In the early years, hospitals stuck close to central Gastonia, from an old house on Airline Avenue to a five-story building on Main Street.
But the focus shifted in 1973 when Gaston Memorial Hospital opened on a site in the eastern part of town.
Now, with about 3,000 employees and an annual budget of almost a half billion dollars, it's become one of the largest independently owned hospitals in North Carolina.
Last week, Gaston Memorial's board of directors voted to keep the hospital independent, nixing possible mergers or affiliations with Carolinas HealthCare System or Novant Health.
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Gaston Memorial already has collaborative relationships with the two giant health care systems and officials didn't want to rock the boat.
“One thing we looked at was that if we chose one (system), we'd be saying no to something else,” said hospital president and CEO Wayne Shovelin. “This was not an easy decision. The board took its time. And everybody is very comfortable with the decision.”
Shovelin said the merger issue came up months ago as the hospital began working on its five-year strategic plan.
The hospital hired a consultant who was asked to include Carolinas Healthcare and Novant Health in discussions about a merger or affiliation. Both systems made presentations to the board.
Carolinas HealthCare System is Charlotte's largest health care provider. In addition to Carolinas Medical Center in Charlotte, the system's properties include CMC-Lincolnton, the new Carolinas Rehabilitation-Mount Holly, Kings Mountain Hospital and Cleveland Regional Medical Center in Shelby.
Novant Health owns several hospitals in the Charlotte area, including Presbyterian Hospital and Presbyterian Orthopedic Hospital in Charlotte, Presbyterian Hospital-Huntersville and Presbyterian Hospital-Matthews.
Over the years, Shovelin said, Gaston Memorial has started such services as the open-heart surgery program through the Sanger Clinic, part of Carolinas HealthCare, and the neonatal intensive care unit, staffed with doctors affiliated with Presbyterian Hospital.
“There's so much intertwining of relationships,” Shovelin said.
Maintaining the balance with the two systems was one factor in the decision to remain independent, he said. Capital spending was another.
While some hospitals have merged because they had difficulties of one kind or another, Shovelin said “we do not have a problem.”
He said Gaston Memorial is financially strong with an A-plus bond rating.
Merging with a larger health care system would add to the hospital's ability to finance capital projects. But Shovelin said consultants have indicated Gaston Memorial is in a good enough position to “do things to maintain our viability, strength and growth.”
Shovelin said another significant factor in the decision to stay independent was diverse and helpful feedback from the medical community.
Recruiting and retaining doctors is one of the hospital's biggest challenges. Shovelin said over the past decade or so the hospital has recruited more than 300 new doctors.
He said Gaston Memorial spends about $25 million a year on new equipment and technology and has an ongoing program of remodeling each wing.
Board chairman Robert Blalock said the decision was made with the participation of the medical community.
“They were very much on board and supportive,” he said.