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. Equipment that produces a lot of heat, like server racks and refrigeration, is cooled with water rather than air, so that heat can be captured where it is created and transferred to the hot water the building circulates for heating. A tightly constructed exterior shell also reduces air leakage and limits the energy used to move air through the building.

PAE brought mechanical, electrical, plumbing, technology, and building analysis and modeling expertise together as one team, enabling decisions to be evaluated across disciplines and optimized for the project as a whole.

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.

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 the capacity of the hospital's backup generators.

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, sorting out which ones cannot stop during an outage, and understanding how building operations would change while utility power was down.

The team at PAE worked to design an electrical infrastructure that remains flexible and can take advantage of 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 hospitals, the most important design decisions are often driven by peak conditions, as those are 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.

Reliability must become part of the decarbonization strategy from the beginning.

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 sized to run consistently rather than cycling on and off, since frequent starts and stops 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 heating 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.

For healthcare owners pursuing electrification, reliability can’t be an afterthought. Decarbonization strategies must preserve the operational resilience essential to patient care.