How to Make a Hospital in RimWorld (1.6.4633) | Builder + Layout Tool

How to make a hospital in RimWorld 1.6

Searching "hospital rimworld" turns up three different things. The vanilla Hospital is a room role the game assigns by itself, like Bedroom or Kitchen. You never place it. You earn it by what stands inside the walls, and this page covers that. The Hospital mod on the Steam Workshop is separate: it adds a patient-arrival event, with strangers dropping in for treatment, and it supports 1.6. Hospitality is a guest mod about visitors and shops, not medicine.

The vanilla rule is short. The room must be enclosed by walls and doors, contain at least one humanlike bed set to Medical, and contain no non-medical or prisoner bed. Any sleeping furniture can be Medical: a sleeping spot, a bedroll, a bed or a hospital bed. Hospital beds start out Medical. Everything else needs the Set to medical button.

Hospital layout for day one

1. Wall and roof a small room near the main door, about 5×5 inside for 2 or 3 beds. Floor it with anything smooth. Concrete or wood is fine for now.
2. Build beds, or sleeping spots if you have nothing else, and click Set to medical on each one.
3. Put a small shelf by the door with the best medicine you have, so doctors don't walk to the stockpile mid-raid.
4. Add a lamp. Surgery loses up to 25% in the dark (see surgery success chance).
5. Check the room with the room stats overlay. It should say hospital. If it says barracks, a non-medical bed is still in there.

Even this cheap ward pays off. A colonist lying in a normal bed heals 16 HP/day from natural healing, against 8 for one walking around. A sleeping spot gives 12 and multiplies surgery by 0.70, so get patients into real beds before anyone gets cut open.

Hospital bed vs medical bed

Bed	Tend offset	Immunity	Surgery	Heal HP/day
Sleeping spot	+0	×1.00	×0.70	12
Bedroll	+0	×1.05	×1.00	16
Bed / double bed	+0	×1.07	×1.00	16
Hospital bed	+0.10	×1.11	×1.10	22
Hospital bed + monitor	+0.17	×1.13	×1.15	22

Natural healing for a healthy adult is 8 HP/day. Lying in a sleeping spot adds 4, a bedroll or bed adds 8, and a hospital bed adds 14. That is where the 12, 16 and 22 in the table come from. Tended wounds heal faster than untended ones in any bed.

Bed quality only changes surgery here: Awful ×0.90, Poor ×0.95, Good ×1.05, Excellent ×1.10, Masterwork ×1.15, Legendary ×1.30. An Awful hospital bed (×0.99) does worse at surgery than a Good wooden bed (×1.05), yet it still wins on tend quality, immunity and healing. Quality does change comfort and rest.

A hospital bed costs 40 of a metal (steel, plasteel or uranium) plus 80 steel and 5 components, and needs Construction 8. A steel one is 120 steel and 5 components in total. Research Hospital bed costs 1,200 points at a hi-tech research bench, after Microelectronics (3,000) and Sterile materials (600).

Is the hospital bed research worth it early?

Weigh it against weapons and power. The tend bonus is a flat +0.10, which matters most when your doctor or medicine is weak. A Medicine 4 doctor using herbal medicine tends at 0.36, and a hospital bed lifts that to 0.46. Immunity ×1.11 instead of ×1.07 is a few percent faster against plague or flu, which only decides a race you were already close to losing. In a jungle or swamp colony with constant disease, research it soon after Microelectronics. In a cold desert with good defenses it can wait. The research roadmap shows where it fits.

Vitals monitor not working: link rules

If the monitor sits there dark, check these in order:

1. Is it a hospital bed? The hospital bed is the only bed that lists the vitals monitor as a facility. A wooden bed marked Medical never links, however you place the monitor.
2. Is it touching? The monitor must be on one of the 8 tiles around any part of the bed: sides, foot or diagonal corners. It doesn't have to be at the head. One empty tile in between and there is no link.
3. Is it powered? It draws 80 W. With power off (no conduit, flicked off, solar flare) it gives nothing.
4. Does the bed already have one? Each bed uses one monitor. A second monitor beside the same bed adds nothing to it, though it can still serve other beds.

A linked monitor adds +0.07 tend quality, +0.02 immunity and +0.05 surgery to the bed. It costs 50 steel and 3 components and needs Construction 8. Research Vitals monitor (2,500 points) after Hospital bed, at a hi-tech research bench with a multi-analyzer attached.

