The United States (US) 44^th General Hospital at Black River was established with 1000 beds. This could increase to 1500 in an emergency and the site was planned for 4500, though this did not occur. The location was believed to be ideal due to the natural landscape of the gum trees and the view of the surrounding hills. The slope of the terrain afforded natural drainage, unlike the 12^th and 13^th Station Hospitals in Townsville. The buildings were of a specially designed 'tropical type' to suit the climate and were shipped pre-fabricated to the site.

It was considered far enough from the city to be removed from noise, but provided good access with a sealed road to Townsville nearby, a railroad siding on the Cairns-Townsville railway within a mile, and the Bohle air strip four and a half miles away.