The Daily Dig
Gov. Larry Rhoden helped break ground on October 20, 2026, on Freeman Regional Health Services’ new hospital and clinic in Freeman, South Dakota.
The building will sit on a single level and cover more than 48,000 square feet along Highway 81. Completion is anticipated in spring 2028, with an opening date still to be announced.
Earthwork was scheduled to start on October 19, 2026, with equipment mobilization anticipated on October 15. The project takes up 26 of FRHS’s 40 acres, between Sixth Street and 279th Street.
Small Bed Count, Full Program
The program is built around a 6 bed hospital and an emergency department open 24 hours, with a helipad on site.
A clinic will serve local providers and visiting outreach specialists. Diagnostic imaging, lab, procedural and therapy spaces will support both inpatient and outpatient care.
Planning for a replacement started back in 2018. The board weighed renovating the existing campus, but industry experts recommended building new because of aging infrastructure, limited space and a constrained site.
“We are grateful for the people and partners who are helping make this project possible as we strengthen healthcare for our communities,” said Courtney Unruh, CEO of FRHS.
The project team includes Avera, BWBR Architects, Journey Construction and Tegra Group as owner’s representative.
Paying Their Own Way
FRHS is financing the project independently, with Colliers providing financing guidance. The board’s financial analysis found that starting with the hospital and clinic was necessary to provide adequate funding and cash flow for future campus development.
Those future phases include plans for a nursing home and more senior living. Timing will depend on financial feasibility, community needs and FRHS’s long term priorities.
In the Governor’s office announcement, Rhoden connected the project to rural health care across the state. “If we want rural South Dakota to thrive, we have to make sure our communities have access to health care they can depend on,” he said.
Snapshot:
Project: Freeman Regional Health Services hospital and clinic (Phase 1 of new healthcare campus)
Owner: Freeman Regional Health Services (FRHS)
Owner Type: Independent community hospital with Avera affiliation
Location: Highway 81 between Sixth Street and 279th Street, Freeman, SD
Sector: Healthcare
Site: 26 acres of a 40 acre property
Size: 48,000+ sq. ft., single level
Scope: 6 bed hospital; emergency department open 24 hours; helipad on site; clinic for local providers and outreach specialists; diagnostic imaging, laboratory, procedural and therapy services
Architect: BWBR Architects
Project Team: Journey Construction (role not specified)
Owner’s Representative: Tegra Group
Financing Guidance: Colliers
Partner: Avera (architectural, legal and finance expertise)
Financing: Independently financed by FRHS
Planning Start: 2018
Mobilization: Anticipated October 15, 2026
Earthwork Start: Scheduled October 19, 2026
Groundbreaking: October 20, 2026, with Gov. Larry Rhoden
Completion: Anticipated spring 2028
Opening Date: To be announced
Phase 1 Also Included: Upgrades at Dewald Street and Walnut Street village (The Villages) bringing assisted living services into the independent living community
Future Phases: Nursing home and additional senior living options
State Context: HB 1044 funded South Dakota’s Rural Health Transformation Program; over $100 million invested statewide, set to approach $1 billion over the next 5 years. Not identified as a funding source for this project, which FRHS is financing independently.
TheJobWalk Thoughts
Earthwork was scheduled for October 19, so foundations will likely go in during a South Dakota winter. Subs should price heated enclosures, blankets and cold weather concrete up front.
Don’t judge this scope by its 6 beds. The emergency department, imaging and procedural rooms typically bring medical gas, radiation shielding and dense MEP coordination, which is where risk on a small hospital usually hides.
A nursing home and more senior living are planned for later phases, with timing undecided. No procurement plan has been announced, but owners on phased campuses often lean on teams that delivered the first phase.
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