Welch Community Hospital, the only state-funded acute care facility in West Virginia, is the only hospital in McDowell County. The hospital originated in 1899 legislation that required the building of state hospitals for people engaged in dangerous occupations, particularly coal mining. Miners Hospital No. One opened in Welch on January 28, 1902, and miners hospitals also were built at Fairmont and McKendree. Dr. Henry Hatfield, a future governor, was a coal camp physician who helped secure funding for the miners hospitals and served on the board of directors of the Welch facility. A nursing school was established in 1914 and operated until 1944.

From its start as Miners Hospital No. One, the name changed to Welch Hospital No. One in 1912, to Welch Emergency Hospital by 1931, and to Welch Community Hospital in 2000. Today, the 124-bed facility employs about 300 people, making it McDowell County's second-largest employer.

The hospital is located on three acres within the town of Welch. The land was donated to the state in 1899 by J. J. Sperry for the purpose of building a hospital. A $12 million renovation was completed in 1984. Medical services include surgery, obstetrics, intensive care, and an emergency department. McDowell County has the highest poverty rate in West Virginia.