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The Haywood County Hospital in Waynesville, North Carolina, was the first county owned and funded hospital in the state and the first hospital to receive a grant from the Duke Endowment. The building, built in 1927 with major additions in 1952 and 1958, is on the National Register of Historic Places. It served as a staple of, and exemplar of trends in, rural North Carolina health care for over 50 years. The hospital itself moved to what is now the Haywood Regional Medical Center facility in Clyde, North Carolina, in 1978. The building has been the home of the Haywood County Schools Central Office since 1981, but plans are in progress for a low-income senior housing project.

Haywood County Hospital - 1927 building

Haywood County Hospital - 1927 building

Rear of 1927 building with 1966 additions on the left and 1952 addition on the right

Rear of 1927 building with 1966 additions on the left and 1952 addition on the right

1952 and 1958 additions

1952 and 1958 additions

In 1916, Haywood County had seven doctors but no hospitals. The next year, a group of private citizens and donors established the Waynesville Hospital, Inc., which opened in a former hotel just in time for a local typhoid outbreak as well as the flu pandemic the following year. It remained in private hands until 1922, when it failed financially and was taken over by the county. Serious plans for a new building began in 1926, and a $100,000 bond referendum was passed by county citizens. Hospital construction was further funded by a $10,000 Duke Endowment grant (the first of its kind) and $2,200 in private donations, as well as $6,500 in county money. Architect Louis H. Asbury, Sr. was selected to design the building. The three-story Classical Revival structure was built in 1927 and opened on January 1st, 1928. The 45-bed hospital was state of the art for its time and similar to many hospitals of the era: classically impressive in design but constructed to be well-lit and ventilated (with many windows), easily cleaned (using materials such as tile and terrazzo), and fireproof. Over its first decade, “Haywood County Hospital staff treated 13,816 patients, 10,410 of whom were admitted for overnight stays, and delivered 810 babies.”[6]

Another Duke Endowment grant, for $6,000, paid for half of a Nurses’ Dormitory built in 1933 to house the women in training at the hospital. A stone retaining wall was also constructed in pieces in 1927, with Depression-era state and federal funding in 1933-35, and again sometime before 1968. 

The hospital was running out of room as early as the 1930s, though its capacity had increased to 75 patients. World War II put it in a near-crisis state due to missing staff. After the war, several state and federal programs (such as the Hill-Burton Act, also known as the Hospital Survey and Construction Act) allotted grant money and loans for hospital improvement programs. The Haywood County Hospital was one of 97 North Carolina institutions that received $47 million in funding under these programs. Another bond referendum was passed in 1951, this one for $225,000, to raise grant-matching funds. A 5-story addition was designed in the Modernist style – like most hospitals of the time - by Lindsey M. Gudger. (The lower two stories were below the first story of the 1927 building due to ground elevation changes.) This building was designed to be simple, efficient, and inexpensive, while remaining practical, hygienic, and well-lit and ventilated. Newer construction methods allowed larger windows and open spaces within the building. This addition was built perpendicular to and centered on the 1927 building; its completion in 1952 resulted in a total hospital capacity of 100 beds. Another addition, designed by Foy & Lee Associates and completed in 1958, was built onto the end of the hospital’s new rear wing and left the complex with a total of 148 rooms. In 1966, additions were built onto the east and west wings of the 1927 building, including stair towers and, on the west wing, an ambulance garage.

The hospital moved to a new facility in Clyde, North Carolina, in 1979, and became the Haywood Regional Medical Center in 1997. This hospital has struggled with internal conflicts and financial struggles (once even temporarily losing its Medicare and Medicaid certifications), but has been doing well under the ownership of Duke LifePoint Healthcare, which bought the struggling facility in 2014. 

As for the original building, it has been home to the Haywood County Schools Central Office since 1981, as well as to the county Department of Social Services for a short time. The main building and grounds – but not the Nurses’ Dormitory, which is owned by the Smoky Mountain Center – were added to the National Register of Historic Places in 2018. The county has worked with two different developers over a nine-year period in attempts to sell the building and convert it into low-income senior housing, but, until 2019, the projects were denied the historic property and low-income housing tax credits they needed to get off the ground. As of August 2019, Landmark Properties, Inc. has been approved for the tax credits and bought the property; it is planning to turn the structure into housing upon the completion of Haywood County Schools’ lease at the end of 2020.

1) About Haywood Regional Medical Center; About Us; Contact Us, Haywood Regional Medical Center. Accessed February 28th 2020.

2) Bowling, Caitlin. Old hospital building needs a new lease on life, but takers are few, Smoky Mountain News. December 19th 2012. Accessed February 28th 2020.

3) Directions; Maps & Directions; About HCS, Haywood County Schools. Accessed February 28th 2020.

4) Dunn, Colby. County to sell old hospital for $1.2 million, Smoky Mountain News. November 24th 2010. Accessed February 28th 2020.$12-million.

5) Dunn, Colby. Old hospital to be repurposed into senior housing, Smoky Mountain News. January 19th 2011. Accessed February 28th 2020.

6) Fearnbach, Heather. Haywood County Hospital, National Register of Historic Places Inventory/Nomination Form, North Carolina Department of Natural and Cultural Resources. June 18th 2018. Accessed February 28th 2020.

7) Haywood County General Hospital. The Health Bulletin - North Carolina State Board of Health. February 1924. 6. The Health Bulletin, Volumes 38-39 (1923-1924). GoogleBooks,

8) Health Care; Live & Work, Haywood Chamber of Commerce. Accessed February 28th 2020.

9) Hendershot, Don. A New Chapter In Healthcare Across Western North Carolina – Duke LifePoint, Southeast Discovery. March 8th 2014. Accessed February 28th 2020.

10) Johnson, Becky. Abandoned hospital to find new purpose, Smoky Mountain News. January 6th 2016. Accessed February 28th 2020.

11) Johnson, Becky. Plan advances to convert old hospital to affordable lofts, Smoky Mountain News. March 16th 2016. Accessed February 28th 2020.

12) Johnson, Becky. Turning Haywood’s shuttered hospital into apartments hinges on tax credits, Smoky Mountain News. January 6th 2016. Accessed February 28th 2020.

13) Martin, Edward. How a hospital had to heal itself, Business North Carolina. March 2009. Accessed February 28th 2020.

14) Vaillancourt, Cory. Commissioners hopeful about future of historic hospital, Smoky Mountain News. January 10th 2018. Accessed February 28th 2020.

15) Vaillancourt, Cory. Haywood lands tax credits for historic hospital redevelopment, Smoky Mountain News. August 14th 2019. Accessed February 28th 2020.

16) Vaillancourt, Cory. Historic Hospital project inches forward, Smoky Mountain News. April 11th 2018. Accessed February 28th 2020.

17) Vaillancourt, Cory. Old Haywood Hospital receives favorable score in pursuit of tax credits, Smoky Mountain News. April 17th 2019. Accessed February 28th 2020.

18) Vaillancourt, Cory. Renewed push for Historic Haywood County Hospital redevelopment, Smoky Mountain News. December 19th 2018. Accessed February 28th 2020.

Image Sources(Click to expand)

Warren LeMay, Flickr (

Warren LeMay, Flickr (

Warren LeMay, Flickr (