If you run a clinic or healthcare practice in metro Denver, making your space accessible is not only the law, it is the right thing to do for patients, families, and staff. At Image Builders, we’ve delivered medical new builds and tenant improvements across Colorado, and we know ADA compliance for medical office construction can feel like a maze. This guide breaks it down in plain language so you can plan with confidence and avoid costly rework.

Why ADA Compliance Matters in Healthcare

Healthcare serves everyone, so every patient should be able to enter, move around, and receive care without barriers. ADA compliance for medical office construction protects your practice from legal exposure, but it also supports safety, privacy, and dignity for patients who use mobility devices, have low vision, or live with hearing loss. In our work at Image Builders, we see accessibility translate into better patient flow, fewer staff assists, and improved satisfaction. It is also a smart business move: accessible clinics attract more patients and reduce risk tied to noncompliance, injuries, or denied inspections.

Codes, Scope, and Project Triggers

2010 ADA Standards and ANSI A117.1 Basics

For most private healthcare facilities, the 2010 ADA Standards for Accessible Design and ANSI A117.1 provide the baseline for accessibility. In Colorado, jurisdictions adopt the International Building Code, which references accessibility requirements and ANSI. Title III applies to private medical offices, while Title II covers government-operated facilities. The ADA sets the federal floor. Local code officials will still review drawings and field conditions, so align ADA, IBC, and jurisdictional amendments in design and during construction.

New Construction vs. Alterations and Change of Use

• New construction requires full compliance throughout the facility, including exam rooms, imaging suites, waiting areas, restrooms, staff and public routes.
• Alterations require the altered area to comply, and may trigger upgrades along the path of travel to that area.
• Change of use often increases compliance obligations. For example, converting retail to a clinic can trigger accessible parking, entry, restrooms, and care spaces that match the new occupancy.

Path of Travel Upgrades and the 20% Rule

When you alter a primary function area, the ADA requires that the accessible path of travel to that area be made compliant, to the extent it is disproportionate. The commonly applied threshold is up to 20% of the alteration cost dedicated to path-of-travel improvements. This can include accessible routes, entrances, restrooms serving the area, drinking fountains, and telephones where provided. We help clients at Image Builders plan these costs early so there are no surprises during permitting.

Existing Facilities and Readily Achievable Barrier Removal

For existing facilities, you must remove barriers when it is readily achievable, meaning easily accomplishable without much difficulty or expense. Low-cost items often include re-striping accessible parking, adding compliant signage, adjusting door closers, relocating dispensers to reach range, or installing grab bars where walls already have backing.

Site Access: Parking, Passenger Loading, and Entrances

Accessible Parking Ratios, Including Outpatient and Rehab Clinics

• Standard facilities follow ADA Table 208.2 for minimum accessible spaces.
• Outpatient facilities require at least 10% of patient and visitor parking to be accessible.
• Rehabilitation facilities and outpatient physical therapy require at least 20% accessible spaces.

These higher ratios reflect the patient population and are a frequent plan review comment for clinics, so confirm counts early.

Van Spaces, Access Aisles, and Signage Placement

• Provide at least one van-accessible space, or one of every six accessible spaces, whichever is greater.
• Van spaces can be 132 inches wide with a 60-inch aisle, or 96 inches wide with a 96-inch aisle.
• Signage should identify accessible and van spaces, with the bottom of the sign at least 60 inches above the ground to keep it visible over parked vehicles.

Accessible Routes, Slopes, Curb Ramps, and Crossings

• Accessible routes must be at least 36 inches wide with a running slope under 1:20. Anything steeper becomes a ramp and must meet ramp criteria.
• Maximum ramp slope is 1:12 with level landings, handrails where required, and a 1:48 cross slope.
• Provide detectable warnings at curb ramps where required by the authority having jurisdiction. Keep route grades, crosswalk markings, and lighting in mind for safe navigation.

