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NOTIONAL REQUIREMENTS
FOR THE
HOSPITAL SHIP REPLACEMENT T-AH(X)
1. Background:
The U.S. Navy’s entire Role 3 theater hospitalization afloat capability resides in only two platforms, USNS MERCY (T-AH 19) and USNS COMFORT (T-AH 20). These strategic assets are designated to support major combat operations as their primary mission, while secondarily providing flexible options for disaster relief and humanitarian assistance worldwide.
The Navy’s two hospital ships, while successful conversions for their era, are now reaching the end of their service lives requiring recapitalization of new vessels. Additionally, as converted 1970s-era tankers, these vessels have inherent limitations, constraining modern medical workflow and limiting modern technology integration. The Next Generation Hospital Ship (T-AH(X)) will replace these aging vessels with modern afloat hospitalization capability.
The T-AH(X) will serve as a cornerstone of the future Navy medical architecture operating from a sanctuary outside a primary conflict zone, serving as an afloat, high-capacity Role 3 hospital. It will be designed to receive patients from various afloat platforms and draft restricted pier-side locations and conduct stabilizing care. Operations will prioritize maximizing patient throughput within these capable assets.
To ensure full operational and regulatory compliance, T-AH(X) must be designed and constructed in full compliance with applicable ABS Rules and satisfy 46 CFR requirements necessary for the issuance of a USCG Certificate of Inspection (COI).
The Navy is currently reevaluating the notional T-AH(X) requirements to “right-size” vessel capabilities to the identified budget. The “Requirement” column in the table in Section 2.0 identifies the existing notional requirement while the “Reduced Requirement” column indicates current areas considered for acceptable capability reduction. Both columns are included to help guide industry inputs of potential capability reductions to major cost driving attributes.
The table in Section 3.0 provides a more specified breakdown of medical spaces within the total Medical Treatment Facility. The values are preliminary estimates. The table is primarily provided to enable potential respondents to better understand the service requirements of these areas.
2. Requirements:
2.1 Vessel Characteristics
| Requirement Number |
| TLR Tier |
| Characteristic |
| Requirement |
| Reduced Requirement |
| R-001 |
| 1 |
| Survival Craft (Lifeboats, Tenders, and Life Rafts) |
| SOLAS compliance. |
| N/A |
| R-002 |
| 1 |
| Range (nautical miles (NM) |
| 10,000 NM at sustained speed |
| N/A |
| R-003 |
| 1 |
| Underway Replenishment |
| One fueling at sea station and one connected cargo replenishment receive station. |
| One fueling at sea station and one Level 1, Class 4 Vertical Replenishment (VERTREP) capability. |
| R-004 |
| 1 |
| Aviation Capability (Flight Deck, Hanger, and Support) |
| Two (2) Level I, Class 1 operating spots capable of simultaneous operations for MV-22, CH-53K, and MH-60 aircraft. Must support oblique approaches or expanded spot configurations. |
Aviation refueling with 90,000 gallons.
A hanger sized to accommodate one of the following aircraft complements: Two (2) folded MV-22s, Two (2) folded CH-53Ks and Four (4) folded MH-60s.
An aviation detachment with organic maintenance and services.
Two (2) Level I, Class 1 operating spots capable of simultaneous operations for MV-22, CH-53K, and MH-60 aircraft. Must support oblique approaches or expanded spot configurations.
Aviation refueling with 90,000 gallons.
| R-005 |
| 2 |
| Beam (ft) |
| <= 130 |
| N/A |
| R-006 |
| 2 |
| Sustained speed (knots (kts) |
| 17 |
| N/A |
| R-007 |
| 2 |
| Endurance Stores Sustainment |
| 45 days without resupply |
| N/A |
| R-008 |
| 2 |
| Medical Supplies Sustainment |
| 45 days without resupply |
| N/A |
| R-009 |
| 2 |
| Draft (ft) |
| < 32* |
| N/A |
| R-010 |
| 2 |
| Afloat Patient Transfer Capability |
| System performance shall be fully operable through Sea State 4. |
| N/A |
| R-011 |
| 2 |
| Chemical, Biological, Radiological and Nuclear Defense |
| Detection, washdown, decontamination stations. |
| N/A |
| R-012 |
| 3 |
| Ice Strengthening |
| Operations in light ice (Baltic 1C). |
| No ice strengthening capability |
| R-013 |
| 3 |
| Expedited Pier-Side Patient Transfer Capability |
| The system shall support the offload of at least 150 litter-borne patients per hour. |
| N/A |
*Preference for as limited of a full load draft as possible.
