Monroe County Poor House

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Monroe County Poor House
Established 1826
Opened 1827/1931
Current Status Preserved
Building Style Single Building
Architect(s) Siegmund Firestone
Location Rochester, NY
Alternate Names
  • Monroe County Almshouse
  • Monroe County Home & Infirmary
  • Monroe Community Hospital for the Care of the Chronically Ill
  • Monroe Community Hospital (Current)


The Monroe County Poor-House, situated three miles southeast from Rochester, was erected by the county in 1826. It was constructed of brick, and was calculated to accommodate from seventy-five to one hundred paupers. It was managed by five superintendents, and had, in 1827, thirty-five occupants, about twenty of whom were employed in useful labor. Population increased, and the building became old and overcrowded. The raving maniac, the young child, the infirm old man, and the seducer’s victim, were crowded in a building whose remembrance must seem painful. Humanity called for a removal of the child from baneful influences, and a separation of the insane from the sane. In 1855 a school was taught by Miss Benedict, and contained some forty scholars. A schoolhouse was finished in 1859. It contained two stories, the lower being for a schoolroom, the upper for a dormitory.

In 1860 a building was set apart for the infirm old men. Year after year the buildings became more dilapidated, and the report in favor of new buildings passed unheeded until early in 1872, when the commissioners began to act in a manner which set the future at rest upon this question. The almshouse was located midway between the insane asylum and the penitentiary, and fifty feet south. By 1862 the number of patients admitted to the Asylum necessitated the erection of a separate building.

By 1929 concerns with overcrowding and fire safety at the Almshouse prompted the County to review the future of the building. County officials commissioned Siegmund Firestone, a notable Rochester architect and engineer, to investigate the current situation and to recommend a plan for its future. It was Mr. Firestone who made the recommendation that the County consider building a new facility better suited to care for the growing number of long-term and chronic care patients and to move the building’s location to East Henrietta Road. The County accepted his plan, and Firestone was hired to design and oversee the construction of this new facility.

Construction of the building that we now know as Monroe Community Hospital began in 1931, in the midst of the nation’s Great Depression. Mr. Firestone incorporated many innovative ideas into his design of the building and ensured that the project employed all local contractors. Mr. Firestone also hired a talented young architectural student and draftsman Thomas Boyde, Jr. as one of his assistants, and Boyde then became the first African-American architect in the community. Following nearly three years of construction and at a cost of $4 million, the new facility opened as the Monroe Community Home and Infirmary on August 1, 1933. The innovations in interior design as well as the beautiful, ornate exterior earned national recognition. The building was heralded as a model health care facility, and one publication called it “the most efficient installation of its kind anywhere.” It set new standards for hospital design, balancing the intertwined medical, psychological, and social needs of its residents with the need for efficient, cost-effective care.

From the 1930s through the 1950s, Monroe County Home and Infirmary functioned as a general hospital, providing medical, surgical, maternity, pediatric, and dental services for the indigent. In 1967, the County changed the facility’s name to the Monroe Community Hospital for the Care of the Chronically Ill. The name change reflected a shift to address the rising population of elderly in the community. At that time, Monroe County also entered into an agreement with the University of Rochester School of Medicine and Dentistry to provide medical personnel and services, improving upon the quality and continuity of patient care.

The population that MCH serves today, however, has changed significantly from its early days. MCH now provides long-term care and rehabilitation for residents of all ages, from eight-week old infants to centenarians. Nearly three-quarters of the residents at MCH use wheelchairs, and the majority have complex medical and psychological needs requiring extensive medical and nursing care.