When Laura Kiker rented a new apartment in September, a few blocks from the Capitol, she knew she was moving into a historical neighborhood.
She had no idea, though, that her new home, at 700 Constitution Ave. in Northeast Washington, was a former hospital dating back nearly a century.
Today, she loves living in what used to be a patient room at what once was known as Eastern Dispensary Casualty Hospital, in a four-story building with wide hallways, high ceilings and restored post-World War II-style architecture. A spacious rooftop deck, a yoga studio and an indoor dog wash are added bonuses for Kiker and her dog, Stella. "There is so much history in this town, it's nice to live in a place that has its own," said Kiker, 30, a management consultant.
Across the country, hospitals that have shut their doors are coming back to life in various ways: as affordable senior housing, as historical hotels and as condos, including some costing tens of millions in the heart of New York's Greenwich Village.
The trend of converting hospitals to new uses has accelerated as real estate values have soared in many cities. At the same time, the demand for inpatient beds has declined, with the rise of outpatient surgery centers and a move toward shorter hospital stays.
As health systems consolidate for financial reasons, they might prefer that patients visit their flagship hospital while buildings of smaller hospitals in their orbit get sold off — especially if the latter have a disproportionate share of indigent patients.
David Friend, chief transformation officer at the consulting firm BDO in Boston, said that real estate is one of urban hospitals' most valuable assets. "A hospital could be worth more dead than alive," he said.
The number of hospitals in the United States has declined by 21 percent over the past four decades, from 7,156 in 1975 to 5,627 in 2014, according to the Centers for Disease Control and Prevention.
Even when the conversions make medical sense, they pull at the heartstrings of communities whose residents have an emotional attachment to hospitals where family members were born, cured or died. But they sometimes create health deserts in their wake.
St. Vincent's Hospital in New York treated survivors of the Titanic's sinking in 1912, the first AIDS patients in the 1980s and victims of the Sept. 11 terrorist attacks in 2001. But it filed for bankruptcy protection and closed seven years ago. Developer Rudin Management bought it for $260 million and transformed it into a high-end condo complex that opened in 2014. Former Starbucks chief executive Howard Schultz bought one of the condos for $40 million.
Jen van de Meer, an assistant professor at the Parsons School for Design in New York, who lives in the neighborhood, said residents' protests about the conversion were not just about the optics of a hospital that had long served the poor being repurposed. "Now, if you are in cardiac arrest, the nearest hospital could be an hour drive in a taxi or 20 minutes in an ambulance across the city," van de Meer said.
St. Vincent's is one of at least 10 former hospitals in New York City that have been turned into residential housing over the past 20 years.
Closing a hospital and converting it to another use is not exactly like renovating an old Howard Johnson's, said Jeff Goldsmith, a health industry consultant in Charlottesville. "A hospital in a lot of places defines a community — that's why it's so hard to close them," said Goldsmith, who noted that after Martha Jefferson Hospital closed its downtown facility in 2009 to move closer to the interstate highway, an apartment building took its place.
But many older hospitals are too outmoded to be renovated for today's medical needs and patient expectations. For example, early 20th-century layouts cannot accommodate large operating room suites and private rooms, Friend said.
"It's all about location, location, location," Terry Busby, chief executive officer of Arlington-based Urban Structures, said when asked why former hospitals are being bought and redeveloped as housing. They are often in city centers near transits
Moreover, the buildings, with their wide hallways and high ceilings, are often easy to remake as luxury apartments.
In some circumstances, a conversion provides a much-needed lift for the community. New York Cancer Hospital, which opened on Central Park West in 1887 and closed in 1976, was an abandoned and partially burned-out hulk by the time it was restored as a condo complex in 2005. Developer MCL Cos. paid $24 million for the property, branded 455 Central Park West.
"The building itself is fantastic and a landmark in every sense of the word," said Alex Herrera, director of technical services at the New York Landmarks Conservancy. He said that it retained some of its original 19th-century architecture.
Likewise, Columbia Hospital for Women in the District's fashionable West End, which had delivered more than 250,000 babies since it opened shortly after the Civil War, closed in 2002 and reopened in 2006 as condos with a rooftop swimming pool.
Some former hospitals are used for purposes other than housing.
In Santa Fe, N.M., St. Vincent Hospital moved into a new facility in 1977, and the old structure downtown was reborn as a state office building. Later, it was abandoned, and locals listed it as one of the spookiest places in town. In 2014, the building reopened yet again as the 141-room Drury Plaza Hotel.
After Linda Vista Community Hospital, in Los Angeles's Boyle Heights neighborhood, closed in the 1990s, the abandoned six-story building fell into disrepair — its empty patient rooms, discarded medical equipment and aging corridors serving as sets for movies such as "Pearl Harbor" and "Outbreak." AMCAL Multi-Housing bought the property in 2011 and redeveloped it into a low-income senior apartment house called Hollenbeck Terrace.
"They really rescued a building with tremendous history . . . while providing really needed low-income senior housing," said Linda Dishman, chief executive officer of the Los Angeles Conservancy, a group dedicated to preserving and revitalizing historic structures. "It is such an iconic building in the neighborhood."
Nicky Cymrot, president of the Capitol Hill Community Foundation, a neighborhood group in Washington, said that when Specialty Hospital Capitol Hill sold off a little-used 100,000-square-foot wing of its facility that became 700 Constitution, neighbors weighed in with concerns about aesthetics and traffic. But by the time the apartment building opened early this year after a five-year, $40 million renovation, the response was positive.
The original building, located at 700 Constitution Avenue NE, was built in 1905 when it was established as the Eastern Dispensary Casualty Hospital. Other additions date to 1928 and 1956. It was renamed Rogers Memorial Hospital in the 1950s and later became Specialty Hospital-Capitol Hill.
The developers restored the 1928 portion of the building, and 1956 additions were altered with a rear addition and roof deck constructed. Specialty Hospital, renamed BridgePoint Hospital, a long-term care facility, remains open next door.
The apartments are brand new, with stainless-steel appliances, including refrigerators, microwaves and gas stoves. A key feature of the units is thick walls that keep things quiet. The bathrooms have modern shower stalls with glass doors and large shower heads. All the units have LED track lighting and granite countertops, and washers and dryers. There is a parking garage below the building.
Other amenities in the building include a yoga studio, fitness center and a spacious living room area on the ground floor with large television and a billiards table. The lighted rooftop is complete with plants and outdoor furniture, including chaise longues, as well as two large gas grills. From the roof, residents enjoy great sunsets and view of the Capitol, the Washington Monument and the Library of Congress. There is also patio seating in the courtyard in the back of the building.
The building is halfway between Lincoln Park and Stanton Park, less than a 10-minute walk to Eastern Market Metro and less than 15 minutes from Union Station. Nearly half of the 139-unit building, where one-bedroom apartments rent for nearly $2,600 per month, is already leased.
Sophie White, 28, who moved into 700 Constitution in the summer, watched the building's transformation and renovation from a rental property a few blocks away.
"It used to be a blight on the neighborhood with unsavory people milling around it," she said. Now, "it's really a cool place to live."
Gorman reported from Los Angeles. Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.