2.2 Medical Treatment Facilities (MTF)
| R-101 |
| 1 |
| Operating Rooms (ORs) |
| 6 ORs. |
| N/A |
| R-102 |
| 1 |
| Intensive Care Unit (ICU) beds and Acute Care Ward (ACW) beds |
| 250 Beds (50 ICU, 200 ACW). The 200 ACW configuration includes isolation beds and the capability to convert up to 50 ACW beds to ICU beds. |
| 226 Beds (26 ICU, 200 ACW). The 200 ACW configuration includes isolation beds and the capability to convert up to 50 ACW beds to ICU beds. |
| R-103 |
| 1 |
| Internal patient flow |
| Facilitate internal patient movement with elevators, stair towers and ramps. Provide for rapid emergency debarkation. |
| N/A |
| R-104 |
| 1 |
| Baseline MTF Capabilities |
(See section 3.0 for descriptions of medical space areas) SQFT: 149,372.2 (estimated) (13,882.5 m2)
Facilities functionally equivalent to a civilian Level II Trauma Center, at a minimum: Patient Decontamination, Triage, Casualty Receiving, Pre-Operative Holding, Operating Rooms, Post-Anesthesia Care Units (PACU), Intensive Care Units (ICU), and Acute Care Wards (including isolation capabilities). Fixed and portable radiology/CT, a full-service laboratory, blood bank, pharmacy, and central sterilization services. O2/N2 production, medical logistics and consumables management, medical/biomedical equipment repair, patient administration, medical laundry, and a morgue. The MTF shall provide organic primary care, dental, ophthalmology, and mental health services to ensure the endurance and sustained mission readiness of all embarked personnel.
SQFT: 135,262 (estimated) (12,570.9 m2)
| R-105 |
| 2 |
| Patient reception |
| The vessel shall be equipped with an integrated internal patient transit and handling system designed for the safe and efficient movement of ambulatory, wheelchair, and litter-borne patients. This system must provide unimpeded flow, seamlessly connecting all patient reception and departure points, including the flight deck, pier, and at-sea transfer systems—with all MTF spaces from triage to discharge. The system shall also be configured to support rapid mass casualty debarkation in an emergency. |
| N/A |
2.3 Accommodations
| R-301 |
| 2 |
| MSC civilian crew |
| 72 Commercial (estimated) |
60 Commercial (estimated)
| R-302 |
| 2 |
| Navy executive and medical personnel |
| 899 Navy Standard (estimated) |
| 629 Navy Standard (estimated) |
| R-303 |
| 2 |
| Embarked Security Team (EST) |
| 12 |
| N/A |
| R-304 |
| 2 |
| Aviation Detachment |
| 35 |
| 0 |
As of 5/20/26
