ZGF Architects garnered little from precedents when designing a seismically resilient, six-story, 183,000-square-foot hospital expansion in Astoria’s tsunami inundation zone.

“As far as the resiliency side of it, there isn’t a precedent for this kind of facility,” project architect Michelle Checkis said. “At least in the United States, we weren’t able to find another medical facility that was doing this or had this kind of resiliency.”

Resiliency is paramount for Columbia Memorial Hospital, a federally designated Critical Access Hospital that is pinched between the Columbia River and Coxcomb Hill in Astoria. The hospital nearest to Columbia Memorial is 18 miles away in Seaside, and U.S. Route 101 between them is linked by seismically vulnerable bridges.

Now a major expansion is under way at Columbia Memorial. Crews led by general contractor Skanska are erecting steel.

“We’re getting out of the ground,” Checkis said.

And, crucially, above water.

Columbia Memorial officials issued a request for proposals in July 2020 after a 2017 report on 11 coastal hospitals from the Oregon Department of Geology and Mineral Industries reached an alarming conclusion: “Due to expected damage to pre-1995 hospital buildings including structural systems and non-structural components of hospital buildings … none of Oregon’s coastal hospitals are ready to operate immediately after a Cascadia disaster.”

Columbia Memorial was built in the 1970s and later received several expansions. Hospital officials worked with University of Washington researchers to precisely model the effects of a tsunami in the area. The results: The bottom two floors of Columbia Memorial are expected to be inundated in a worst-case earthquake and tsunami.

So ZGF — with the help of Degenkolb Engineers — went vertical. Building on lessons learned from the Gladys Valley Marine Studies Building in Newport, ZGF designed a staircase leading to a rooftop shelter. Overall, safe refuge areas at the hospital expansion will be able to protect up to 1,900 people, ZGF estimates.

Acute patient care rooms were moved to higher floors, except for the emergency department, which must remain on the ground floor for everyday access. The greatly expanded emergency department will meet a crucial need for more ER capacity on the North Coast.

Also, mechanical and electrical systems are located above the projected maximum tsunami inundation line. So is a rooftop helipad; it replaces a landing spot at ground level, only 20 feet above the grade of the Columbia River.

A swooping mass-timber entry pavilion provides an entry to the existing hospital structure and a nod to Clatsop County’s timber heritage.

Perhaps the project’s biggest hurdle came in April 2025 when Trump administration officials canceled a previously awarded $20 million resiliency grant from the Federal Emergency Management Agency.

The status of the 2023 grant remains unclear. In March, FEMA sent the state Department of Emergency Management a letter indicating it could still be funded.

Meanwhile, the hospital’s foundation has raised nearly $8 million of a $10 million goal to support completion of construction.

Hospital officials “have stayed hopeful that the grant program would be revived, while also searching for other avenues of funding, as well as cost savings in the project,” hospital spokeswoman Sarah Bello stated in an email. “There have been no major design changes, and the resiliency aspects remain part of the expansion despite the uncertainty with the BRIC grant.”

On the Boards is a 91��Ƶ feature offering a look at projects in Oregon and Southwest Washington being tackled by local architecture firms. To have your firm’s projects considered, contact the 91��Ƶ at newsroom@djcOregon.com.

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As mass timber pushes into more project types, contractors and advocates are pursuing its inclusion in designs for one of the few construction sectors showing growth: health care.

Mass timber has long been used in office buildings and residential structures as supporters credit it for appealing aesthetics, faster tilt-up times, and competitive costs and performance. Health care is a tougher sector to crack, with strict code requirements for hospitals and unique considerations related to patient health.

Yet those hurdles have done little to dissuade mass-timber backers, who see a growing health-care sector that comprises one-sixth of the $30 trillion U.S. economy while commercial real estate has pulled back dramatically.

“We’re going to see more (mass-timber) projects that are health care, and we’re going to see larger portions of the projects that are mass timber,” said Dean Lewis, director of mass timber and prefabrication at Skanska, one of the large contractors working with the material.

Health care was a central topic at this week’s International Mass Timber Conference in Portland. Lewis covered health care as an emerging market for mass timber, while University of Oregon researcher Mark Fretz discussed “Mass Timber in Health Care and Infection Control.”

It makes sense for contractors and other industry insiders to pursue health care projects, said Iain Macdonald, director of the Tallwood Design Institute, a collaboration between Oregon State University‘s colleges of forestry and engineering, and the UO College of Design.

“Commercial is kind of a stagnant construction sector, and life sciences is one that’s growing,” he said.

While clients continue to rely on traditional concrete-and-steel construction for key hospital functions, the use of cross-laminated timber (CLT) and similar products in health care facilities is growing.

On the Oregon Coast, ZGF Architects‘ design for the Columbia Memorial Hospital expansion in Astoria uses mass timber for the entryway’s roof and other structural elements. The 183,000-square-foot facility will also include safe refuge areas in the event of a tsunami and acute care patient rooms on upper floors. The expanded hospital is slated to open in 2027.

The foyer of the new St. Charles Cancer Center in Redmond, a 53,000-square-foot facility that will open later this month, is made from mass timber.

The University of Oregon’s $71 million Ballmer Institute for Children’s Behavioral Health, a 54,000-square-foot building under construction in Portland and designed by ZGF, will feature mass timber extensively, as does a $47 million building designed by Hacker for Mosaic Community Health in Bend.

In Lakewood, Washington, a behavioral health facility designed by HOK topped out in March.

“The mass-timber design serves a number of goals,” Loren Supp, HOK’s design principal in Seattle, stated in a news release. “It highlights the natural beauty of western Washington and its evergreen forests. It reinforces the state’s commitment to environmentally friendly design, and it creates a warm and calming environment that benefits well-being.”

Advocates point to the well-studied psychological benefits of inhabiting timber buildings. UO researchers last year published a study finding CLT had fewer viable bacteria than a plastic sample. The researchers also found that volatile organic compounds in CLT decreased over time.

Industry and UO researchers are studying the possibilities for expanding use of mass timber in hospitals.

“You’re not going to have it in the (operating rooms), but there are distinct advantages to having it in patient rooms, waiting areas and that sort of thing,” Macdonald said.

Industry officials are also studying mass timber’s potential for other uses, including warehouses, data centers and military bases.

Portland has long been the epicenter of mass-timber construction in the United States. Portland is home to notable projects such as the Mississippi Building, an all-wood office structure designed by Waechter Architecture; the 12-story Julia West House, designed by Holst Architecture; and Carbon12, an eight-story mixed-use building designed by Kaiser + Path.

Extensive use of CLT in the new Portland International Airport terminal marked a new chapter for mass timber in major public projects. And even some never-built concepts, including Framework and the Spar, led to important research for building tall wood structures.

In health care, Skanska’s Lewis said clients don’t need to be persuaded — they’re eager to build with mass timber.

“A lot of the clients, especially in the Pacific Northwest, harken back to our affinity for wood,” Lewis said.

Clients point to sustainability and valuing the experience of being inside the building.

“It seems like the ones that want to do timber are really invested in trying to create a space that they feel is above what they’ve seen in the market,” Lewis said.

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