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by CityBuilderAK47

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FAQ/Strategy Guide by CityBuilderAK47

Version: 1.11 | Updated: 09/19/19

Table of Contents

  1. Intro
    1. Theme Hospital vs. Two Point Hospital
    2. Additional Resources
    3. Where Your Save Files Are Stored
    4. Updates / Additional Content
  2. Before You Build: What Makes An Effective Layout?
    1. 11 Tips for Hospital Success
    2. The Patient Process
    3. Patient Happiness
    4. The 9 General Rules of Hospital Layout
    5. Kudosh & Recommend Items
  3. Before You Build: Staffing
    1. Staff Happiness & Staff Threats
    2. Doctor Skills
    3. Nurse Skills
    4. Assistant Skills
    5. Janitor Skills
    6. Common Skills
    7. Staff Traits
    8. Staff Attire
  4. Countryside Region
    1. Level 1: Hogsport
    2. Level 2: Lower Bullocks
    3. Level 3: Flottering
  5. Cold Region
    1. Level 4: Mitton University
    2. Level 5: Tumble
    3. Level 6: Flemington
    4. Level 6: Flemington - Case Study - 2 Stars to 3 Stars
    5. Level 6: Flemington - 3-Star Winning Layout
  6. Industrial Region
    1. Level 7: Smogley
    2. Level 7: Smogley - Case Study - From Failing 1 Star to Succesful 3 Star
    3. Level 7: Smogley - 3 Star Winning Layout
    4. Level 8: Melt Downs
    5. Level 8: Melt Downs - 3-Star Winning Layout
    6. Level 9: Duckworth-Upon-Bilge
    7. Level 9: Duckworth-upon-Bilge - 3-Star Winning Layout
  7. Tropical Region
    1. Level 10: Sweaty Palms
    2. Level 10: Sweaty Palms - Case Study - A Failing Hospital (When to Give Up)
    3. Level 10: Sweaty Palms - 3-Star Winning Layout
    4. Level 11: Grockle Bay
    5. Level 11: Grockle Bay - 3-Star Winning Layout
    6. Level 12: Blighton
    7. Level 12: Blighton - 3-Star Winning Layout
  8. Urban Region
    1. Level 13: Rotting Hill
    2. Level 13: Rotting Hill - 3-Star Winning Layout
    3. Level 14: Pelican Wharf
    4. Level 14: Pelican Wharf - 3-Star Winning Layout
    5. Level 15: Croquembouche
    6. Level 15: Croquembouche - 3-Star Winning Layout
  9. Sandbox
  10. Interior Designer
  11. (Snowfall) Pointy Mountain Region
    1. (Snowfall) Level 16: Underlook Hotel
    2. (Snowfall) Level 17: Swelbard
    3. (Snowfall) Level 18: Roquefort Castle
    4. (Snowfall) Level 18: Roquefort Castle - 3-Star Layout
    5. (Snowfall) New Items
    6. (Snowfall) New Rooms
    7. (Snowfall) New Illnesses
    8. (Snowfall) Other New Things
  12. (Pebberley Island) Pebberley Island Region
    1. (Pebberley Island) Level 19: Pebberley Reef
    2. (Pebberley Island) Level 19: Pebberley Reef - 3-Star Winning Layout
    3. (Pebberley Island) Level 20: Overgrowth
    4. (Pebberley Island) Level 21: Topless Mountain
    5. (Pebberley Island) Level 21: Topless Mountain - Case Study - Working Successfully with Waves
    6. (Pebberley Island) New Items
    7. (Pebberley Island) New Rooms
    8. (Pebberley Island) New Illnesses
  13. (Close Encounters) Desert Region
    1. (Close Encounters) - Level 22: Goldpan
    2. (Close Encounters) - Level 23: Camouflage Falls
    3. (Close Encounters) - Level 23: Camouflage Falls - Anatomy of a 3-Star Wave-Smashing Hospital
    4. (Close Encounters) - Level 24: Chasm 24
    5. (Close Encounters) - New Items
    6. (Close Encounters) - New Rooms
    7. (Close Encounters) - New Illnesses
  14. (Superbug Initiative) - The Superbug Initiative
    1. (Superbug Initiative) - Research Projects
    2. (Superbug Initiative) - Project-Unlocked Items
  15. Building a Better Hospital
    1. GP Queues
    2. Hospital Level Snowballing
    3. Expansion Strategy
    4. Examples in Efficiency
    5. Room Prestige
    6. The Great Patient Purge
  16. Training
  17. Marketing
  18. Common 2-Star Challenges
    1. Money Troubles
  19. Common 3-Star Challenges
    1. You want HOW Much in Hospital Value?
    2. Attractiveness Rating
    3. Bump that Cure Rate Up!
    4. Staff Morale? Are You Kidding Me?
  20. Staff Challenges
  21. Illnesses
    1. List of Illnesses
    2. Chance of Cure
    3. Rogue Monobrows
  22. Epidemics
  23. Emergencies
  24. Disasters
  25. Rooms
  26. Item Listing
    1. Kudosh Item Listing
    2. (Special) Item Listing
    3. (Retro Items Pack) DLC Item Listing
  27. Research Projects
  28. VIP Visits
  29. End of Year Awards
  30. Steam Achievement Guide
  31. Two Point Humor
  32. Contact the Author
    1. Legal Bla Bla Bla

(Close Encounters) Desert Region

(Close Encounters) - Level 24: Chasm 24

In-Game Description: Head underground to the operation's headquarters.