3.0 Medical Space Area (Notional Requirements)
| Area per Unit Qty |
| Area Required |
| Space Name |
| Unit Qty |
| Unit |
| m2 |
| ft2 |
| m2 |
| ft2 |
CASUALTY RECEPTION (CASREC) BLOCK
| Casualty Reception Area |
| 46 |
| CASREC Patients |
| 19.9 |
| 213.7 |
| 913.6 |
| 9829.9 |
| CBRN Laboratory |
| 2 |
| Spaces |
| 18.6 |
| 200.1 |
| 37.2 |
| 400.3 |
| Decontamination Station (Clean) |
| 4 |
| Spaces |
| 10.9 |
| 117.2 |
| 43.6 |
| 468.7 |
| Decontamination Station (Dirty) |
| 4 |
| Spaces |
| 10.9 |
| 117.2 |
| 43.6 |
| 468.7 |
| Department Office |
| 4 |
| Desks |
| 4.5 |
| 48.3 |
| 18.0 |
| 193.2 |
| Litter Storeroom |
| 400 |
| Litters |
| 0.1 |
| 0.9 |
| 32.0 |
| 344.3 |
| Medical Linen Issue Room (Clean) |
| 46 |
| CASREC Patients |
| 0.5 |
| 5.4 |
| 23.0 |
| 247.5 |
| Medical Storeroom |
| 46 |
| CASREC Patients |
| 0.02 |
| 0.2 |
| 41.4 |
| 445.5 |
| Medical Utility Room |
| 46 |
| CASREC Patients |
| 0.5 |
| 5.4 |
| 23.0 |
| 247.5 |
| Showers |
| 1 |
| Shower Stalls |
| 3.0 |
| 32.3 |
| 3.0 |
| 32.3 |
| Soiled Linen Locker |
| 46 |
| CASREC Patients |
| 0.5 |
| 5.4 |
| 23.0 |
| 247.5 |
| Staff Room |
| 4 |
| Person Occupancy |
| 2.2 |
| 23.7 |
| 8.8 |
| 94.7 |
| Waterclosets |
| 4 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 12.2 |
| 130.8 |
OPERATING COMPLEX BLOCK
| Apparatus Room |
| 6 |
| Operating Room QTY |
| 8.6 |
| 92.1 |
| 51.4 |
| 552.6 |
| Department Office |
| 24 |
| Desks |
| 4.5 |
| 48.3 |
| 107.8 |
| 1159.5 |
| Medical Linen Issue Room (Clean) |
| 18 |
| Pre-Op (+) OR (+) PACU Patients |
| 3.7 |
| 39.7 |
| 66.4 |
| 714.7 |
| Medical Storeroom |
| 18 |
| Pre-Op (+) OR (+) PACU Patients |
| 0.1 |
| 1.1 |
| 81.0 |
| 871.6 |
| Medical Utility Room |
| 6 |
| Operating Room QTY |
| 5.6 |
| 59.7 |
| 33.3 |
| 358.3 |
| Operating Room (OR) |
| 6 |
| Spaces |
| 36.9 |
| 396.6 |
| 221.2 |
| 2379.7 |
| Passage (Sterile Core) |
| 6 |
| Operating Room QTY |
| 10.8 |
| 116.4 |
| 64.9 |
| 698.5 |
| Post-Anesthesia Care Unit (PACU) |
| 6 |
| PACU Patients |
| 32.8 |
| 353.4 |
| 197.0 |
| 2120.2 |
| Pre-Operative (Pre-Op) |
| 6 |
| Pre-Op Patients |
| 32.8 |
| 353.4 |
| 197.0 |
| 2120.2 |
| Scrub Changing Room |
| 24 |
| Person Occupancy |
| 2.2 |
| 23.7 |
| 52.8 |
| 568.1 |
| Soiled Linen Locker |
| 18 |
| Pre-Op (+) OR (+) PACU Patients |
| 3.7 |
| 39.7 |
| 66.4 |
| 714.7 |
| Showers |
| 3 |
| Shower Stalls |
| 3.0 |
| 32.3 |
| 9.0 |
| 96.8 |
| Staff Room |
| 15 |
| Person Occupancy |
| 2.2 |
| 23.7 |
| 33.0 |
| 355.1 |
