To determine how many ICU beds are needed to serve patients within a given hospital, the authors report methods which allow hospitals to answer the following questions. (1) How are the surgical ICU facilities currently utilized? (2) How many additional overnight recovery room beds are needed? (3) What would be the ideal number of surgical ICU beds to manage patients beyond the scope of conventional care? (4) Have adverse results been reported on patients denied intensive care because of inadequate bed supply? (5) Can the need for intermediate care be defined? Data were collected for 6 months to balance seasonal variation and staffing changes. Recovery Room (RR) patients requiring intensive care (even if denied an ICU bed for lack of space) were identified and followed for 3 days or more to determine Therapeutic Intervention Scoring System (TISS) points and adverse results. ICU demographic data were obtained daily and full-service ICU patients were evaluated each day until discharged. “Triage” patients (nonelective discharges) were followed as described previously. Finally, the number of refused admissions to the ICU was obtained. Adverse results—defined as: (1) return to ICU; (2) death in hospital; (3) still in hospital 1 month or more after ICU discharge—were less than 1% in patients requiring overnight intensive care, 15% in potential triage patients (those who would have been discharged nonelectively but were able to remain in the ICU because the need for ICU beds diminished), and 23% in actual triage patients (those who were nonelectively discharged). Triaged patients averaged 17 TISS points the 1st day after ICU discharge while receiving floor care. Although the results pertain only to this hospital setting, they illustrate the methodology by which answers to the posed questions may be obtained. These methods have been used to support Certificates of Need (ultimately granted at several other large and small hospitals).