Awards Available: Rising Star, Employer of the Year, No Deaths, Best Teaching Hospital, Patients' Choice Award, Most Prestigious Hospital, Best Research Hospital, Hospital of the Year

Disasters Seen: ALL OF THEM!!! (If Stabilisers are not maintained properly)

Emergencies Seen: Psychiatry Emergencies (Psychiatry)

Online Challenges:
Days Since Last Death Challenge - Compete with rival organisations to go the longest with without a losing a patient.(Length: 180 days, Reward: K20)
Training Challenge - Compete against other organisations to train the most employees.(Length: 180 days, Reward: K20)
Cure Rate Challenge - Compete against other organisations to get the highest cure rate.(Length: 180 days, Reward: K20)

Unlocks in this level:
Rooms: Personification
New Illness: Lack of Humanity
All Illnesses Seen:
8-Bitten, Animal Magnetism, Anty Matter, Aller-Gs, Bowhine, Confidentures, Cosmoss, Cubism, Deeply Ill-Suited, Extraterrestical, Fanatick, Flack Hole, Flat-Packed, Frogborne, Gorm Deficiency, Grey Anatomy, Grunt, H.G. Swells, Headcrabedness, Hero Complex, Highly Ill-Suited, Home Sick, Horrorscope, Hyperrealty, Isotrope, Jest Infection, Lack of Humanity, Lightheadedness, Neutrainers, Pandemic, Planetary Ring, Science Friction, Shock Horror, Situational Gravity, Space Caged, Sputneck, Star Struck, Telemutation, Turtle Head, Warped, Zodiac Arrest,
Most Frequently Seen Illnesses: Coming soon!
Star Rewards: Lack of Humanity Poster (1 Star), Science Station (1 Star), Alien Plant (2 Stars), Robo Kit (3 Stars)
Note: the Lack of Humanity Poster currently seems glitched and hasn't properly unlocked.

Starting Blurb:
Welcome to Chasm 24. If you're reading this, it means that you've been given the highest level of security clearance that the County has to offer. This cavern was acquired, years ago, from the mole-people and converted into a top secret research centre by the aliens (that sentence was a lot).

In this severe environment, deep under the County's surface, you'll need to maintain a series of stabilisers to keep the area - you guessed it - stable. They make up an incredibly advanced system, with different stabilisers preventing different problems, that require maintenance by janitors with computer-like brains. Which is exactly what we have: Robo-Janitors. Every type of Robo-Janitor can maintain the stabilisers; however, each model is also programmed in a few, regular janitorial tasks, so make sure to check their qualifications. You'll receive more Robo-Janitors as you expand the hospital, but each new plot will have a stabiliser that needs maintaining.

New Game Concepts:
Don't get me wrong. This is probably by far the most beautiful and well-executed level. It is artistically unrivaled and really pulls you into the story. But man, adding the threat of all disasters that can be triggered at any time because your handymen...on one of the busiest levels in the game...don't have enough to do already? Disasters that can be steamrolled and conjoined and literally bankrupt even the strongest of hospitals? Whoo-ee. Welcome to the world with stabilisers in them. These are stationary objects that can't be moved, take up a few tiles of space, and have to be constantly maintained by savvy janitors.


Robo-Janitors are robotic assistants that can help with minor janitorial tasks. While this level introduces them as part of the level and progression, when you clear 3 stars, or possibly just unlock them all, you will then be able build more. However, there seems to be some sort of limit in game, and it appears once you've unlocked them all on Chasm 24, you reach the limit. I will be looking into this more, but for now, here are the five types you can build.

BinBoi - This Robo-Janitor comes with the ability to clean up litter and empty bins, and has an additional +70% Speed
In & Out - This Robo-Janitor comes with the ability to restock vending machines and service toilets and has an additional +100% Maintenance|
Mend-Friend - This Robo-Janitor comes with the ability to maintain machinery and has an additional +150% Maintenance Skill
Life & Death -This Robo-Janitor comes with the ability to water plants and capture ghosts and has an additional +50% Speed
Build & Repair - This Robo-Janitor comes with the ability to upgrade machinery and has an additional +120% Upgrade skill

Blank Layout

Your default Plot, Plot 1, comes with a threat of Earthquakes and the corresponding Stabiliser

Plots available:

