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Each player manages their own personal hospital, each round placing nurses and specialists in departments to heal the patients. Players gain points for discharging patients, with the goal to have the most points at the end of 8 rounds.

Start of Round

Patient Intake

Dice (representing patients) are rolled until they show 2 to 5, then placed in the ambulance. They are placed lowest to highest, but for any ties. the last player can choose which color goes where.

Each player in turn picks a different ambulance, and places its dice on the bottom of their board. Any dice unable to be placed are instead moved to the morgue and the player takes a fatality token.

The First Player may not choose ambulance 1. The player taking the lowest ambulance also takes a "blood bag" and becomes the First Player for the next round.

Hospital Improvement

Each player in turn (lowest ambulance to highest ambulance) takes one of the hospital department or specialists to add to their hospital board. Note a player can have multiples of a particular department or specialist, and where it's placed does not matter for usability. This helps heal more patients as the game goes on.

During the Round

Hospital Activation

Each player individually "heals" patients, by moving a meeple of any color to a particular department on their hospital board, performing the department's effect, and then performing the meeple effect (if a specialist). Note that each meeple and department can only be used at most once per round.

Any patient healed at least once is slid down to keep track for round end. It seems if a department needs a group of patients, then that exact group must be present to use the department. However for departments that heal one patient multiple steps at once, the exact number of steps is not required if the patient would be discharged with fewer steps.

Any patients healed when at 6 are instead moved to the discharge department -- they will score points at the round end.

As a free action, you can discard any "blood bag" tokens you have. Each one discarded can heal a die one step, or change the die's color. Players have the option to discard improvements at the start of this phase to gain blood bags.

End of Round

Neglected Patients

Each player reduces any patients not healed that round by 1; if any were already at 1, they are instead moved to the morgue, and that player takes a fatality token for each one moved. (Some Administrator powers also affect this phase.)

Discharged Patients

Each player scores their discharged patients for that round as in the chart below. Note discharging many patients in the same round is preferable to doing it over multiple rounds, since the more patients you discharge, the more each patient discharged is worth.

First patient discharged: 1 point

Second through Sixth Patients discharged : 2 points each

Seventh and Eighth Patient discharged : 3 points each

Ninth and Tenth Patients Patients discharged : 4 points each

Eleventh and Twelfth Patients discharged: 5 points each

(So if they discharged 7 patients that round, they would score 1 + 2 + 2 + 2 + 2 + 2 + 3 = 14 points.)

Shift Change

To prepare for the next round, discharged patients are returned to the supply, all meeples are returned where they came from, ambulances are returned/refilled, and patients are slid back up. Last round's unchosen departments/specialists are removed, and new ones are dealt out for the next round.

End of Game

At the end of 8 rounds, each player gains 1 point per "blood bag" remaining, and loses 2 points for each fatality token. The player with the highest score wins. (In case of a tie, fewest patients remaining, then highest total value remaining.)