U.S. ARMY GARRISON YONGSAN, SEOUL, SOUTH KOREA --2019 has been a year of "historic" events for the 65th Medical Brigade. Col. Derek Cooper, the 65th Medical Brigade Commander, reflected upon this time during a reflagging ceremony July 16 at the Brian Allgood Army Community Hospital Asia Gardens on U.S. Army Garrison (USAG) Yongsan in which after more than 69 years on the Korean peninsula, the 121st Combat Support Hospital (CSH) cased its colors. The CSH was reflagged as the 549th Hospital Center (HC) as part of the U.S. Army Force Design Concept.

The change was made in accordance with a Forces Command force design update executive order made June 26, 2018. The order states that the U.S. Army "is executing Hospital Center (HC) and Forward Resuscitative and Surgical Team (FRST) force design updates to convert all combat support hospital units into five distinct hospital and hospital-related capabilities and forward surgical teams into a new deployable force that may be split into two 10-person resuscitative and surgical elements to enhance combatant commander flexibility and deliver optimal health service support to the operational force."

"The modularity and capability upgrades can and will be more relevant as the Brigade rewrites its Health Service Support Concept Operational Order," said Cooper. "This FH concept will allow us to cover our Role III care requirements across the entire peninsula, improving our abilities to support the warfighter."

The HC will have an increase in staff to provide more surgical capability and with increased modularity will have the increased capability to deploy field hospitals throughout the peninsula, while still maintaining a Core Hub of over 170 beds at USAG Humphreys.

"The 549th will be the only fully doctrinally organized hospital center in the Department of the Army," said Cooper. "We will have the staff and equipment for both subordinated field hospitals and the four other detachments. Other HC's only have a single field hospital and couple of detachments."

The conversion reconfigures the 248-bed CSH into a smaller, more modular 32-bed field hospitals with three additional augmentation detachments including a 24-bed surgical detachment, a 32-bed medical detachment, and a 60-bed Intermediate Care Ward detachment. The FH and the augmentation detachments will all operate under the authority of the headquarters hospital center.

The 549th will have two FH's under their command.

The 549th Hospital Center is comprised of two Field Hospitals (FH): the 121st FH and 502nd FH, Four Medical Detachments: 129th, 125th, 150th, and 197th, and finally the 135th Forward Resuscitative Surgical Team.

The FH design is based on lessons learned from more than a decade of combat that have reinforced the Army's need to have forward-based medical capabilities that are advanced yet also agile and logistically scalable. Traditional CSHs have proven to be too large and logistically difficult to deploy as a whole, which is why the Army has historically only deployed "slices" or sections of the CSH. The move to the FH design codifies that practice by restructuring the CSH in the way it is primarily used -- as a customizable, scalable resource.

Col. Andrew Landers, Commander of the new 549th HC and former commander of the 121st CSH, stated that the ceremony marks the closure of one chapter and the initiation of another as the unit restructure, mandated by the Army, will make field hospitals more agile and tailorable in the long term to better support large scale ground combat operations.

"Although I am a little emotional seeing the colors of the 121CSH getting cased, I am excited with this conversion as it will make us more mobile and more scalable to support the warfighter," said Landers. "We will deter aggression thru a ready medical force sustaining medically ready soldiers along with resilient families and always be ready to fight while maintaining a focus on high quality, compassionate and safe care."

Under the new structure, each element assumes the following missions:

• Hospital center: Deploys to provide mission command for up to two functioning field hospitals.

• Field hospital: Deploys to provide hospitalization and outpatient services to all classes of patients in a theater of operations.

• Medical detachment: Deploys to augment the capabilities of the field hospital with thoracic, urology, oral maxillofacial surgical capabilities, additional intensive care unit beds, outpatient services and microbiology.

• Surgical detachment: Deploys to augment the field hospital with operational dental care, one additional ICU ward, one intermediate care ward, additional microbiology capabilities and outpatient services.

• Intermediate care ward detachment: Augments the field hospital as required with three wards providing intermediate nursing care and additional personnel to support nutrition and patient administration capabilities.

Cooper concluded his remarks reminding those that the 121CSH lineage will continue on. "It's important to note the 121CSH has served here in Korea since 1950 at the very outset of the Korean War. We will carry this lineage on as the 121CSH will become the 121st Field Hospital underneath the 549th."