpage.

OPRI Annual Report – 2017

The OPRI Annual Report 2017, P-01449 (PDF) includes information on project costs, life safety code citations and additional plan review related statistics.


Wisconsin Admin. Code ch. 124 – NEW Plan Review Fees and Application

Wisconsin Department of Health Services has published the updated edition of the hospital Wis. Admin. Code ch. DHS 124, on July 1, 2020, pursuant to Wis. Stat. §§ 50.36 (1m) (a), (b), and (c). This rule affects hospitals that are licensed by the State of Wisconsin. Highlights of administrative rule updates include the following:

  • change in plan review fees and application  
  • plans of correction
  • waivers and variances
  • maternity
  • patient rights
  • freestanding emergency departments 
  • physical environment

The existing rules under Wis. Admin. Code ch. DHS 124 relating to the hospital’s physical environment continue to require hospitals to design, construct, and operate their facilities in accordance with the Life Safety Code (LSC), Wisconsin Commercial Building Code, and national standards on construction and fire safety. The rules also require patient rooms be of sufficient size, supported by sanitary support spaces and afford the patient privacy and the means to contact staff, fire safe finishes, emergency procedures, and fire incident reporting to the department. The rules also require hospitals to meet the provisions of the LSC adopted into the federal Conditions of Participation.

See Wis. Admin. Code ch. DHS 124 for additional information including plan review fees and application.

Digital Construction Plans Accepted

Digital construction plan submittals are accepted by OPRI in a pdf file. The digital documents must bear the seal and signature of the representing design professional. The plan review fees still need to be sent into the plan intake office in the form of a check along with a copy of the plan application. This will ensure the plan review coordinator matches it to the correct construction project.  

The Health Care Built Environment Committee

In 2016, following the first Health Care Built Environment Conference, OPRI established the Health Care Built Environment Committee (HCBEC). The committee is based on the participation and representation of all health care facilities, design, construction and regulatory organizations representing their members, goals and objectives. It was formed to continue the built environment conversation as Wisconsin remains a leader in delivering those environments of health, safety and wellbeing.

The HCBEC continues to meet on a quarterly basis to continue the dialog with the health care industry on the issues facing complex and challenging moderation of physical environments while maintaining code compliance. Please follow up with your professional organization to verify participation. 

Community-Based Residential Facility Building Code Occupancy Classification

DHS CBRF licensing categories are based on size and classification as found under Wis. Admin. Code § DHS 83.04.

CBRF classification and size criteria:

(a) A CBRF for 5 to 8 residents is a small CBRF.

Regulated under Wis. Admin. Code § DHS 83.04 specific to the Uniform Dwelling Code and chs. SPS 320 to 325.

(b) A CBRF for 9 to 20 residents is a medium CBRF.

Regulated under Wis. Admin. Code § DHS 83.04 specific to chs. SPS 361 – 366 and adopted 2015 International Building Code (IBC).
Occupancy grouping R-4, I-1 or I-2 based on size and classification.

(c) A CBRF for 21 or more residents is a large CBRF.

Regulated under Wis. Admin. Code § DHS 83.04 specific to chs. SPS 361 – 366 and adopted 2015 IBC.
Occupancy grouping I-1 or I-2 based on size and classification.

CBRF occupancy grouping based on the 2015 adopted IBC:

  • CBRF serving 9 – 16 residents
    R-4 condition 1 license category AA
    R-4 condition 2 license category AS and ANA
  • CBRF serving 17 or more residents
    I-1 condition 1 license category AA
    I-1 condition 2 license category AS and ANA
    I-2 condition 1 license category CA, CS and CNA

Preliminary Project Meetings (PPM) Continue to Promote Project Success

Preliminary project meetings (PPM) for health care projects are structured to promote successful outcomes. The PPM, facilitated by OPRI representatives, brings together the owner/provider, designer(s), builder(s) as well as the local building and fire officials. The meeting addresses project scope, schedule, expectations, communications and responsibilities. PPM for all the stakeholders are highly recommended for any health care project early in the planning stage. Reference the OPRI county maps found on the OPRI Plan Intake Staff and Plan Intake webpage to contact staff representatives to schedule a meeting.

Last Revised: July 29, 2020