Tsali Care Center, Cherokee, North Carolina
Tsali Care Center in Cherokee, N.C., represents a culturally grounded, resident-centered eldercare environment for the Eastern Band of Cherokee Indians (EBCI). A finalist in Environments for Aging‘s 2026 Design Showcase, the community includes 120 private rooms across skilled nursing, assisted living, and memory care, along with adult day care and an onsite dialysis center serving both residents and the broader tribal community.
The primary design goal was to honor elders with dignity while embedding Cherokee values of kinship, balance, and connection to land into a contemporary care setting. With McMillan Pazdan Smith (Charlotte, N.C.) serving as architect and interior designer, the project team collaborated with tribal leaders, elders, and caregivers throughout the design process to ensure Tsali Care Center reflects shared community goals alongside functional and operational needs.
Sustainable design strategies—including a high-performance building envelope, all-electric systems, and native landscaping—align with the community’s relationship to the land.
Embracing a household model and cultural identity
The Tsali Care Center features a household model with six 20-bed neighborhoods. Each household has its own living, dining, and activity spaces, which support autonomy and social connection among residents.
Throughout the building, cultural identity is expressed through material choices and architectural detailing.
Heavy timber framing, locally quarried stone, and basket-weave patterning reference Cherokee craft traditions. Additionally, artwork by Cherokee and local artists is integrated throughout common spaces.
Tsali Care Center project details
Location: Cherokee, N.C.
Completion date: August 2024
Owner: Cherokee Indian Hospital Authority (CIHA)
Total building area: 131,765 square feet
Total construction cost: Not disclosed
Cost/sq. ft.: Not disclosed
Architect: McMillan Pazdan Smith
Interior designer: McMillan Pazdan Smith
General contractor: Robins & Morton
Engineers: Civil Design Concepts (civil), SKA Consulting Engineers (MEP, structural)
Project details are provided by the design team and not vetted by Environments for Aging.
