When CIHA’s Public Relations Department was preparing for the final Flashback Friday post to complete the “A New Generation of Care” campaign celebrating the 10-year anniversary of opening the doors of the new Cherokee Indian Hospital Authority facility, they envisioned a colorful collage of “first day” photos—some grand gesture showing happy employees and smiling patients.
When PR staff started to look for old newspaper articles or social media posts that would contain that content, they came up empty. As they dug into archived files and old photos on storage drives at CIHA, again, they came up empty again. The only thing the PR department was able to find that marked the official move or first day in the new facility was a single social media post shared on CIHA’s Facebook page.
And honestly, that is perfectly fitting because it is beautifully indicative of the intent and purpose the facility held 10 years ago. It also shows that even a decade ago, CIHA leadership was committed to our Guiding Principle, ᏂᎯᏣᏤᎵ (Ni hi tsa tse li), meaning “it belongs to you.”
From the very beginning of the process that led to a new hospital facility, the weeks, months, and years that went into it were all patient-focused. Every single aspect of planning, design, purpose, intent, and reason—literally every step of the journey—ensured that the health and prosperity of the next seven generations of the Eastern Band of the Cherokee Indians remained not just the central theme, but the only “why” behind the project.
In 2008, four years before a location was even selected, the Health Board determined that it would be more feasible and financially responsible to build a completely new Cherokee Indian Hospital rather than continue attempting to remodel the aging facility. This decision demonstrated intentional financial stewardship and a commitment to creating a health system capable of serving future generations, not merely reacting to immediate needs.
In 2012, when the plans for the new site were finalized, it opened the door for extensive planning, analysis, and community involvement. CIHA leadership stressed that nothing would move forward without deep listening. Geological surveys, engineering assessments, and cost-analysis work began. At the same time, CIHA started shaping a financing strategy that would protect the Tribe’s long-term fiscal health.
Dozens of community input sessions were held. Tribal and hospital leadership repeatedly emphasized that the new hospital belonged to the community, and its design must reflect what Cherokee people needed to heal. Planning teams refused to begin design work until the community had fully spoken into the vision. These meetings shaped the earliest phases of the project, including programming for the new facility, schematic design, and eventual development of construction documents.
Even in 2012, CIHA CEO Casey Cooper was clear that the goal of the new hospital was to ensure patients would enter a space that promoted healing rather than stress. He also emphasized that CIHA was reorganizing its workflow and improving primary care long before moving into a new building, because organizational culture needed to be aligned with the purpose of the new facility. Staffing and practice changes were already underway to strengthen population health efforts years before the building itself took shape.
By 2014, when the groundbreaking was held, financing had been secured through First Citizens Bank with a 10-year, $75 million note at a rate of 1.95 percent. CIHA and Tribal leadership had been adamant that the project would only proceed if it was fiscally right for the Tribe. That commitment shaped every step of financing negotiations.
The Tribe and CIHA selected Robins & Morton as the construction manager through an intentional process focused on partnership and alignment with Cherokee values. The project used an Integrated Project Delivery approach in which CIHA, Robins & Morton, subcontractors, and Design Strategies collaborated from the beginning, sharing risks, responsibilities, and solutions. This structure promoted efficiency, communication, and honesty—qualities essential for a health facility meant to serve generations. This unique model spread the risks across parties involved, strengthening the project and creating a foundation for guaranteed success.
Design Strategies was awarded the architectural contract specifically because of their demonstrated commitment to honoring Cherokee culture, language, and identity. Architect Ben Rook noted that the team refused to begin drawing until they deeply understood what the community wanted. The 14 community design meetings held during this phase were described by Rook as the defining difference in how Cherokee approached this project compared to other health systems. The original concept for the Rotunda entrance was to mimic a vase shape as a tribute to traditional pottery; however, the design evolved into Maddie’s basket after Rook was inspired by spending time in the community.
Putting ᏂᎯᏣᏤᎵ into practice, cultural intentionality extended into every detail, including outfitting the new facility with Cherokee art. Children from the Cherokee Youth Center participated in a three-part art installation project that included photography, drawings, and a hanging mobile. The children even visited the construction site so their artwork could reflect a true understanding of the space.
By 2015, more than 30 Cherokee artists attended a Healing Art planning meeting with Distinctive Art Source. Their work remains visible throughout the hospital today, shaping the healing environment and preserving culture through color, symbolism, and storytelling.
The ceremonial ribbon-cutting held in October, a month before opening the doors of the new facility to patients, hosted hundreds of community members who took part in the celebration not as bystanders but as active participants. Community tours were regularly held to ensure patients could familiarize themselves with the facility and ease the transition when the new hospital officially began serving the community.
The completed Cherokee Indian Hospital Authority stands today as a gathering place, a healing environment, and a reflection of Cherokee values. Every choice was driven by the responsibility to the next seven generations and represents the physical expression of a long-held commitment to improve population health, preserve culture, and safeguard the wellbeing of Cherokee people.
So, when PR staff wasn’t able to locate pictures or any big ceremonial, definitive marker of when the new facility began to serve patients on November 16, 2015, aside from a single post on social media, it made complete sense. Because for the seven years leading up to that moment, the purpose and focus were always the patient. It was always to deliver care without compromise.
So, after the final boxes were moved and the doors of the new facility opened, CIHA staff began providing a new generation of care to the community as they had set out to do years prior. As they fulfilled the original intent and vision the new facility was built on, it was simply business as usual.
The true value of the new Cherokee Indian Hospital Authority is found in the people who brought the facility to life. The staff who have shown up every day with dedication and compassion, the patients who placed their trust in us, and the Cherokee community who shaped this facility long before its doors opened have each given this place its purpose.
The structure that CIHA now calls home is the living expression of a community committed to caring for one another. It is that commitment that has defined the past decade and it is that commitment that will guide the next seven to come as we continue to deliver a new generation of care.