The monitor is a cheap upgrade once you have hospital beds. One monitor serves every hospital bed that touches it, so even a 2-bed ward needs only one.

Why your hospital is still a barracks

The game gives every room a score for each role and keeps the highest one. On 1.6.4871 the scores are:

The usual cause is an extra bed built in the ward "for the doctor". The room flips to Barracks, and patients lose the hospital impressiveness thought. That thought runs from awful (−4) and dull (−2) up to wondrous (+6), and it only applies to a patient in a Medical bed in a room labelled Hospital.

The lab case works the other way. A medical bed in your research lab makes the room a Hospital, and research benches outside a laboratory lose speed. Keep the sterile wing as two rooms. The laboratory tool covers the bench side.

Hospital room checker

Count the humanlike beds inside the room's walls. Setting any bed For prisoners switches the room's other beds too, so a room is one or the other.

Sterile tile: where to place it

Many guides say a clean room raises tend quality. It doesn't. Tend quality is the doctor's skill × medicine potency + the bed's offset, then a random ±25%. Cleanliness changes two other things: the chance a tended wound gets infected, and the bed's surgery factor.

Room cleanliness is the floor value of every tile, plus filth and items, divided by the number of tiles. Sterile tile is +0.6 per tile, steel tile +0.2, concrete and wood 0. Filth is negative per stack: dirt −5, blood −10, vomit and fuel −15, corpse bile −20. Thicker blood counts as several stacks.

Sterile tile is mostly an infection upgrade, and it pays off under and around the beds of a real ward. It costs 3 steel and 12 silver per tile, needs Construction 6 and the Sterile materials research, and cleans in 60% of the normal time, like steel tile. Floor under a door does not count toward room cleanliness, so skip the doorway.

Place it in this order: under the beds, along the doctors' walking lane between beds, around the monitors and the surgery bed, then the rest of the room. Two habits matter more than the floor. Give someone the Cleaning job at high priority, and keep raid casualties from bleeding across the ward floor.

Straw matting suits the short entryway outside the ward, where it cuts tracked-in dirt and trash by about 95%. It is a poor floor for the ward itself. A small triage room on steel or sterile tile with a cleaner assigned does better, and the infection roll keeps the factor of the room where the wound was tended, so a clean triage room protects the patient even after you move them. More on filth in this cleaning guide.

Best hospital layout: 4-bed core, 8-bed ring, triage split

What else goes in the ward

• A small medicine shelf by the door. Industrial works as the default, herbal covers colds and minor cuts, and glitterworld is for risky surgery. Shelves hold three stacks per tile (see shelving). Set each colonist's medical care level in the Health tab, then read the medicine guide for stock levels.
• At least 50% light on every bed you operate on. A standing lamp covers a 4-bed core.
• A television. Bedridden patients can watch from bed when the bed is inside its viewing area, which keeps recreation up during long recoveries.
• A sculpture or two and enough floor space. Hospital mood comes from impressiveness, and a good room moves patients from "dull" (−2) to positive. See impressiveness.
• End tables and dressers add +0.05 comfort each and no medical stats. An end table must touch the bed's head on a side. A dresser links from up to 6 tiles away, so it never needs a monitor's spot.
• A heater or cooler. Bedridden patients can't walk away from a bad temperature.
• A powered autodoor, not stone. It opens about four times faster than a manual door of the same material, which adds up over many carries. Keep through-traffic out: never route the kitchen or prison through the ward.

Hospital builder: cost of each layout

Costs for steel hospital beds (120 steel and 5 components each) and monitors (50 steel and 3 components each), before floor and lights.

Sterile tile adds 3 steel and 12 silver per tile. A 6×6 interior (36 tiles) costs 108 steel and 432 silver. Mix tile types if silver is tight and put sterile under the beds first. Build a hospital near the door your fights happen at, then expand with the 4-bed core once the triage pair is running.

Hospital near the killbox: why rescuers walk past triage

This is the hidden rule behind most "my hospital is too far" complaints. When a patient needs a medical bed, the game does not take the nearest one. It goes through bed types from the highest tend bonus down and stops at the first type with a usable Medical bed: free, reachable, not forbidden and not reserved. Inside that type it looks for the closest bed in a safe spot first, and only accepts a dangerous spot if no safe one exists.

