08/05/2026
Nearly 65 million Americans live in rural communities. Yet rural counties have fewer healthcare professionals, specialists, critical-care units, emergency facilities and transportation options. Between January 2010 and October 2025, 152 rural hospitals closed or stopped providing inpatient services.
Those numbers help explain why this year’s National Health Center Week theme, “Building Innovative Care Where It Matters Most”, is especially relevant to DSGW Architecture.
For DSGW, rural and Tribal healthcare design is not a smaller version of urban healthcare design. It requires a different approach.
Facilities must serve large geographic areas with limited resources. Every square foot has to work harder. Departments need to share space efficiently. Technology must be carefully integrated. Buildings must support staff recruitment and retention, accommodate future services and reflect the communities they serve.
At Riverwood Healthcare Center in Aitkin, DSGW designed a 66,500-square-foot expansion that includes Minnesota’s first Hybrid Operating Room in a Critical Access Hospital. By combining advanced imaging and surgical capabilities in one room, Riverwood can perform more complex procedures locally, reducing the need to transfer patients to metropolitan hospitals.
Our work with Tribal Nations brings another important dimension to healthcare planning and design.
The 50,716-square-foot expansion of the Bad River Health and Wellness Center was planned around the community’s physical, mental and spiritual health. It expands dental, behavioral health, community health, rehabilitation, laboratory, optical and pharmacy services while adding an aquatic center, fitness areas, a walking track and flexible spaces for community use. The original center was designed with future growth in mind, allowing this expansion to build on a long-term plan rather than forcing the Tribe to start over.
At the Red Cliff Community Health Center, DSGW worked with Tribal citizens, clinic staff, Indian Health Service and government partners to create a center grounded in place and culture. Reclaimed Northern White Cedar, which is sacred to the Red Cliff Band of Lake Superior Chippewa, was incorporated into the facility. The center also serves both Tribal citizens and people from the surrounding region--an uncommon operating model that required careful planning.
Each of these projects responds to a different community, care model and set of operational demands. The common thread is listening first. We then translate what we learn into efficient spaces, stronger clinical workflows and facilities prepared for what comes next.
In rural and Tribal healthcare, design decisions have measurable consequences. They affect which services can be delivered locally, how efficiently clinical teams can work, whether a facility can adapt as needs change—and how many patients must leave their community to receive care.
Keeping more care local isn’t simply a design goal. It is the measure of whether the design works.
Riverwood Healthcare Center Bad River Health & Wellness Center Bad River Band of Lake Superior Chippewa Cliff Band of Lake Superior Chippewa Indians
