MASSENA — Signing off on the highest point of a building expansion has become a tradition at Massena Memorial Hospital.

Nine years ago, hospital officials wrote their signatures on the highest point of the 28,000-square-foot building expansion. On Thursday, they repeated the tradition on a wooden truss later installed on the tallest point of the $3.9 million, 20,300-square-foot Maple Street medical office building.

Officials broke ground on the Maple Street building in May. Contractors expect to finish the facility’s exterior by the fall, complete interior construction during the winter and open the building by spring.

The facility will have two levels. The top level, which will accommodate 10 to 12 medical practitioners and have a sunlit atrium, a phlebotomy center, a conference room and a waiting area, will open first. The bottom level, with an entrance facing the Grasse River, will follow.

The facility has been built into the slope of a hill, which will give the appearance from Maple Street of a one-floor structure to fit in better with surrounding buildings, hospital officials said.

Hospital CEO Charles F. Fahd II, board member Real C. “Frenchie” Coupal and Senior Director of Ancillary Services Mark P. Brouillette were among those who signed the truss.

“It’s very gratifying to see the building come to fruition,” Mr. Fahd said. “We’ve been talking about this for the better part of three and a half years.”

This year has been a difficult one for Massena Memorial financially; the hospital is running $1.6 million in the red for the year. But the hospital’s finances began to stabilize in July with a $38,555 profit, and August’s patient volumes have been tracking close to budget, Mr. Fahd said.

“It’s a month-to-month thing,” he said. “We hope it will continue in the month of August.”

Despite the difficulties, which range from lower-than-expected patient volumes in past months to escalating state retirement costs and adjustment in Medicare and Medicaid reimbursements, the investment in the medical office building is part of the solution to remain viable, Mr. Fahd said.

Its construction will retain existing physicians looking for a state-of-the-art space and attract new ones, which in turn will help keep the hospital profitable into the future, officials said.

“Hopefully in the future there will be other projects developed on this 21-acre site as well,” said Mr. Fahd, who added that it was too early to determine what those would be.

Mr. Brouillette complimented the building’s four contractors — Northern Tier Contracting, Collins-Hammond Electrical, Burns Bros. plumbing and Hyde-Stone HVAC — who worked diligently through the summer heat to construct the exterior.

Seven health care providers have committed to using 75 percent of the building’s top floor so far, Mr. Brouillette said. “We’ve had serious interest and inquiries for the entire first floor,” he said.

Contractors initially had to replace some of the on-site fill, but otherwise work has proceeded as expected, Mr. Brouillette said. “We’re on schedule and we’re close to budget,” he said.

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