Hazen was 28 years old when it got its first real hospital, a dozen or more beds on the second floor of one of the original main street buildings. The hospital was a private undertaking by a Beulah woman who ran the facility for several years until Hazen's plans for a new, modern hospital facility were well underway. Community effort continued to keep the hospital open for a time. However, in the fall of 1946 the hospital closed due to difficulty in finding competent help.

In 1945 an agreement was entered with Lutheran Hospital and Homes Society for operation of the proposed hospital. In the fall of 1946, construction got underway.

The hospital, which was classified as a 30 bed facility, but only 23 beds were installed, became operational February 16, 1948. By the late 1960's, it was apparent that either major remodeling or a new facility was needed. With local donations and Hill-Burton federal funds, a 39 bed, 8 bassinet hospital was built at the east edge of Hazen. It was dedicated June 28, 1970 and officially opened its doors in August 1970. (The Hazen Memorial Hospital Association took over the hospital from Lutheran Hospitals Homes Society in July 1969.)

After several years of planning and a long range feasibility study, the Board of Directors decided to proceed with the construction of a $1.2 million expansion and renovation of the hospital in February 1982.

In 1988 the name of the hospital was changed to Sakakawea Medical Center (SMC). Currently SMC is classified as a "Critical Access Hospital" licensed for 25 beds and is a community owned and operated hospital under the Hazen Memorial Hospital Association.