Primary Entrances, Door Thresholds, and Automatic Operators

• At least one primary entrance must be accessible.
• Clear opening at doors must provide a minimum 32-inch clear width, measured with the door open 90 degrees.
• Thresholds should not exceed 1/2 inch, beveled. Weatherstripping and mats must not create tripping points.
• Automatic operators help with patient flow, gurney movement, and infection control. Many Denver-area clinics we build choose operators at the main entry and at key internal doors to reduce touch points.

Interior Circulation and Public Areas

Corridor Widths, Passing Spaces, and Turning Clearances

• Maintain 36-inch minimum clear routes. In busy clinics, we often design wider corridors for two-way traffic with mobility devices.
• Provide 60-inch diameter turning spaces where wheelchairs must reverse direction.
• Add passing spaces at intervals when long routes are narrower than 60 inches.

Doors, Hardware, Maneuvering Clearances, and Vision Lights

• Doors need maneuvering clearances on the pull and push sides, especially where closer forces are higher.
• Use lever hardware or push/pull sets operable with one hand without tight grasping, pinching, or twisting of the wrist.
• Set vision lights to help patients and staff avoid collisions in hallways.

Waiting Areas: Seating Integration and Wheelchair Spaces

• Integrate wheelchair spaces within waiting rooms, not off to the side. Provide adjacent companion seating.
• Keep circulation paths free of furniture creep by anchoring or planning fixed seating zones.

Reception and Transaction Counters: Heights and Knee/Toe Clearance

• Include at least one accessible counter section between 28 and 34 inches high with 36 inches minimum length, plus knee and toe clearance if forward approach is provided.
• Protect patient privacy by planning low sections away from high-traffic lines and by using acoustic treatments.

Patient Care and Diagnostic Spaces

Exam Rooms: Clear Floor Space, Turning, and Furniture Placement

• Provide a 30 by 48 inch clear floor space adjacent to the exam table for side transfers, plus a turning space in rooms where a turnaround is needed.
• Place seating, scales, and carts outside the required clearances. We lay out rooms with clinicians so the space works for real patient flow.

Sinks, Dispensers, and Reach Ranges in Care Rooms

• Mount lavatories to maintain knee and toe clearance. Insulate or guard pipes.
• Place soap, towel, and glove dispensers within reach ranges, typically 15 to 48 inches above the finished floor, and ensure approach is clear.

Accessible Medical Diagnostic Equipment Considerations

• Adjustable-height exam tables help with independent transfers.
• Provide an accessible scale with a platform and handholds that accommodate mobility devices.
• Document equipment specifications during submittals so accessibility features are verified before ordering.

Imaging and Treatment Rooms: Doors, Shielding, and Transfer Planning

• Choose door widths and hardware that allow equipment, stretchers, and wheelchairs to pass without strain.
• Coordinate radiation shielding with door operators and frames so added layers do not reduce clear openings.
• Where transfer is required, plan the clear space on the transfer side of the table and keep booms or carts out of that zone.

Restrooms and Changing Facilities

Toilet Room Layouts, Clearances, and Door Swings

• Provide a 60-inch turning circle or T-shaped turning space where required.
• Water closet centerline, side clearance, and front approach must meet ADA dimensions. Coordinate grab bar lengths and positions with tile layouts to avoid last-minute patching.
• Door swings cannot encroach on required clear floor spaces, so verify approaches during shop drawings.

Grab Bars, Backing, and Mounting Heights

• Install blocking during framing at side and rear walls. This is one of the easiest ways to prevent costly change orders.
• Mount grab bars to the heights and offsets in the ADA, checking tile thickness and finished floor elevations.

Lavatories, Knee/Toe Clearance, and Accessories

• Ensure 27 inches minimum knee clearance and 8 inches minimum depth, with 34 inches maximum lavatory rim height.
• Keep mirrors, towel dispensers, and hooks within reach range and above clear floor spaces. Wrap pipes to prevent contact burns.