A free hospital bed anywhere on the map, even a much longer walk away, beats a wooden medical bed next door. A wooden bed beats a bedroll, and a bedroll beats a sleeping spot. A triage pocket of medical sleeping spots by the killbox only gets used once every better bed type is full or unreachable.

Four ways to fix it:

• Use the same bed type in the triage pocket. Two hospital beds by the defense line are enough. When both rooms are safe the nearer bed wins, so the pocket fills first. If the pocket is in a danger area mid-fight, a safe bed further back can still be chosen.
• Forbid the far beds during a fight. Forbidden beds are skipped. Unforbid them afterwards and move patients to the main ward.
• Tend on the spot. Draft a doctor and order a tend on the downed pawn. Bleeding is the clock, and a bandage on the ground buys time for the long carry. Doctors on the line should carry a few herbal or industrial medicine.
• Put the hospital near the door the fights happen at. The killbox guide covers rescue paths from the defense line.

Rescue bed picker

Assumes both rooms are reachable and safe, and the beds are free and allowed for the patient. Slab beds (Ideology) sort first only for pawns whose ideoligion prefers them.

Surgery success chance: what multiplies

For normal operations, surgery chance = surgeon's success chance × bed surgery factor × medicine factor × the operation's own difficulty, doubled by a surgery inspiration, then capped at 98%. A few operations skip this roll: Biotech's blood transfusion always succeeds, and xenogerm implantation uses its own outcome rules.

• The surgeon's factor by Medicine skill is 0.10 at 0, 0.50 at 4, 0.70 at 6, 0.90 at 10, 1.00 at 15 and 1.10 at 20. Sight and manipulation scale it.
• The bed surgery factor is bed type (+0.05 for the monitor) × room cleanliness × light × outdoors × quality. Light runs from ×0.75 in darkness to ×1.00 at 50% light. Outdoors is ×0.85 and applies when the bed's tile is unroofed or the room is more than 25% unroofed. A space that isn't a proper room uses ×0.60 in place of its cleanliness factor.
• The medicine factor is herbal ×0.88, industrial ×1.00 and glitterworld ×1.18.

Worked example: a Medicine 10 surgeon (0.90) on a Normal hospital bed with a monitor (1.15) in a 0.5-clean room (1.05), using industrial medicine, gets 0.90 × 1.21 × 1.00 ≈ 1.09. That is capped to 98%, so glitterworld medicine would be wasted here. Swap in a Medicine 6 surgeon (0.70) and the same room gives about 85%. The room helps, but the doctor is the biggest single factor.

Failures come in three kinds. A minor failure does small damage. A catastrophic one does heavy damage to the part. A rare "ridiculous" one damages other parts. Some operations can kill, so plan risky jobs such as brain or heart with your best surgeon and a clean, lit bed.

Patient calculator

Pick a bed and a doctor to see tend quality, surgery chance, immunity, infection and healing. It assumes healthy sight and manipulation for the doctor.

Prisoners, solar flares and DLC extras

• A prisoner bed makes the room a prison cell or prison barracks, never a hospital, even if every bed is Medical. Setting one bed For prisoners converts the other beds in that room too, so a colonist ward and a prisoner bed can't share a room. Build a separate prison infirmary. The prison guide shows one.
• A solar flare cuts power to the monitor, so its +0.07 / +0.02 / +0.05 drops out, and electric lights may go dark too. The hospital bed's own bonuses stay. Postpone elective surgery until the flare ends (solar flare tips).
• For plague, flu and sleeping sickness, immunity gain is the race. A hospital bed with a monitor (×1.13) beats a plain bed (×1.07), and good tends slow the disease. See plague, sleeping sickness and blood rot.
• Ideology: the sleep accelerator links to beds, double beds, bedrolls and hospital beds, but not sleeping spots. It gives +35% rest effectiveness and draws 400 W while in use, and only a Transhumanist pawn can build it. It is a rest bonus, not a medical one. Slab beds exist for ideoligions that prefer them.
• Biotech: gene labs score as laboratories, so keep them in their own room.
• Odyssey: a gravship infirmary follows the same room rules. Life support, oxygen and vacuum are separate problems, covered in life support.

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