The Smith Memorial Hospital is pictured after construction in 1914. Architect Enock Hill Turnock planned its site so that it would face the northeast, and be so situated that “the sun will shine into every room of the hospital at some point of the day.” A.R. Coffeen was the contractor for the original hospital, which was completed in 1914. (Photo courtesy Paul and Adrienne Coffeen.)
The Smith Memorial Hospital is pictured after construction in 1914. Architect Enock Hill Turnock planned its site so that it would face the northeast, and be so situated that “the sun will shine into every room of the hospital at some point of the day.” A.R. Coffeen was the contractor for the original hospital, which was completed in 1914. (Photo courtesy Paul and Adrienne Coffeen.)
EDITOR’S NOTE: The Winneshiek County Historic Preservation Commission is seeking a National Register designation for the old Smith Memorial Hospital building on Montgomery Street in Decorah. First steps in helping the Winneshiek Board of Supervisors secure funding for its restoration are underway. Not a lot is known about the building’s history, and the local preservation group is supporting awareness of the building history and its importance to the county and the surrounding area over the years. Following is a submitted history of the Smith Memorial Hospital.

Submitted by Elizabeth Lorentzen

Rev. Paul Koren had a dream for Decorah, and despite many discouraging setbacks and much hard work, lived to see that dream realized. In 1909 a law was passed providing that hospitals could be built with county taxes at a small increase in the tax levy. Koren, pastor of Washington Prairie Lutheran Church, saw the need for better health care and a hospital where patients could be treated. He brought the matter to the Winneshiek County voters who straightaway defeated the idea. Anything that would increase taxes was not enthusiastically received, and as Koren put it, “My friends promptly sat down upon me.” Still, Koren had seen mothers and their newborns suffer for lack of care, accident and sickness claim victims, doctors perform surgery on a patient’s dining room table. “He had seen their souls go out like candle-flames in a strong wind when bodies become twisted in the agony of physical distress.” These memories spurred him on to pursue his vision of a hospital to serve the county’s needs.   
Though discouraged by the voters’ defeat of the hospital idea, Koren heard that William Smith, a retired Bluffton area farmer and bachelor, was interested in the hospital project. Smith and his sister Matilda had agreed on a plan prior to her death in 1913 to make a donation to fund a hospital. When Koren called on Smith on May 15, 1913, he discussed the benefits of a hospital, and broached the subject of a financial contribution from Smith. Smith responded, “I’ll give you $10,000 for your hospital if you raise $15,000 more.” $10,000 was a sizable contribution, but Koren questioned what would happen if he couldn’t raise the remaining $15,000. Smith replied, “You’ll raise it all right.” Koren with help from the Commercial Club did raise the required $15,000 match with community donations ranging from $1 to $2,500. Contributions totaled $26,221.70 or about $689,667.42 in relative money values of 2021. Before the project was completed, William Smith gave the $10,000 he had first pledged as well as an additional $15,000.

A board organized, 
a hospital built
A public meeting was held to organize a hospital board. Ben Bear was chosen as president and Koren was elected vice president even though he was not in attendance. The first order of business for the newly elected board was to secure a building. At first, the board set out to find a large home that could be used to house a hospital. Accompanied by donor William “Uncle Bill” Smith, the board toured sizable area homes, including the Paine, Phelps, and Marlow houses, which might be adapted for their purpose. After investigating a number of these, the board concluded that a larger, more permanent structure was needed. For a building site, Koren suggested a quiet oak grove on the east side of the city and the board concurred. Enock Hill Turnock, an Elkhart, Indiana architect, was charged with the task of designing “a first class hospital…as nearly fireproof as possible,” and A.R. Coffeen was hired as contractor for $12,950, his first construction contract. Fred Carlson Company was the cement contractor. Koren and Smith took an active part, assisting with details of architecture and inspecting the carpenters’ work. 

It takes a woman…
But when the hospital opened in 1914, another problem reared its head. People were reluctant to use it. As Rev. Koren expressed it: “They thought a hospital was a good place to go to die!” Anna Haugsness was the first patient brave enough to enter the Decorah Hospital. She had her teeth extracted and recovered. (Cost for the extraction and operating room - $5.) Although there were 256 patients served during the first year, people were reticent to trust their lives to the facility and the hospital lost $2,260 in operating expenses. William Smith paid the hospital’s debts for a long time. Rev. Koren also contributed his own money as did some of the board to keep the hospital afloat. The hospital board finally met and came to the sad conclusion that the hospital should close. Koren pleaded for more time to organize a fund drive. The Lutheran Hospital Association, a nonprofit managing corporation, was formed in 1918 with Rev. Koren elected president. The hospital was leased to the association and managed by the corporation. Membership was open to all denominations and each member paid $1 to support the hospital association. Bills continued to mount, and Koren signed notes personally until he felt he could incur no more debt. In desperation, he appeared before a meeting of the Decorah Chamber of Commerce, outlined the hospital’s problems, then appealed to them, “Are you going to get behind this thing, or do I have to continue alone? I’ve got to have money!” The Chamber rose to the challenge, joined forces with Koren, and raised $2,000. A women’s hospital club was organized in September of 1920 with Mrs. Elizabeth Ness as president, and its members also aided the hospital’s cause. The women were divided into units, and they solicited a wide membership of Decorah women. As Koren expressed it, “After we got the women in the fight, the battle was won.” Because of their personal and financial support, seeking contributions to keep the hospital operating was no longer necessary and the hospital finally began to pay its own way. 

And it continued to grow
As more people used the hospital, more space was needed to handle the growing number of patients. Rev. Koren, Ben Bear and the hospital board launched a drive to raise funds for an addition and this time most of the contributors came to them. $30,000 was raised in two weeks and as the funds continued to come in, it was decided to extend the fund drive. In the end, almost $53,000 was raised to finance a sizable hospital addition which included new operating room facilities and more space for patients. In 1933 the south end addition was completed, in 1947 an addition was placed on the north end, and a new operating suite was finished in 1954. 
In 1957, the Lutheran Hospital Association was dissolved, the Decorah Hospital incorporated as a non-profit organization, and renamed Smith Memorial Hospital in honor of its first donor. Eight years later, the Smith Memorial Hospital Board of Trustees felt a new hospital should be built and would need county support for its construction. On January 1, 1969, the Smith Memorial Hospital dissolved its ownership and donated the building, equipment, and funds to the county. The Winneshiek County Memorial Hospital opened for occupancy in new facilities at 901 Montgomery Street on February 3, 1971. The original Smith Memorial Hospital building remains in use today as the location for public health and other county offices.
Over 100 years ago, Rev. Paul Koren saw a need and stayed the course until it was met. William Smith jumpstarted financial support for a hospital, and the community responded with contributions of their own. This group’s legacy remains today as Winneshiek Medical Center continues to serve the needs of Winneshiek County and the surrounding area.