A Place in Time spotlights a significant cultural resource - a district, site, building, structure or object - entered in the National Register of Historic Places.
Coatesville Veterans Hospital.

Coatesville Veterans Hospital
Coatesville Veterans Administration Medical Center / Photo by Richard Sama

More than 4.5 million men and women served in the various branches of the United States military during World War I. It was the first fully mechanized war, with soldiers exposed to mustard gas and other chemicals. The large number of veterans and the hazards of service resulted in a need for the U.S. government to provide specialized medical care on a scale not seen since the Civil War.

Within the context of the U.S. military, the Coatesville Veterans Hospital is identified as a “Second Generation” facility, designed to address the medical needs of World War I veterans and reflecting a profound shift from the care offered prior to the war. “First Generation” hospitals were created primarily for Civil War veterans, with a focus on providing long-term housing and few services for out-patients or rehabilitation care.

Changes in veterans care were underway during World War I, and by 1921 money was appropriated for the construction of new hospitals to consolidate and streamline efforts, resulting in 21 Second Generation hospitals built between 1919 and 1950 by the Veterans Bureau. Second Generation hospitals focused on rapid rehabilitation and the return of veterans to civilian life through modern therapies, medicines and surgical techniques. Most of the new facilities were placed near rural areas offering the large tracts of land necessary for campus settings and agricultural operations; many hospitals, including Coatesville, incorporated working farms producing food for the patients and doubling as resources for occupational therapy. The hospital designs generally featured nationally popular Colonial Revival architectural styles, conveying patriotic themes and American influences.

The teams selecting sites for the new Second Generation hospitals sought locations with large populations of veterans accessible to existing transportation systems and utilities. Nearby rail service and proximity to highways would be necessary for the delivery of supplies and fuel and transit of patients, staff and visitors. One of the new hospitals was to be located within 50 miles of Philadelphia, where an outdated and overcrowded hospital was slated for closure. A site just northeast of Coatesville in Chester County’s Caln Township met all of the selection requirements and also fulfilled the need for sufficient land for farming operations and future expansion. Located between Lancaster and Philadelphia, the site was selected to serve veterans living in southeastern Pennsylvania and parts of Delaware, Maryland and New Jersey. The Main Line of the Pennsylvania Railroad and the Lincoln Highway (U.S. Route 30) were along the southern edge of the hospital property, a definite plus, and some of the 386 acres were already in use for farming.


Uniformed World War I veterans at the hospital’s opening ceremony. Coatesville Veterans Administration Medical Center

Uniformed World War I veterans at the hospital’s opening ceremony.
Coatesville Veterans Administration Medical Center

Placement of the hospital in a prominent visual space was a logistical priority for the Second Generation sites, and many were located on rises or hilltops. Typically, the main administration building was sited to serve as a focal point for patients and staff, as well as the surrounding community. The Coatesville hospital’s main administration building was placed at the top of Blackhorse Hill, looking out over the city and surrounding area, readily visible from the Lincoln Highway.

Construction of the Coatesville hospital’s first 16 buildings began in 1929, with a formal opening in 1931 and beds for 400 patients. The campus began to expand immediately, and by 1932 patient capacity was 953. The hospital kept growing through the 1950s. The initial construction during the Great Depression provided an economic boost to the area, and the hospital continues to be an important local employer.

Second Generation hospitals were divided into subtypes: neuropsychiatric, tuberculosis, and general medicine and surgery. Tuberculosis hospitals focused on patients with damaged respiratory systems, either from independent disease or wartime exposure to chemicals. Neuropsychiatric facilities treated conditions such as anxiety, depression and degenerative diseases such as Parkinson’s. Although the hospitals had specific focuses, they all generally included smaller departments that offered care in the other areas. Coatesville was designed to fit the neuropsychiatric type.

The location of neuropsychiatric veterans hospitals in rural landscapes on the outer fringes of a city or substantial town was crucial. Situated on large tracts of land, they had dozens of buildings and hundreds of patients, more than were receiving treatment at the other types of hospitals. The large tracts buffered patients from the outside world and made possible the agricultural operations important for food production and therapy. The Coatesville hospital had nearly 250 acres set aside for farming, and nearly 60 percent of the farm labor was the responsibility of patients. Cultivation of crops and animal husbandry was believed to have calming effects and concurrently offered job skills. With the introduction of psychotropic drugs in the 1950s and changes in food procurement, hospitals’ agricultural operations began to decline and most appear to have ended by the 1960s.

A veteran receiving therapy at the hospital.

A veteran receiving therapy at the hospital.
Coatesville Veterans Administration Medical Center

Initially, various federal bureaus and agencies were tasked with providing benefits or offering care and rehabilitation to returning World War I veterans, but they were unable to handle the scale and logistical demands. In 1921 the three entities managing veterans’ health care needs were merged into a single independent agency, the Veterans Bureau. Veterans Bureau hospitals were focused on returning veterans to their families and the work force, not long-term residential care. The hospital facilities varied depending on their subtypes and whether they specialized in treatment of tuberculosis, neuropsychiatry, or general medicine and surgery. In 1925 the bureau also began limited research programs. In 1930 Congress authorized the merger of the Veterans Bureau with the agencies managing pensions and long-term residential needs into a single entity, the Veterans Administration.

Thousands of veterans from Pennsylvania and neighboring states received subsidized neuropsychiatric care that they may not have otherwise received without the Second Generation hospital at Coatesville.

The Coatesville Veterans Hospital was listed in the National Register of Historic Places in 2013.


Recent listings in the National Register of Historic Places include Delaware Station of the Philadelphia Electric Co., Philadelphia; Paupack School, Palmyra Township, Pike County; Perkasie Park Camp Meeting, Perkasie, Bucks County; Progress Lighting Manufacturing Co., Philadelphia; George Christian and Anna Catherine Spangler Farm, Mifflinburg, Union County; and Times Finishing Works, Philadelphia.


April E. Frantz is a historic preservation specialist who coordinates the National Register Program for the eastern part of the state at PHMC’s State Historic Preservation Office.