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During the game, a number of events may come up which provide you with the chance to earn extra money and increase your reputation, or alternatively to reduce your reputation and cause problems in the hospital.


Earthquakes happen every once in a while after the first few levels. Luckily earthquakes warn about themselves with a small tremble. When the big one hits, it damages your machines by adding to the number of times they have been used by a few. If this number exceeds the strength of a machine, it will explode.

Before an earthquake you should therefore examine all your equipment and replace the ones that whose "strength minus times used" is too low. You may not have enough time to get handymen to fix the equipment before the earthquake but you will need to do repairing afterwards.

In times of crisis, when you know an earthquake is about to strike but you are unsure if your machine(s) will explode, you can use the "Replace hardware" button to replace the machine. This costs a bit of money, determined by the value of the machine, but instantly repairs it along with restoring it's strength to the maximum. Do not be afraid to hire more handymen if you are having problems keeping your machines maintained. They have very low wages, and a late-game hospital can upkeep an army of them.


From time to time a blue emergency light might pop up on the fax machine bar. When this occurs and you select it a message will come up saying an accident happened at (place) and (number) people have (condition). It will go on to say that you do/do not have the resources to handle this. If you don't think you can handle the emergency turn it down, as these people will count towards your death count but remember you can still send some of them home if you're running out of time and still have some to cure. However, this drops your reputation as if you would have killed them. A better doctor or nurse will improve the speed at which each patient is dealt with. With large numbers of patients, it may be necessary to construct another room of the same kind required for their treatment. There are usually big cash bonuses on offer if you successfully deal with an emergency. Kill someone however, and your reputation will go down.


When your hospital is hit by an epidemic, firstly remember what the disease is and then go around your hospital either moving people with it to the front of the queue. DO NOT LET ANY EPIDEMIC PATIENTS GO HOME. Shooting rats is supposed to reduce the chances of having an epidemic in the first place.

If an epidemic hits that you know you cannot handle, don't be afraid to send them all home. Nine times out of ten you will get away with it and get a cash bonus. These are much better odds than the automatic fail of not having the right facilities to deal with an epidemic. It is also a good idea to send the infected patients home if they still have lots of diagnosis pending, such as requiring a ward or numerous visits to the GP.

Just take note that as soon as you hit the "Go home" button on one of the infected patient's options, the health administrator will immediately start making his way to your hospital. You can successfully cover up an epidemic by making sure there are no traces of the epidemic inside your hospital - you can even have infected patients walking home but still within the map boundaries and the epidemic will not be detected.

Important note: if the epidemic patients walk through the outdoors to get to another area of your hospital, time's up immediately and MoH start inspecting your hospital. It's a central thought of a strategy building a hospital with areas linked up with each other so that NONE will have to walk outside. If necessary, build room blocking the exit door of an area to ensure it. Using benches or drinking machine might not be approved as total blocking.

VIP Visit[edit]

Occasionally a message may inform you that a VIP wishes to visit your hospital. In all but the worst hospitals you should agree as the visit (providing there are no major problems) should result in a reputation boost and bonus cash. A few fairly obvious tips to follow while a VIP is visiting...

Before the VIP arrives:

  • Clean up the existing trash with handymen specialized in janitoring and keep them in crowded areas.
  • Repair all machines with handymen specialized in repairing. Replace the ones in low maximum condition (below 6). Watch out for earthquakes!
  • If you have plants, have handymen specialized in plant watering water as many as possible.
  • Send all of your tired staff to the Staff Room and adjust the Go To Staff Room slider if any of them went crazy and ended up overworked (they will keep losing happiness and rest slower).
  • Monitor your staff's morale and give a one-time bonus (not a pay increase) to anyone below 75% happiness. Dedicated GPs or doctors in training should be further monitored as their happiness will drop by 10-20% every month (affected by Difficulty) if the pay doesn't match their skill level.
  • If any cure is below 100% efficiency, have your researchers Specialize on it - or dedicate all of the budget to Drugs instead if there is more than one.
  • Make sure you have at least one happy and fresh consultant with very high skill to send to the GP office to avoid uncertain diagnosis. Set the diagnosis slider back to 100% if it is set any higher.

While the VIP is around:

  • Don't take gambles. Don't take guesses on cures and send patients home instead. Turn down emergencies if you can't handle them or they involve Drugs you haven't fully researched yet.
  • Make sure neither the VIP nor patients are thirsty. If the hospital is too warm, place more drinks machines and don't place radiators too close to benches. VIPs don't use drinks machines but they check for them like any other item.
  • Keep the VIP warm. VIPs don't enter rooms, so make sure the heat's turned up and there are enough radiators in corridors. They should neither be hot (over 80%) nor cold (below 20%).
  • Keep both the patients and staff happy (above 75% average happiness).
  • Make sure the VIP notices happy and fresh staff when they inspect a room. Very skilled staff (at least 80% skill) also impresses the VIP but only while in a room they are inspecting.
  • Have plenty of benches, fire extinguishers and other room items.
  • Have enough toilets (at least one per 10 visitors).
  • Cure as many patients as possible.
  • Keep deaths to a minimum, preferrably none at all.
  • Avoid sending too many patients home. This should be restricted to patients in critical condition.
  • DO NOT have any machine explode.
  • DO NOT send any patient to Autopsy.

Most of the above is advice you should be following anyway when running the hospital.

Possible outcomes:

  • Unsatisfied VIP (may lead to a reputation loss trophy at the end of the year)
    • Terrible: Your reputation drastically decreases.
    • Bad: Your reputation decreases.
  • Satisfied VIP (may lead to a reputation bonus trophy at the end of the year)
    • Mediocre: You get $800-$1500.
    • Good: You get $1200-$2000. Your reputation increases.
    • Awesome: You get $2000-$4000. Your reputation greatly increases.