Not to safeguard the medical confidentiality of their patients but rather to keep from elbowing one another or backing their chair into a co-worker. Their shared office is smaller than some walk-in closets, built for one, maybe two, but definitely not the three or four doctors who use it.
While still a few years away, Cherokee is laying plans for a new hospital aimed at solving a space crunch that these days is more the rule than the exception.
The new hospital will be almost twice as big — a 141,000-square-foot, three-story building compared to the existing 78,000-square-foot, one-story hospital. The projected cost ranges from $50 million to $65 million. Planning what health care services it will have and how much space each department needs is still a work in progress. Once final blueprints are in hand, actual construction will take anywhere from 36 to 60 months.
The Cherokee Indian Hospital is more like a medical complex than traditional hospital, housing a litany of doctors practices, clinics, a lab, a pharmacy, and even a dentist and eye care office.
The tribally owned and operated hospital aims to provide enrolled members with a one-stop location for their basic health care needs, from mammograms to dentures. It has an emergency room but doesn’t do surgeries or deliver babies — few if any rural hospitals in a community of Cherokee’s size do. But the fact a community of its size has a hospital at all, let alone the range of services — from pediatric dental care to an MRI machine to acupuncture — is impressive.
The Cherokee Indian Hospital has grown and adapted to meet the demand for health care services in the community but is limited by space.
“So it’s like we bring it in, and then we’ve got to figure out where we are going to put them — how we are going to offer that service,” said Jody Bradley, public relations officer for the Cherokee Indian Hospital.
Bulging at the seams, all these tribally run health services no longer fit under the hospital’s roof, leading to various clinics spread around the reservation at off-site locations. The hospital’s finance department currently works out of a trailer behind the hospital, for example, and pediatrics will soon move out to free up more space.
“That’s hard on staff, but again, there is that promise of that new facility,” Bradley said.
The new hospital will fix that — and then some.
Hospital leaders want everything from meeting rooms for health seminars and exercise equipment.
“How can we be a community facility?” said Bradley.
The current hospital tries to reflect Cherokee’s identity. A new interior design scheme was rolled out a few years ago, drawing on cultural elements to create a warm, rather than institutional, feel, including exam rooms decorated by Cherokee artists.
Among the messages inscribed on the wall of the main waiting room in Cherokee syllabary is the hospital’s slogan “It belongs to you.”
While there’s a preliminary master plan, hospital leaders are still finalizing what services will be under roof and how much space they would each need.
“We have taken the master plan and still continue to kind of tweak it and make sure that the size is the size that will accommodate us through 2020,” said Chrissy Arch, operations director for the Cherokee Indian Hospital.
In the months to come, the hospital leaders will meet with staff and community members to discuss what they would like the new hospital to look like and what amenities they want to see.
The hospital’s advisory board weighed the idea of renovating the current facility or adding onto it. But, Bradley said, they decided, “we deserve better.”
“It would cost us as much to renovate this facility as it would to build new, and you know, when you build new, you can fix things you would just have to live with,” Arch said. “It just seemed more cost effective to build new.”
Like most of the tribe’s projects over the past decade, casino revenues will fund it at least in part, although grants and fundraising could play a supporting role.
“Building this is possible because of the casino,” Bradley said. “If the casino wasn’t here, we probably wouldn’t be building a new hospital. We would be trying to figure out how to get by in this one.”
The hospital is just one of many recent and current projects that the tribe has undertaken. There was the $633 million expansion of Harrah’s Cherokee Casino and Resort, the on-going construction of a $20 million justice center to house tribal court and a jail, the new Emergency Operations Center, a $140 million K-12 school, a golf course, skate park, movie theater and plans for a more than $90 million family adventure park, which includes a hotel, indoor water park, climbing walls and zipline.
The tribe’s many building projects of late have sported “green” building elements — a trend hospital executives hope to continue with their project.
“We want it to be an environmentally friendly facility. It is part of our culture. That is the way it should be,” Bradley said.
The Eastern Band took ownership of the health care facility, which dates back to the 1970s, in 2002. Before that, the hospital was part of the U.S. Indian Health Services, but was hamstrung by federal bureaucracy and funding formulas. The Eastern Band believed it could do a better job running its own hospital and spun off from the federal agency.
Growing beyond its bounds
Since the Eastern Band of Cherokee Indians took over ownership and operation of its Cherokee Indian Hospital from the federal government in 2002, it has added new services, equipment and staff. The staff numbers 250, who handle an average of 1,700 ambulatory visits, 1,500 emergency room visits and 750 dental appointments a month.