Single-User/Family Rooms and Adult Changing Options

• Single-user rooms are helpful for caregivers assisting patients and for clinics serving bariatric or pediatric populations.
• If your practice frequently serves adults who need changing support, plan for an adult changing bench with adequate maneuvering space.

Communication, Signage, and Project Best Practices

Tactile/Braille Room Identification and Wayfinding

• Provide tactile and Braille signage for permanent rooms and spaces, with the baseline of tactile characters 48 to 60 inches above the floor, located on the latch side of the door.
• Use high-contrast, easy-to-read fonts, and keep wayfinding consistent from the main entry to clinics and restrooms.

Visual Alarms and Effective Communication Features

• Where fire alarms are required, install audible and visible notification appliances per code.
• For registration and check-in, consider assistive listening systems at counters and clear sightlines for lip reading.

Field Measurements, Tolerances, and Closeout Documentation

• Confirm door clearances, slopes, and heights in the field before finishes go in. A 1/4 inch slope error can push a ramp out of compliance.
• Maintain an accessibility punch list, capture as-built measurements, and compile product data for adjustable medical equipment. At Image Builders, we close projects with photos, measurements, and O&M data so owners have clean records for inspections and future renovations.

Conclusion

ADA compliance for medical office construction is achievable with the right planning, details, and on-site verification. We help Denver owners balance patient comfort, privacy, and code compliance without slowing schedules. If you need tenant improvements or a ground-up clinic, Image Builders can guide design coordination, permitting, and construction so accessibility is built in, not bolted on.

Ready to move from uncertainty to a clear plan? Contact Image Builders to review your drawings, walk your space, or scope a new build. Let’s create a medical facility that welcomes every patient and passes inspection the first time.

ADA Compliance for Medical Office Construction: FAQs

What triggers ADA compliance for medical office construction during renovations?

New construction must fully comply. For alterations, the renovated area must meet standards, and you must upgrade the accessible path of travel to that area up to the “disproportionate” threshold—commonly 20% of the alteration cost. Change of use (e.g., retail to clinic) can trigger accessible parking, entrances, restrooms, and care spaces.

How many accessible parking spaces are required for outpatient and rehab clinics?

Standard facilities follow ADA Table 208.2. Outpatient clinics need at least 10% of patient/visitor spaces accessible; rehabilitation and outpatient physical therapy facilities need at least 20%. Provide at least one van-accessible space (1 of every 6 accessible), correct access aisles, and signage with the bottom edge at least 60 inches high.

What exam room accessibility dimensions should I plan for?

Provide a 30-by-48-inch clear floor space next to the exam table for side transfers and a 60-inch turning space where turnaround is needed. Keep carts and seating out of required clearances. Mount sinks with knee/toe clearance, insulate pipes, and place dispensers within typical 15–48 inch reach ranges.

What restroom features are essential for ADA compliance in medical office construction?

Plan a 60-inch turning circle or compliant T-turn, ADA-positioned water closet with correctly located grab bars, and backing installed during framing. Set lavatory rims at max 34 inches with 27-inch knee clearance and 8-inch depth. Ensure door swings don’t encroach on required clear floor spaces and wrap pipes for protection.

Are automatic door operators required in medical clinics?

The ADA doesn’t universally require automatic operators if door clearances, forces, and hardware meet standards. However, many healthcare projects add operators at main entries and key internal doors to improve patient flow, gurney movement, and infection control. Some local codes or health systems may require them—verify with your jurisdiction.

Does the ADA require accessible medical diagnostic equipment like adjustable exam tables and scales?

ADA building standards focus on spaces, not equipment. The U.S. Access Board has Medical Diagnostic Equipment (MDE) standards guiding adjustable-height tables and accessible scales, and some funders or regulations reference them. While not universally mandated under ADA, providing MDE is best practice to ensure equal access and reduce staff assists.