Her dream was realized as the American Evangelical Lutheran Mission Hospital, Guntur, India, which opened on 22 June 1897.

The 50-bed hospital was established on an 18-acre (7.3 ha) campus and was considered one of the best[citation needed] in India, with surgical facilities, maternity and children's wards, and a nursing school.

On 23 February 2010, it was leased from the Andhra Evangelical Lutheran Church (AELC) by M/s Karunya Healthcare & Academic Foundation who plan to renovate and modernise the hospital.

On 19 April 2010, Dr. Kugler's birth anniversary, M/s Karunya Healthcare & Academic Foundation held a prayer ceremony to bless the work of renovation and the re-opening of the hospital.

In the function M/s Karunya Healthcare & Academic Foundation stated that the hospital will balance the continued commitment to the care of the poor and those most in need with the provision of highly specialized services to a broader community.