Investing in Community Well-Being: The Tsali Care Center Story

More than 3.7 million people 50 and older live in the state of North Carolina, the ninth-highest number among all states and the District of Columbia. When compared to all fifty states, North Carolina is ranked 24th in Long-Term Care and 32nd in the country’s health rankings. Twenty-eight percent of the state’s seniors live alone. This makes the need for quality housing options for these and all seniors very important.


The Cherokee Indian Hospital Authority (CIHA) in partnership with the Eastern Band of Cherokee Indians saw a need to better care for seniors in Western North Carolina and together made the investment in the Tsali Care Center. This investment not only signifies a commitment to the well-being of the local community but also marks a pivotal moment in healthcare for all of Western North Carolina.


The Tsali Care Center, nestled in the heart of Cherokee, North Carolina, is more than just a long-term care facility. It’s a beacon of hope and care for seniors in need of long-term care or skilled nursing home services. While it is part of the CIHA, the Tsali Care Center is dedicated to serving any and all seniors who require its services, regardless of their background or affiliation. Designed through the lens of the CIHA Guiding Principles, the new facility was intentionally crafted to provide a stigma-free and vibrant environment for aging.


The decision to invest in the Tsali Care Center was driven by a deep-rooted commitment to community well-being. The CIHA and the Eastern Band of Cherokee Indians recognize the importance of providing high-quality, compassionate care to seniors in a comfortable and nurturing environment. By expanding and upgrading the Tsali Care Center, it ensures that seniors in Western North Carolina have access to the best possible care.


Adjacent to Cherokee Indian Hospital, the new, $120 million, 135,000-square-foot Tsali Care Center will stand two stories and consist of 120 rooms. The featured room options for residents seeking skilled nursing includes 80 private resident rooms with bathrooms, each sectioned into households. The households will have 20 rooms, forming a smaller community within Tsali. Each community household boasts shared dining and living spaces to keep residents active and involved.


The new facility has been designed to include 20 private resident rooms with bathrooms for the memory care unit. This section of the facility features dedicated spaces specifically designed to best serve the needs of residents needing specialty care.


Tsali will also include 20 private resident rooms with bathrooms to meet the needs of residents seeking assisted living care. These rooms feature a small kitchenette and cafe table dining in each resident room, ensuring residents maintain independence, while also having access to care they need. The Assisted Living section of Tsali includes a large, shared dining as well as living and activity spaces for community programs and interactions.


Tsali Care Center’s design is centered around bolstering shared congregate spaces such as large community rooms, friends & family areas with a bistro, and multiple outdoor courtyards for residents to enjoy the fresh air or even watch the elk graze. There are covered porches off both shared dining areas and living spaces, activity spaces with technology access, and a spiritual room to provide residents with a quiet, private space.


The dialysis center will be housed within the new center, providing a direct connection for residents while also having a separate entrance for outpatient treatments. A new Adult Day Services Program will be opened to the community, integrated into the facility to share program services.

This investment is not just about bricks and mortar; it’s about investing in the future of our community. The Tsali Care Center will not only provide essential healthcare services but also create jobs and stimulate the local economy. By supporting the Tsali Care Center expansion, the Eastern Band of the Cherokee Indians are investing in the well-being of the community for generations to come.


Keeping in mind the potential economy impact of the facility, designers enhanced workspaces to ensure that Tsali Care Center meets the Cherokee Indian Hospital Authority’s goal of being the employer of choice for Western North Carolina. Staff break areas are oversized and central, secluded from resident spaces to ensure a balance during the workday and even include a dedicated staff covered porches. To support CIHA employee’s continuing education, the new facility was designed to include a training room for teaching equipped with computer workstations, and a simulation lab for professional development opportunities.


Tsali Care Center is a testament to the CIHA’s commitment to innovation and excellence in healthcare. The facility is equipped with state-of-the-art technology and staffed by a team of dedicated healthcare professionals who are committed to providing the highest level of care to every resident.


The new Tsali Care Center Facility is scheduled to open in Fall of 2024. For more information about the new facility, to inquire about job openings, or to schedule a tour for yourself or a loved one, visit

Click Here to view a virtual tour of the new Tsali Care Center featuring architectural renderings.

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