Greetings Directors!

Challenge Mode is our new FREE DLC full of unrelenting stress for the management masochists! You thought our game was too easy. 

Well, feedback received; we've worked day and night twiddling our knobs and levers into a diabolical arrangement that's sure to make even the most experienced director perspirate. As they say, be careful what you wish for.

Be sure your game is fully updated to play! See the full patch notes summary below.

Patient Overload!

Swarms of inconsiderate patients will barge into your hospital on the brink of death – often requiring rooms you’ve yet to build. But be quick, as every condition now kills patients quicker than it did previously. Leave them too long and you'll pay hefty fines. 

They're Mutating?!

At any moment one of your previously discovered conditions can mutate into a far deadlier variant strain. A perfect time to get those doctors you forgot to fire into the Research Lab, I’d say.

Goodbye, Money!

We hope you’re responsible with your finances because you’ll be burning holes in your pockets keeping up with patients’ vexing needs and staff demands. Say goodbye to your money, we’re robbing you of credits and free items.

And don’t even think about crying to Baz, he won’t be any help. The generous colossal is now a colossal ****. Baz’s freebies will now only consist of cheap consumables. You’ll have to pay full price for everything else!

Fine, we’ll allow you to use The Research Lab, Training Room, Recovery Ward and all Craftech blueprints immediately. You’ll need them in order to avoid killing too many patients.

Patch v1.1.0

Challenge Mode

• Challenge Mode is available is an optional setting that can be enabled when starting any level (both story and sandbox) if you enjoy suffering and misery
• In order to experience challenge mode on a level you’ll need to start again from scratch, it cannot be enabled in an already-existing hospital
• All career progress (research, consultants, unlocks, etc) is shared between challenge mode and regular mode
• Each level has an additional cosmetic reward available for reaching a 5 star hospital rating in challenge mode (it’s quite hard)
• Several new achievements are also available for reaching 5 stars in challenge mode

All of the features and changes listed below are exclusive to challenge mode, and do not impact regular gameplay!

Mutated Conditions!

Conditions have begun to mutate into deadly new strains, and it’s a race against time to research the cures before your hospital is flooded with death and disaster. Put those nerds in the Research Lab to work before it’s too late!

• Conditions now randomly mutate, massively increasing their treatment difficulty, health decay rate, and patient spawn rate
• Mutated conditions do not benefit from any existing research bonuses (they are effectively research level 0)
• All mutated conditions are the same difficulty level, regardless of their original difficulty
• Mutations must be researched (via normal means or by making use of the Research Lab) in order to re-discover the treatment, at which point the mutation is cleared
• Successfully clearing a mutation results in a bounty of credits and Loamite

More Patients!

Infection rates have surged and HEAL’s “KPI safeties” were switched off because they were illegal, so keep an eye on the shuttle bays – the goddamned patients are coming in hordes!

• A new “Challenge Spawner” system will progressively increase the number of patients spawning, regardless of if your hospital is also growing in size
• Patients are more likely to require rooms you haven’t yet built and enter with less health than usual

More Death!

The cost of MEDI’s body-disposal tech was extortionate but, with the state of these patients, it’s about to save us a fortune on body bags.

• Conditions of every danger level will cause patients to deteriorate faster than before - even danger level 0 conditions have health decay now!
• Treatments are harder to perform, and more likely to result in patient fatalities if your doctors are unhappy, tired, or poorly trained

More Poverty!

By 2049, medical debt exceeded 1,800% of global GDP, and the entire economy turned into mashed potatoes. The ghost of that terrible time has returned, and both we and our patients are flat broke.

• Income from treatments is 20%~ lower
• Travelling merchants will no longer offer room upgrades or corridor upgrades for free - the only freebies still available are cheap consumables, you’ll have to pay full-price for everything else!

New Ways to Lose!

For those of you lacking a sense of shame, we thought there should be a more tangible penalty for killing all of your patients.

• If over 25% of your patients die (or leave) for an extended period of time, your hospital will be shut down
• This loss condition works the same way as bankruptcy: once the threshold is hit, you have 10 minutes to correct it, after which you will be shut down if the situation hasn’t improved

More!!!

I’m all out of exclamation points now.

• Meteor strikes and pest incursions occur with more frequency and a greater intensity
• Doctors can only be recruited at rank 1 & 2, all the rank 3 recruits have been hoovered up by the private sector
• The Research Lab, Training Room, Recovery Ward and Craftech upgrades are all available from Chapter 1 - without them, you’d be toast
• Patients are less patient (they’ll become unhappy waiting sooner than before)
• Staff & patients are slightly more unhappy by default, requiring a bit more effort to stave off their existential dread

Game Systems & Balance

Hospital Life

We've instilled all the inhabitants of your hospital with a new sense of purpose and wonder in life. They'll react to the happenings around them, to their own moods, admire art on the walls, or puke on the floor. They might even strike up a conversation or two. All this brings a sense of life to the hospital, provided your patients are indeed living that is.