Plot 2 - northwest of Plot 1 - $25,000 - Days to Build: 16, Size: 468 m2 - Adds threat of Frog Storms/Stabiliser- Includes Robo-Janitor Phillup Plunge (In & Out Qualification )
Plot 3 - northeast of Plot 1 - $25,000 - Days to Build: 16, Size: 468 m2 - Adds threat of Electrical Storms/Stabiliser - Does Not Include Robo-Janitor
Plot 4 - due north of Plot 1 - $45,000 - Days to Build: 16, Size: 736 m2 - Adds threat of Avalanches/Stabiliser- Includes Robo-Janitor Audrey Fixsimmons (Mend-Friend Qualification)
Plot 5 - north of Plot 4 - $45,000 - Days to Build: 16, Size: 800 m2 - Adds threat of Volcano Eruptions/Stabiliser - Does Not Include Robo-Janitor
Plot 6 - northeast of Plot 4 - $45,000 - Days to Build: 16, Size: 672 m2 - Adds threat of Epidemics/Stabiliser - Includes Robo-Janitor Coggerly Douse (Build & Repair, Mechanics Qualification)
Plot 7 - east of Plot 3 - $40,000 - Days to Build: 16, Size: 864 m2 - Adds threat of Water Tornadoes / Stabiliser- Does Not Include Robo-Janitor
Plot 8 - south of Plot 7 - $50,000 - Days to Build: 16, Size: 864 m2 - Adds threat of Earthquakes / Stabiliser - Includes Robo-Janitor Audrey Fixsimmons (Mend-Friend Qualification)
Plot 9 - south of Plot 1 - $40,000 - Days to Build: 16, Size: 760 m2 - Adds threat of Ghost Hauntings / Stabiliser- Includes Robo-Janitor Sprinkle Spectre (Life & Death, Ghost Capture Qualification)
Plot 10 - south of Plot 9 - $40,000 - Days to Build: 16, Size: 760 m2 - Adds threat of Volcano Eruptions/Stabiliser - Does Not Include Robo-Janitor
Plot 11 - southwest of Plot 1 - $50,000 - Days to Build: 16, Size: 800m2 - Adds threat of Avalanches/Stabiliser - Includes Robo-Janitor Sweepy Leroux (BinBoi Qualification)
Plot 12 - north of Plot 11 - $40,000 - Days to Build: 16, Size: 600m2 - Adds threat of Frog Storms/Stabiliser- Does Not Include Robo-Janitor
Plot 13 - east of Plot 5 - $40,000 - Days to Build: 16, Size: 600m2 - Includes Robo-Janitor Phillup Plunge (In & Out Trait)
Plot 14 - north of Plot 12 - $20,000 - Days to Build: 16, Size: 256m2 - Adds threat of Ghost Hauntings / Stabiliser - Does Not Include Robo-Janitor

My Current 3-Star Layout

Level Notes

  • HAVING MANY JANITORS WILL SAVE YOUR HOSPITAL! OK. So I definitely learned some lessons about the importance of last-level DLC janitors from Topless Mountain. Although this is not the most technically challenging of the hospitals in the DLC (Camouflage Falls definitely takes the cake for that), it definitely requires you to master using your Janitors. They are the key to winning this level. Let me tell you, those stabilisers really add a whole new layer of complexity because they require constant diligence on top of you know, the ten million others things to attend to at any given time. You also still have aliens invading your hospital too! UGH! Even neglecting the Stabilisers to 25-30% can generate a milder disaster, but may luck be on your side if you let multiple ones fall to practically 0%. It seems the size of the disaster scales with the amount of disrepair.]
  • You may have very well coasted along the whole game pretty smoothly without touching the Job Assignments grid for Janitors, but now, everything changes. You simply must hire additional janitors whose sole purpose is to repair machines and maybe put out fires. I devised a strategy prototype to make some janitors what are called "runners" - their sole job is to be fast (it is a vast hospital) and to run to machines and maybe put out fires. So, train them with Motivation and Maintenance and Stamina Training, and that's that.
  • All it's going to take is one one-two punch of horrible disasters from un-maintained stabilisers to make you paranoid about checking those things frequently enough. Having a runner or a half a dozen will help, but you still need to check your map manually every few minutes. Here's what I want you to do. Think about your shopping list for the week when you're out to buy groceries. Probably like you know, milk, eggs, pizza, drinks, ice cream, toilet paper...now, add to that grocery list, "Check on Stabilisers"...Think about...and then "Check on Stabilisers". When you do your daily check for phone, wallet, and keys, think "...check stabilisers". Go into your phone and set 4-minute reminders to "Check Stabilisers". When you're listening to bacon sizzle on the stove or grill, think to yourself "By golly, I should go check on the stabilisers". And then...now, say it with me "Oh gosh CityBuilderAK47 told me to check on the stabilisers! I can't believe I almost forgot to check on them". The fear of what the stabilisers will do can get into you that much. They're frustrating, but another element you must master!
  • The Robo-Kit is your 3-star reward! It allows you to plop a brand new Robo-Janitor into absolutely any level of your choosing. Brilliant, and thankfully not a couch or artistic sofa! Phew!

Star Goals

1 Star

  • Cure Rate of 70%
  • Own 4 Plots
  • Complete Personification Research Project
  • Cure 10 Patients in Personification

2 Stars

  • Cure Rate of 80%
  • Own 8 Plots
  • Cure 25 Patients in Personification
  • Generate 3000 Research Points

3 Stars

  • Cure Rate of 90%
  • Generate 5000 Research Points
  • Cure 50 Patients in Personification
  • Own 12 Plots