SMITHFIELD — On a bright and chilly morning, laughter and people in scrubs filled the emergency department during training sessions about a month ahead of the opening of the community’s first hospital.
“We get asked a lot if we’ll be open 24/7, and I think it speaks to the fact that this community has never had access to 24/7 care before,” Jessica Macalino, the hospital’s president, said during a tour. “Once we turn the lights on, we never turn them off again.”
A ribbon-cutting ceremony — with 400 guests expected, including Gov. Glenn Youngkin — is set for 3 p.m. Thursday. Riverside Smithfield is targeting Jan. 6 as the first day to receive patients.
In the meantime, equipment installations, finishing touches, testing and training are ongoing.
One challenge in organizing and training a new team is bringing together the 70 people who will staff the ER who may not have worked together before, said Kristy Makula, the emergency department’s director. She’s been overseeing staff training and team-building events, including a hospital-wide scavenger hunt.
Makula is joining Riverside Smithfield from Riverside Regional in Newport News, as are many others. The clinical team includes Dr. Justin Billings, the hospital’s inaugural chief medical officer. Billings said the hospital’s opening will eliminate a medical desert.
The emergency department waiting area at Riverside Smithfield Hospital. (Nate Delesline III/The Virginian-Pilot)
In its 2022 project approval letter, the state health department agreed with the assertion of local leaders and residents that Smithfield and Isle of Wight are medically underserved. State officials said they received nearly 2,100 letters and emails of support for the project.
Saleema Karim, an associate professor in the Department of Health Administration at Virginia Commonwealth University’s College of Health Professions, said structural and economic challenges can make it difficult to deliver and sustain health care in more rural communities.
“Many rural communities have an aging population with a high proportion of Medicare and Medicaid patients, as well as higher rates of low-income households,” Karim said in an email. “This payer mix, combined with consistently lower patient volumes, places significant pressure on rural hospitals’ financial stability.”
Kristy Makula, Riverside Smithfield Hospital’s emergency department director, stands next to an emergency department bed. Makula will lead a staff of 70 people when the hospital opens next month. (Nate Delesline III/The Virginian-Pilot)
Additionally, Karim said, workforce shortages and recruiting and retaining clinicians may be a challenge. Reimbursement changes and rising operational costs are also a concern.
But on the upside, Karim said, “rural providers are leveraging telehealth and other digital tools to expand access to care, especially for specialty services that would otherwise require long travel times. Additionally, investing in the healthcare workforce that wants to work in rural communities can help to create capacity to support rural residents.”
Isle of Wight had an estimated population of about 41,000 people in 2024 and is expected to grow to over 50,000 by 2050, according to the University of Virginia’s Weldon Cooper Center for Public Service.
In addition to the 24/7 emergency department, Riverside Smithfield has 34 inpatient beds, a 10-bed intensive care unit and four operating rooms.
An inpatient room at Riverside Smithfield Hospital. (Nate Delesline III/The Virginian-Pilot)
With the opportunity to design a hospital from the ground up, the leadership sought feedback from a variety of stakeholders. One of the design choices was to limit the use of curtains to separate spaces. The post anesthesia care unit, for example, has all private rooms with doors instead of large bays divided by curtains. There’s also a pass-through door between rooms to make it easier for one nurse to care for two patients simultaneously.
“The only place we have curtains is in some of the bathrooms for the showers,” Macalino said. “Outside of that, we’ve done integral blinds everywhere. So it allows for patients to have privacy but we can also have visibility as patients are recovering.”
Natural light, photos and art from around Smithfield and Isle of Wight fill the halls.
The hospital expects to employ 324 people on its opening day.
A separate facility on the Smithfield campus, the Jamison–Longford Medical Office Building, also recently opened. The building has 40 exam rooms and will accommodate cardiology, gastroenterology, orthopedics, urology, vascular specialists and physical therapy.
An operating room at Riverside Smithfield Hospital. The hospital is slated to open in early January. (Nate Delesline III/The Virginian-Pilot)
The hospital and medical office building are a $300 million investment, a spokesperson for the health system confirmed.
Riverside Smithfield is hosting a public open house and self-guided tour from 1–4 p.m. Sunday. The hospital is about 5 miles from downtown at 19339 Benn’s Grant Blvd.
Nate Delesline III , nate.delesline@virginiamedia.com
https://www.pilotonline.com/2025/12/04/smithfield-hospital-preps-debut/