• Characters will now react when witnessing death and vomit in the corridor (and may even vomit themselves, creating an exquisite chain reaction)
• Characters will now play animations to indicate if they are hungry, bored of waiting, or need the toilet
• Characters will now cough and sneeze, with increasing frequency if they are close to death
• Characters will now stop and have a chat with each other in the corridor
• Staff with no work to do will now idle in the Staff Lounge, instead of wondering aimlessly around the corridor

Global Balance Adjustments

We’ve made a few balance changes which impact the game both in challenge mode and in regular difficulty.

• Starting credits in all levels increased from 125,000 to 150,000
• The Recovery Ward now heals patients twice as fast
• The disruptive spawner is slightly less disruptive outside sandbox mode
• Hospital zones are approximately 15% cheaper to unlock
• The travelling merchant now visits every 5.5 minutes, up from every 6 minutes
• Consultants no longer have inflated salaries at lower levels, but still end up costing more once they have levelled up
• The “I See Dead People” thought is now -10% mood (down from -20% mood, because dead people aren’t that bad)
• You now start with 500 craftium in all levels and all modes, *except* for MC1 & MC2 in non-challenge story mode (as you haven't been taught to craft yet)

Campaign

Chapter 1

•  Fixed a part of tutorial where you could pass by doing the wrong thing

Chapter 3

• Fixed a randomly highlighted wall
• Fixed an issue where cured patients are unable to leave the hospital

Chapter 6

• Fixed an issue where the level would force all duplicated doctors to be named Otto Ohdious

Chapter 8

• Fixed asteroids doing 0 damage to rooms

Chapter 11

• Moved burning moon memory so it stops clipping through

Sandbox

• Colossal panel progress bar now correctly updates
• Jellified Spiel event now uses the correct Charles Barryborough prefab
• Fixed incorrect Avatar appearing on some lines

Visuals

Visual Improvements

• Made changes to lens colours for better info

Visual Fixes

• Fixed an issue where an inactive room would have a different wall colour to the rest of the hospital
• Put the particle VFX back into the Recovery Ward
• Fixed an issue causing conflict between wall props and windows being placed near each other
• Fixed an issue where background particles would fly around the hospital
• Fixed Charles Barryborough's hair moving weirdly with jellification on it

User Interface

UI Improvements

• Added some scroll functionality to level select UI
• Hospital Rating is now better presented to the player at the beginning of a level
• Assigning staff to a research room through the staff picker will automatically fill up empty assignment slots instead of forcing the player to manually select each slot.
• Made changes to how the patient panel is extended
• Added tooltip for health that isn't recoverable
• Changed the credits tooltip in the closed hospital stage
• Research undertaken in other Research Labs now has the 'remove' button in research list
• Can now send eligible patients to Recovery Ward through the Patients Overview panel

UI Bug Fixes

• Fixed WFTO arcade cabinet tooltip that incorrectly displays 'fulfils nutrition need'
• Doctors assigned to Research Labs will not show as Unassigned anymore
• Fixed an issue where hospital ratings were not recording deaths (the culprit has not been found)
• Fixed misplaced lens icons
• Fixed dramatic patients with critical health icon showing when they're non-critical
• Fixed the patient reject menu not showing a penalty
• Fixed an issue where Research Lab ‘add doctor’ icon remains after selecting doctor
• Fixed an issue with Consultant traits stacking up and overflowing the consultant window
• Fixed various line breaks/cutoffs on patient tooltip tags
• Fixed "Doctor On Break" escalating to a UI notification
• Fixed an issue where every single room has 0% Treatment Quality
• Fixed a bug preventing the Research Lab panel to openFixed Patient Overview panel crash

Other

Other Changes

• Made some changes to passive reactions like sneezing and yawning
• Research Labs now automatically assign a random research when built/finishing research
• Made improvements to how patients move from shuttles into the hospital
• Pests are no longer immediately targeted by Medibots when they spawn, and are only detected after being in the hospital for a while or biting a couple of patients

Additional Bug Fixes

• Fixed an issue where playing a new level would continue the last
• Fixed an issue where Ultra's 'Translocation Ray' skill wouldn't work
• Fixed an issue causing crashes on PS5
• Fixed an issue where patients would rather wait in a long queue than use another available room
• Fixed an issue where switching research room tasks would disrupt research
• Stabilizing Solution can no longer be used on Baz, sorry Baz.
• Fixed an issue with patients complaining about mess even though there is no mess
• Fixed an issue where patients assumed the hospital was untidy when entering
• Fixed the Diagnosis Room queue distribution system
• Fixed an issue where dramatic patients would head to the Recovery Ward despite being full health or fully cured
• Fixed an issue with placing props behind other props
• Fixed an issue with Stabilizing Solution not doing its job
• Fixed an issue where placing a Subsonic Dampener room upgrade decreases number of Efficiency Regulators in the inventory
• Fixed an issue where Skin Lab template gets permanently stuck
• Fixed an issue where HEAL says you need to buy more vending machine when there is already plenty
• Fixed an issue where Kouber Baly Doctors would get stuck in the entrance
• Fixed an issue where you can build a room with a canister in it
• Fixed Holographic Doctor having 'poor decoration' thought
• Fixed pests crawling into the Diagnosis Rooms
• Fixed an issue where patients would walk through other patients when close to the benches