To explore the implications of the single family room (SFR) care environment of neonatal intensive care units (NICU) compared to Open-bay, Combination and Double-occupancy configurations, focusing on family experience, neonate outcomes, staff perceptions, cost and environmental design. This study uses a multimethod design with 11 Level III NICUs. Space allocations, construction costs, staff preferences and perceptions, and occupant behaviors were evaluated. SFR NICU design provides solutions for increasing parent privacy and presence, supporting Health Insurance Portability and Accountability Act compliance, minimizing the number of undesirable beds, increasing staff satisfaction and reducing staff stress. The analysis of this study suggests that there are benefits to SFR NICU. This study is an initial, comprehensive effort, the purpose of which is to spawn future, narrower, in-depth studies focused on SFR NICU design.