NFPA 101, Life Safety Code, and NFPA 99, Health Care Facilities Code, play a critical role in the planning, design, construction, renovation, and operation of healthcare facilities throughout the United States. This session examines how these codes are adopted and enforced through the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs), and how those requirements directly influence healthcare architecture, engineering, facility management, and regulatory compliance. Attendees will gain an understanding of the federal regulatory framework governing Medicare and Medicaid-certified healthcare facilities, including the continued use of the 2012 editions of NFPA 101 and NFPA 99 by CMS and the challenges created when state and local jurisdictions adopt newer code editions. The session will explore how differing code adoption cycles can affect healthcare facility planning, phased renovations, infrastructure upgrades, operational continuity, construction costs, and compliance strategies for hospitals and other healthcare occupancies. The presentation will also explain the NFPA standards development and adoption process and the important role architects, engineers, healthcare organizations, and facility managers play in influencing future healthcare regulations and standards through technical committees, public comments, and professional advocacy. Participants will learn how stakeholder involvement contributes to the development of safer, more functional, and more resilient healthcare environments. In addition, the session will highlight the role of the American Society for Health Care Engineering (ASHE) in assisting architects, engineers, and healthcare facility managers with navigating the complex and evolving landscape of healthcare codes and standards. ASHE provides a national interdisciplinary forum for collaboration among design professionals, regulators, engineers, code officials, and healthcare organizations. ASHE also develops and publishes widely used guidance documents, tools, and best practices that support compliant and safe healthcare project delivery, including resources such as ICRA 2.0 and numerous monographs, compliance guides, and operational recommendations addressing life safety, infection prevention, emergency management, infrastructure resiliency, and healthcare facility operations. Presented from the perspectives of an architect, fire protection engineer, and healthcare facility executive, the session will evaluate the benefits and challenges associated with adopting newer editions of healthcare codes and standards, including impacts on patient safety, emergency preparedness, fire and life safety systems, healthcare infrastructure resiliency, and design flexibility needed to support modern healthcare delivery environments.