As building electrification becomes more common, healthcare facilities present a distinct set of design challenges. Hospitals in rural settings have additional layers of stress, where facilities often serve large geographic areas and act as a community’s primary point of care. For these hospitals in particular, decarbonization must be planned around the need for reliable, continuously operating systems that support patient care and emergency readiness.

Samaritan Healthcare’s new replacement hospital in Moses Lake, Washington, offers a useful example. The 50-bed facility is nearly all-electric, with natural gas used only for kitchen cooking—a strategy that supports both environmental and long-term financial sustainability given Moses Lake’s cost-effective electricity. Electric boilers, chillers, and a heat-recovery system work together to minimize energy use, while water-cooled data racks and refrigeration equipment capture heat at its source and transfer it to the building’s heating-water loop. A tightly constructed building envelope also reduces air leakage and limits fan energy. PAE provided mechanical, electrical, plumbing, technology, and building analysis and modeling services for the project.

The work showed how quickly electrification becomes an infrastructure question in healthcare, especially when the building has to support continuous care through seasonal peaks, outages, and long-term growth. What’s more, rural hospitals often serve large regions, with fewer nearby alternatives if services are interrupted. They also need facilities that can adapt as community needs change, particularly in growing areas where healthcare demand may outpace older infrastructure.

Infrastructure Strategy for Healthcare Electrification

At Moses Lake, supporting an all-electric hospital required the team to closely examine how the facility would use power under normal operations, seasonal peaks, and emergency conditions. Utility coordination was an important part of the early design process, requiring vital early decisions around emergency generator capacity.
Those generator decisions shaped many of the engineering choices that followed. Rather than increasing generator size, the team developed approaches that allowed critical systems to continue operating within the established capacity. That meant looking across systems, prioritizing critical loads, and understanding how building operations would change during an outage.

The team at PAE worked to design an electrical infrastructure that remains flexible and leverages cleaner energy sources as they become available through the regional grid. The hospital’s all-electric design means it can benefit directly as the utility’s power supply continues to evolve.

Peak Conditions Matter More Than Averages

Moses Lake’s climate of extreme heat in summer and extreme cold in winter also influenced the design.

For many buildings, annual energy use is the main performance story. For hospitals, the most important design decisions are often driven by peak conditions— the days when conditions are most demanding. A cold winter morning, a hot summer afternoon, or an outage during a peak load condition can reveal whether the building has enough resilience built into its systems.

At Moses Lake, the team evaluated heating and cooling loads to account for the extreme seasonal conditions. That analysis informed decisions around system capacity, redundancy, and backup operation.
In an all-electric hospital, these questions are especially important. Electric systems may be efficient year-round, but the design still has to account for the moments when the hospital is under the greatest stress.

Waste Heat Is Part of the Design

Hospitals produce heat through many of the same processes that support care. Sterilization equipment, IT cooling, food preparation, and domestic hot water systems can all contribute to internal heat loads.

The heat-recovery system at Moses Lake captures waste heat that would otherwise be rejected from cooling equipment and transfers it to the heating-water loop. This reduces the operating hours of equipment like primary chillers and electric boilers, helping extend their life. The system was carefully right-sized to operate consistently within its optimal range, limiting frequent starts and stops, which are a common source of wear and maintenance issues.

Re-using waste heat improves overall efficiency while reducing the amount of new energy required to serve the building’s thermal needs.

Design for the Conditions of Care

Samaritan’s new hospital is one example, but the lesson in electrification extends beyond Moses Lake. Owners need to consider utility capacity, emergency power, equipment loads, peak weather, and future growth.

Rural hospitals make that point especially clear. They often serve large regions, with fewer nearby alternatives if services are interrupted. They also need facilities that can adapt as community needs change, particularly in growing areas where healthcare demand may outpace older infrastructure.

As more healthcare owners pursue electrification, reliability must become part of the decarbonization strategy from the beginning. Healthcare systems must advance decarbonization without compromising the operational resilience essential to patient care.