| Sterilizing Room (Clean) |
| 6 |
| Operating Room QTY |
| 22.1 |
| 237.4 |
| 132.4 |
| 1424.2 |
| Sterilizing Room (Dirty) |
| 6 |
| Operating Room QTY |
| 19.9 |
| 213.9 |
| 119.3 |
| 1283.5 |
| Sterilizing Room (Instrument Tray) |
| 6 |
| Operating Room QTY |
| 5.7 |
| 61.3 |
| 34.2 |
| 368.0 |
| Waterclosets |
| 12 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 36.5 |
| 392.5 |
INTENSIVE CARE UNIT (ICU) BLOCK
| Burn / Isolation Patient Room |
| 10 |
| Spaces / Burn/Isolation Patients |
| 18.0 |
| 194.0 |
| 180.3 |
| 1940.0 |
| Department Office |
| 5 |
| Desks |
| 4.5 |
| 48.3 |
| 22.5 |
| 241.6 |
| Intensive Care Unit (ICU) |
| 40 |
| ICU Patients |
| 25.9 |
| 278.7 |
| 1036.0 |
| 11147.4 |
| Medical Linen Issue Room (Clean) |
| 50 |
| ICU (+) Burn / Isolation Patients |
| 0.5 |
| 5.4 |
| 25.0 |
| 269.0 |
| Medical Storeroom |
| 50 |
| ICU (+) Burn / Isolation Patients |
| 0.2 |
| 2.2 |
| 450.0 |
| 4842.0 |
| Medical Utility Room |
| 50 |
| ICU (+) Burn / Isolation Patients |
| 0.5 |
| 5.4 |
| 25.0 |
| 269.0 |
| Nourishment Room |
| 50 |
| ICU (+) Burn / Isolation Patients |
| 0.4 |
| 4.2 |
| 19.5 |
| 209.8 |
| Showers (Staff Only) |
| 4 |
| Shower Stalls |
| 3.0 |
| 32.3 |
| 12.0 |
| 129.1 |
| Soiled Linen Locker |
| 50 |
| ICU (+) Burn / Isolation Patients |
| 0.5 |
| 5.4 |
| 25.0 |
| 269.0 |
| Staff Room |
| 13 |
| Person Occupancy |
| 2.2 |
| 23.7 |
| 28.6 |
| 307.7 |
| Waterclosets (Staff Only) |
| 13 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 39.5 |
| 425.2 |
ACUTE CARE WARD (ACW) BLOCK
| Acute Care Ward (ACW) |
| 150 |
| ACW Patients |
| 12.5 |
| 134.8 |
| 1879.5 |
| 20223.4 |
| ACW / ICU Flex |
| 50 |
| ACW / ICU Patients |
| 25.9 |
| 278.7 |
| 1295.0 |
| 13934.2 |
| Department Office |
| 13 |
| Desks |
| 4.5 |
| 48.3 |
| 58.4 |
| 628.1 |
| Medical Linen Issue Room (Clean) |
| 200 |
| ACW (+) ACW / ICU Patients |
| 0.5 |
| 5.4 |
| 100.0 |
| 1076.0 |
| Medical Storeroom |
| 200 |
| ACW (+) ACW / ICU Patients |
| 0.1 |
| 1.1 |
| 1125.0 |
| 12105.0 |
| Medical Utility Room |
| 200 |
| ACW (+) ACW / ICU Patients |
| 0.5 |
| 5.4 |
| 100.0 |
| 1076.0 |
| Nourishment Room |
| 200 |
| ACW (+) ACW / ICU Patients |
| 0.4 |
| 4.2 |
| 78.0 |
| 839.3 |
| Patient Lounge |
| 20 |
| ACW (+) ACW / ICU Patients |
| 1.4 |
| 15.0 |
| 27.8 |
| 299.1 |
| Patient Mess |
| 20 |
| Seats |
| 2.2 |
| 23.7 |
| 44.0 |
| 473.4 |
| Showers (Staff & Patients Share) |
| 15 |
| Shower Stalls |
| 3.0 |
| 32.3 |
| 45.0 |
| 484.2 |
| Soiled Linen Locker |
| 200 |
