      
In 1907, 14 Salem physicians formed a corporation called the Salem City Hospital Association. Through an organized fund drive, the first of its kind in the U.S., the Association raised $65,000 in donations. A building fund was established, and the Hospital was built at its current location on East State Street. The Hospital opened in 1913 and could accommodate 70 patients. The Hospital began to take root and grow with each decade bringing a major improvement to the facility. In 1948, a wing was added increasing the patient capacity to 108 beds and 24 bassinets. In 1956, construction commenced on the addition of a warehouse, power plant, laundry and pharmacy. In 1963, construction of the East wing increased the Hospital's bed capacity from 108 to 150, and provided a chapel, lobby, outpatient waiting room and treatment rooms.  On July 1, 1969, the Northern Columbiana County Community Hospital Association (NCCCHA) was founded through the merger of the Central Clinic and Hospital Association and the Salem City Hospital Association. The Central Clinic and Hospital Association had been in existence since 1921 as both a proprietary and non-profit corporation. NCCCHA's new, non-profit corporation structure included the trustees of both institutions. The bed complement after the merger was 210.
The next major construction project at NCCCHA occurred from 1972 through 1978, and resulted in an additional forty-two patient beds, as well as a new outpatient diagnostic and emergency treatment department, an additional operating suite and expansion of the existing laundry facilities.
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