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Rural health care modernization can mean a renovation, an expansion, or replacing an entire hospital—and each scope must be planned around the care already being delivered. Journey Construction’s South Dakota and Iowa examples show how facility projects can combine new clinical space with staged work and operational coordination. SDAHO reports that Journey’s portfolio includes more than 1,700 health care projects, nine critical access hospitals, and 18 rural health care projects; those are figures reported in its September 29, 2026 feature, not independently audited totals.
What does rural health care facility modernization involve?
Modernization is not one standard construction project. A hospital may renovate existing rooms, expand a facility, or replace an aging building with a new one. The appropriate scope depends on the services the organization needs to support and the constraints of its site and operations. Journey Construction’s portfolio includes both replacement hospitals and expansions, illustrating that the term covers different kinds of work.
For rural facilities, construction planning also has to account for continued patient care. SDAHO’s feature on Journey describes considerations including project phasing, infection prevention, utility coordination, patient and staff safety, commissioning, and occupancy. These are planning factors, not a substitute for project-specific engineering, clinical, regulatory, or financial review.
How can a rural hospital build while staying operational?
The project team needs to coordinate construction with the facility’s clinical and support operations. In practical terms, planning should address which services and spaces must remain available during each phase, how work will be separated from active care areas, and how utility changes and safety controls will be managed. Commissioning and occupancy planning matter as the new or renovated areas are prepared for use.
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Phasing is especially important when work affects multiple services or when an organization is transitioning to a replacement facility. SDAHO quotes Mark Burkett, CEO of Platte Health Center Avera, praising Journey’s coordination of project phases and its work to keep the facility fully operational while minimizing disruption to services, staff, and the public. This is a testimonial reported by SDAHO, not an independent performance evaluation across Journey’s projects.
Journey vice president of operations Brent Smith describes the company’s approach as allowing health care leaders to focus on care while Journey manages construction complexity, risk, and disruption. That statement reflects the company’s stated approach; actual continuity plans and responsibilities need to be defined for each project.
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What does a replacement critical access hospital look like?
Avera Missouri River Health Center in Gettysburg, South Dakota
Journey lists the Avera Gettysburg project as a completed 19,000-square-foot replacement critical access hospital—not simply an interior renovation. The project page identifies patient rooms, emergency services, therapy, outpatient clinical services, radiology, laboratory, and support space. SDAHO describes the project as a replacement intended to support emergency and primary care close to home. These descriptions establish project scope, not measured effects on patient outcomes or access.
Avera Merrill Pioneer Community Hospital in Rock Rapids, Iowa
SDAHO describes this as a replacement critical access hospital delivered during an organizational transition. Its account emphasizes planning and coordination around clinical needs and patient experience, underscoring why a replacement project requires decisions about operations as well as the building itself.
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How can modernization combine hospital and long-term care services?
Avera Gregory Hospital and Nursing Home in Gregory, South Dakota
Journey’s health care portfolio describes Avera Gregory Hospital as a 63,000-square-foot facility with a 24-hour emergency room, clinic, diagnostic imaging, and surgical suite. SDAHO describes the broader development as bringing acute care, emergency services, imaging, surgical services, and long-term care together. In a June 23, 2023 company-hosted article, Journey says the development also included a connected 27,000-square-foot nursing home for 30 residents. The hospital and nursing home figures describe distinct parts of the broader development.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What should a facility consider before choosing a project scope?
- Services to support: Identify current and anticipated clinical functions and the spaces and utilities they require.
- Continuity of care: Decide which services must remain available during work and how transitions between phases will be managed.
- Safety and infection prevention: Plan controls for active care areas, construction zones, patients, staff, and the public.
- Utilities and commissioning: Coordinate infrastructure changes and verify that completed systems and spaces are ready before occupancy.
- Schedule and procurement risks: Consider how project sequencing and materials or equipment coordination could affect the schedule; the available project descriptions do not establish comparative cost or schedule performance.
- Future service needs: Evaluate whether renovation, expansion, or replacement best fits the facility’s intended functions and long-term plans.
Journey’s portfolio and SDAHO’s account provide examples of project types and construction-planning considerations. They do not establish that modernization by itself improves clinical outcomes, lowers operating costs, boosts recruitment, or causes better access to care.
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