| ACW (+) ACW / ICU Patients |
| 0.5 |
| 5.4 |
| 100.0 |
| 1076.0 |
| Staff Room |
| 18 |
| Person Occupancy |
| 2.2 |
| 23.7 |
| 39.6 |
| 426.1 |
| Waterclosets (Staff & Patients Share) |
| 29 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 88.2 |
| 948.6 |
ANCILLARY SUPPORT BLOCK
| Biomedical Repair Facility and Storeroom |
| 318 |
| Patients Serviced |
| 0.6 |
| 6.2 |
| 184.4 |
| 1984.6 |
| Blood Bank |
| 318 |
| Patients Serviced |
| 0.3 |
| 3.7 |
| 108.1 |
| 1163.4 |
| Blood Bank Storeroom |
| 318 |
| Patients Serviced |
| 0.01 |
| 0.1 |
| 143.1 |
| 1539.8 |
| Clinical Laboratory |
| 318 |
| Patients Serviced |
| 0.3 |
| 3.7 |
| 108.1 |
| 1163.4 |
| Clinical Laboratory Storeroom |
| 318 |
| Patients Serviced |
| 0.01 |
| 0.1 |
| 143.1 |
| 1539.8 |
| Communal Watercloset |
| 36 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 109.4 |
| 1177.6 |
| Consultation Room |
| 3 |
| Spaces |
| 23.9 |
| 257.4 |
| 71.8 |
| 772.1 |
| Consultation Room Watercloset |
| 3 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 9.1 |
| 98.1 |
| CT Scan Suite |
| 1 |
| Space |
| 47.9 |
| 514.9 |
| 47.9 |
| 514.9 |
| Dental Operating Room |
| 1 |
| Space |
| 23.9 |
| 257.4 |
| 23.9 |
| 257.4 |
| Dental Storeroom |
| 21 |
| 10% of ACW (+) Quiet Room Patients |
| 0.03 |
| 0.3 |
| 23.6 |
| 254.2 |
| Dental Suite |
| 1 |
| Space |
| 23.9 |
| 257.4 |
| 23.9 |
| 257.4 |
| Elevator (Single Patient Capacity) |
| 3 |
| Elevators (Assume 5 decks) |
| 4.3 |
| 46.3 |
| 64.5 |
| 694.0 |
| Elevator (Stores) |
| 1 |
| Elevators (Assume 5 decks) |
| 4.3 |
| 46.3 |
| 21.5 |
| 231.3 |
| Medical Gas Storage |
| 202 |
| H-Cylinders |
| 0.2 |
| 2.5 |
| 46.5 |
| 499.9 |
| Medical Incinerator |
| 3 |
| Incinerators |
| 15.0 |
| 161.3 |
| 45.0 |
| 483.9 |
| Medical Laundry |
| 318 |
| Patients Serviced |
| 0.9 |
| 9.8 |
| 289.4 |
| 3113.7 |
| Medical Suction Plant |
| 314 |
| Patients Serviced (–) Quiet Room Patients |
| 0.2 |
| 1.7 |
| 50.2 |
| 540.6 |
| Medical Storeroom (MISC) |
| 318 |
| Patients Serviced |
| 0.004 |
| 0.04 |
| 57.2 |
| 615.9 |
| Medical Treatment Room (STAFF USE) |
| 5 |
| Treatment Tables |
| 38.0 |
| 408.6 |
| 189.9 |
| 2042.8 |
| Medical Treatment Room (STAFF USE) Storeroom |
| 5 |
| Treatment Tables |
| 0.4 |
| 4.6 |
| 96.8 |
| 1041.0 |
| Medical Treatment Room (STAFF USE) (Waterclosets & Showers) |
| 5 |
| Waterclosets, Sinks, and Showers |
| 6.0 |
| 65.0 |
| 30.2 |
| 325.0 |
| Medical Waste Stowage Area |
| 318 |
| Patients Serviced |
| 0.3 |
| 3.3 |
| 394.3 |
