Unique Considerations for Rural Healthcare Facility Construction

Approximately 15% of the U.S. population lives in rural areas. Smaller communities have a lot to offer, but they’re also at risk of having fewer healthcare options. 

Small-town residents often have to travel long distances to reach a healthcare facility, yet these individuals often have a greater need for the services those facilities offer. That’s because rural communities often have higher poverty rates, a higher percentage of older adults with chronic health problems, higher rates of substance abuse, and more exposure to environmental hazards.

Add on top of that the global pandemic, and the disparity is amplified. Of concern is that as many as 20% of the more than 2,000 rural hospitals across the country are at risk of closing. But some administrators and facility managers are looking at upgrading their facilities to provide more services and become a healthcare destination. Rural healthcare facility construction, however, has unique challenges compared to urban hospitals and clinics. 

Here, we’ll take a look at the top considerations when addressing aging or underutilized facilities in smaller communities and tips for planning a healthcare construction project. 

RELATED: Download Our Healthcare Construction Planning Guide

Be Budget Conscious

Rural healthcare facilities face greater funding challenges than urban areas. A smaller population means there are fewer patients to treat. Fewer patients means less revenue. However, many fixed operational costs rival those of urban areas, resulting in even tighter profit margins. Additionally, worker shortages prompt some rural healthcare facilities to raise wages to compete with those in urban areas. These factors make it all the more important to avoid commonly overlooked healthcare construction costs.

A lack of funding may force healthcare facilities to limit the extent of renovations or new construction. Instead of renovating waiting rooms, patient rooms, or a building facade, rural facilities may need to opt for a smaller construction project that involves updating critical radiology equipment. For example, installing a new nuclear medicine imaging machine requires prep work, including opening up ceilings or flooring to install conduit and wiring. These types of smaller construction projects are often a priority.

It can be difficult to know where to start, so have a qualified healthcare construction team perform a facility assessment to help identify the most critical upgrades and compliance concerns.

Build in Phases 

Another budgetary concern with a building project is the potential for lost revenue while waiting for construction to be completed. A smaller healthcare facility typically doesn’t have back-up equipment, so if a construction project puts it out of commission for prolonged periods of time, that poses a problem. One way to minimize potential disruption and revenue loss is to plan a building project in phases. 

Construction phasing and sequencing allows for a construction project to occur in stages, allowing a healthcare facility to remain operational and continue to bring in revenue. Construction workers can also work during off hours to ensure optimal uptime. Working with a construction manager that uses a value engineering process can also help identify which functions are priorities and provide ideas for lowering costs. They can help develop a long-range master plan that includes various improvement projects, along with a timeline for completing them. 

READ MORE: When and Why to Consider Construction Phasing and Sequencing

Create Flexible Facilities

Rural facilities need to provide a wide range of services and procedures to serve the greater population. Healthcare design and construction for smaller communities needs to be adaptable, able to shift with the ever-changing healthcare climate. Intuitive design will not only be able to determine various phases of a construction project, but it can also factor in easy ways to remodel or change spaces in five or 10 years to keep everything up to date.

Procedural rooms may need to serve multiple functions to share resources and staffing. Surgical suites may double as procedural spaces, for example, with the supply room and instruments centrally located to serve both. Some rural facilities offer niche services to become a far-reaching destination and bring in additional revenue. Constructing facilities for specialty surgery or cancer treatment can be more expensive, but it may be a differentiator for patients as well as recruitment efforts, drawing in top-notch surgeons and clinicians.

Design With Community in Mind

When building a new facility or renovating an existing structure, it’s important to have it be a reflection of the community it serves. For example, a clinic with ultra-modern design featuring metal, glass, and contemporary features might not resonate with residents in the northwoods of Wisconsin or the back farm fields of Iowa. A construction management and architectural team should make efforts to get to know the area, its heritage, and its story. 

A facility’s exterior with natural materials like wood, stone, and brick would likely be much more suitable in these settings and help patients feel more comfortable when visiting. Interiors should also reflect the community and can use similar materials. Additional touches like etched glass or artwork from local artisans can add a special touch. Sometimes a local philanthropic organization or individual is willing to donate toward such endeavors.

VIEW PROJECT PORTFOLIO: Howard Young Medical Center — Minocqua, WI

An advantage of most rural healthcare facilities is that they often have larger campuses. Use that extra real estate to design walking paths and memorial gardens with benches and signage. Rural healthcare facilities often have more flexibility with their surroundings and should leverage extra acreage to enhance the structure.

Collaborate for the Best Outcome

A key to any rural construction project is to keep the community involved. That includes hospital staff, administrators, and residents. This is especially true if a facility that’s being renovated or even torn down has historical or nostalgic significance to a community. Work with local officials to help inform the public of proposed large-scale projects that might impact them.

Be sure to download our Healthcare Construction Planning Guide below for additional tips on how to plan a successful building project.

A qualified construction firm will help you avoid costly construction mistakes and know which questions to ask to help determine next steps and the level of community involvement that might be needed. Their team will also help to make sure a facility gets the most out of their money by providing a full scope of services and be willing to do small projects in addition to full-scale facility construction. 


Rural healthcare facility construction is just as important as building larger facilities for the masses. Choose your construction firm wisely to help ensure better treatment for patients and better working conditions for those who serve them. Contact The Samuels Group to see how we can find the right fit for your community.

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