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

Before the Game

• Starting with the First Player, each player draws 3 dice at random as starting figures.
• They are set to 3, 4 and 5 - players choose which dice is set to which value. (1 would be the sickest patient, 6 the most healthy)
• Each player draws 2 hospital administrators, plays one and return the other to the box.

Start of Round

Patient Intake

• The first player chooses whether an extra department or an extra specialist to be revealed.
• Dice (representing patients) are rolled until they show 2 to 5, then placed in the ambulance from low to high.
• 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.
• If there is not enough room for incoming patients, existing patients must be moved to the mortuary and the player takes a fatality token per patient moved.
• 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

• If there are only 2 players, the first player can choose to reveal an additional department or specialist.
• Each player in turn (lowest 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.
• Each player can return one improvement per round to get a blood bag token.

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.
• When moving the meeple, the department's effect then the meeple effect (if a specialist) is performed.
• 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.
• 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 (ie the dice would be changed to 7 or beyond).
• Any patients healed when at 6 are instead moved to the discharge department and they will score points at the round end.
• As a free action, you can use any "blood bag" tokens you have to heal a die one step, or temporarily change the die's color. Used blood bags are then discarded.
• 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 mortuary, and that player takes a fatality token for each one moved.
• Some Administrator powers also prevent some patients from deteriorating.

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 Patient discharged : 2 points each
• Seventh and Eighth Patient discharged : 3 points each
• Ninth and Tenth Patient discharged : 4 points each
• Eleventh and Twelfth Patient discharged: 5 points each
• Bonus 5 points if the wards are empty.

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.

Variants

• Opening Crisis: During setup, take 5 patients with value 3, 3, 4, 5 and 5 in any colour.
• Nationwide Epidemic: When a player takes an ambulance, roll an extra dice and place it into a ward.
• Resistant Superbug: If a patient is neglected, it deteriorates 2 steps instead of 1.
• Experimental Medicine: Add 8 department tiles and 12 specialists to the improvements.