| 4242.9 |
| Mental Health Clinic |
| 5 |
| Person (Staff & Patient) Occupancy |
| 4.8 |
| 51.4 |
| 23.9 |
| 257.2 |
| Morgue |
| 22 |
| Casualties |
| 1.5 |
| 16.1 |
| 33.0 |
| 355.1 |
| Narcotics Storeroom |
| 318 |
| Patients Serviced |
| 0.1 |
| 1.1 |
| 31.8 |
| 342.2 |
| Nitrogen (N2) Plant |
| 1 |
| Space |
| 50.2 |
| 540.6 |
| 50.2 |
| 540.6 |
| Ophthalmology Suite |
| 1 |
| Space |
| 23.9 |
| 257.4 |
| 23.9 |
| 257.4 |
| Oxygen (O2) Plant |
| 314 |
| Patients Serviced (–) Quiet Room Patients |
| 0.8 |
| 8.6 |
| 251.2 |
| 2702.9 |
| Patient Administration / Department Office Overflow |
| 18 |
| Desks |
| 4.5 |
| 48.3 |
| 80.8 |
| 869.6 |
| Patient Ramp |
| 1 |
| Sets of Ramps (Assume 5 decks), 8° slope, 8ft deck height |
| 50.4 |
| 542.3 |
| 252.0 |
| 2711.5 |
| Pharmacy |
| 318 |
| Patients Serviced |
| 0.7 |
| 7.5 |
| 222.6 |
| 2395.2 |
| Pharmacy Clean Room |
| 318 |
| Patients Serviced |
| 0.2 |
| 2.4 |
| 70.0 |
| 752.8 |
| Pharmacy Storeroom |
| 318 |
| Patients Serviced |
| 0.02 |
| 0.2 |
| 229.0 |
| 2463.6 |
| Pharmacy Watercloset |
| 4 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 12.2 |
| 130.8 |
| Physical Therapy Clinic |
| 4 |
| Patients |
| 9.6 |
| 102.9 |
| 38.2 |
| 411.5 |
| Physical Therapy Watercloset |
| 1 |
| Toilets & Sinks |
| 3.0 |
| 32.3 |
| 3.0 |
| 32.3 |
| Quiet Room |
| 4 |
| Quiet Room Patients |
| 12.5 |
| 134.5 |
| 50.0 |
| 538.0 |
| Quiet Room Showers |
| 1 |
| Shower Stalls |
| 3.0 |
| 32.3 |
| 3.0 |
| 32.3 |
| Quiet Room Watercloset (Staff & Patients) |
| 1 |
| Toilets & Sinks |
| 3.0 |
| 32.7 |
| 3.0 |
| 32.7 |
| Radiology Office |
| 2 |
| Radiology Suites |
| 7.6 |
| 81.8 |
| 15.2 |
| 163.6 |
| Radiology Suite |
| 2 |
| Spaces |
| 31.9 |
| 343.2 |
| 63.8 |
| 686.5 |
FOOD SERVICE BLOCK
| Patient Meal Preparation & Food Cart Stowage |
| 254 |
| ACW (+) ACW / ICU (+) ICU (+) Burn / Isolation (+) Quiet Room |
| 0.5 |
| 4.9 |
| 116.8 |
| 1257.2 |
HABITABILITY BLOCK
| Conference Room(s) |
| 63 |
| Seats (split into one large, two small) |
| 4.5 |
| 48.3 |
| 282.9 |
| 3043.7 |
| Embarked Medical Staff Office (single occupancy) |
| 5 |
| Space |
| 10.0 |
| 107.6 |
| 50.0 |
| 538.0 |
| Enlisted Lounge |
| 30 |
| Person Occupancy |
| 1.4 |
| 15.0 |
| 41.7 |
| 448.2 |
| Medical XO Office |
| 1 |
| Space |
| 10.0 |
| 107.6 |
| 10.0 |
| 107.6 |
| Officer Lounge |
| 45 |
| Person Occupancy |
| 1.4 |
| 15.0 |
| 62.5 |
| 672.3 |
| Senior Medical Officer (SMO) Office |
| 1 |
| Space |
| 10.0 |
| 107.6 |
| 10.0 |
| 107.6 |
