A rendering of the proposed new main entrance to Three Rivers Hospital in Brewster.
‘Modernization’ proposal will be on Nov. 3 ballot
Three Rivers Hospital is back with another bond issue proposal that would fund wholesale modernization of the 77-year-old Brewster facility.
A $48 million request will be on the Nov. 3 ballot for voters in Okanogan-Douglas Public Hospital District No. 1, which includes the Methow Valley. District residents will be asked to approve a 30-year bond issue that would require an assessment of about 73 cents per $1,000 of property value, or about $219 per year for a home valued at $300,000.
In November 2025, a majority of voters in both Okanogan and Douglas counties approved a proposed $45 million, 30-year bond issue to pay for a “hybrid renovation” plan for Three Rivers Hospital, but that didn’t meet the 60% “supermajority” approval needed for passage.
Three Rivers proposed a complete rebuild of the hospital for $72 million in 2023, but that proposal failed to get a majority of votes. The subsequent scaled-back proposals in 2025 and 2026 have been promoted as necessary for substantial renovations and improvements of existing facilities.
According to a press release, the modernization project “would preserve and maximize the hospital’s existing building while making critical upgrades to infrastructure, patient spaces and clinical areas.” It would include a two-story addition connecting the hospital to Three Rivers Family Medicine.
Three Rivers currently provides emergency care, inpatient and transitional care, surgery, imaging, laboratory services, rehabilitation therapy, women’s health, orthopedics, family medicine, and other services.
“But much of the hospital’s infrastructure and some of its clinical spaces are aging,” the press release said. “Electrical, plumbing, HVAC and other building systems require more investment to meet the demands of modern healthcare. Some patient and clinical areas also no longer provide the space, privacy, or workflow needed for today’s standards of care.”
“We have a responsibility to make thoughtful investments that allow [the hospital] to remain here for the people who depend on it,” Chief Executive Officer Scott Graham said in the release.
Major objectives
Major components of the project would include a centralized entrance for hospital and clinic services to improve access; a dedicated ambulance bay connected to the Emergency Room; updating inpatient rooms with private showers; expanded operating rooms to meet current technology standards and state requirements; expanded radiology space to accommodate modern imaging equipment; an upgrade to the electronic medical record system, improving communication and medical record sharing between Three Rivers and larger organizations like Confluence Health, and allowing patients to take advantage of the MyChart patient portal; replacement and modernization of aging electrical, plumbing, medical gas and HVAC systems; and accessibility and other improvements throughout the facility, such as moving the laboratory to a larger location closer to the other services.
Many of the same objectives were cited in the 2025 bond issue proposal.
The project is intended to make better use of the hospital’s existing footprint while “addressing the infrastructure and space limitations that have developed over decades of technology advancements and healthcare regulation changes,” the press release said.
According to the release, “the current proposal builds on years of community conversations and planning about the future of local healthcare. The updated proposal reflects that ongoing work and is intended to provide a responsible path for modernizing the existing hospital, rather than starting over with a completely new facility.”
“We appreciate everyone who takes the time to reach out to us and make their voice heard,” said Board Chair Mike Pruett, a Methow Valley resident. “We want to know what our district residents and patients think. Behind the scenes, Three Rivers has been working with the other two hospitals in Okanogan County regarding what the future of health care should be and how we can work together. Those conversations are continually happening to preserve access to care in a county as large as ours.”
If approved, construction is currently anticipated to take approximately two years, according to the release. In the meantime, the hospital will continue to pursue grants, loans and other funding opportunities that could help offset the cost of the project.
Info sessions
The hospital will provide additional information about the proposed project at community meetings this month and in October. Hospital representatives will be at the Methow Valley Health & Wellness Fair at Winthrop Barn on Thursday, Oct. 1, from 1-3 p.m.
Three Rivers provides 24-hour emergency care and has 25 patient beds. It’s a critical-access hospital, a designation for small hospitals in rural communities to ensure people can get emergency care without traveling long distances, according to Best.
The designation addresses care for trauma patients, who are stabilized and transferred to larger hospitals. It provides better reimbursement from Medicaid and Medicare. (The other two hospitals in the county, Mid-Valley in Omak and North Valley in Tonasket, are also critical-access hospitals. All three were built with federal funds in the 1940s.)
In 2025, a group calling itself the Okanogan Health Care Planning Group opposed the bond issue will proposing an alternative to the Three Rivers renovation. The group of retired health care professionals and health care consultants, all based in the Methow Valley, favored a centralized medical center in Okanogan County. A spokesperson for the group indicated that it will have input about this year’s proposal as well.
For more information, visit threerivershospital.net/bond.
