The hospital complex has been open to the public on a limited basis for hard hat tours since 2014, provided by the Save Ellis Island Foundation.

[15][16] The hospitals involved were called “Contract Hospitals.” On June 15, 1897, the wooden immigration station on Ellis Island was destroyed by fire.

[20] By September, the treasury's supervising architect, James Knox Taylor, opened an architecture competition to rebuild the immigration station.

According to one New York Times article, "those less fortunate had to submit to physical inspections that required stripping off all of one’s clothing – an entirely foreign concept, particularly to many immigrant women.

Because their entry in the US was prohibited by immigration law and because these patients needed to be housed in a separate facility, a new secure ward was required.

Contemporary hospital design and medical knowledge indicated that a single building was less desirable than a series of several small pavilions, where various diseases could be treated in isolation from other wards.

The immigration department now had clear title and construction was resumed,[38][41] By the end of 1909 island 3 and the new contagious disease hospitals were completed,[42] but insufficient funds had been allocated to connect the utilities and purchase furniture and equipment for the facility.

It is likely that many of these diagnoses were the product of cultural differences, language barriers, or the immigrants' anxiety about entering a new country, which made their behavior seem slow or out of the ordinary to hospital doctors.

In 1913, Howard Andrew Knox developed more objective testing methods to determine with increased accuracy whether an immigrant was mentally deficient.

In 1923, the Daughters of the American Revolution provided a robust occupational therapy program[45] for immigrants detained at Ellis Island.

Because of the success of the DAR's occupational expertise, they were given an entire pavilion (Isolation Ward J) where they worked with U.S. servicemen, merchant seamen, and members of the U.S. Coast Guard and other U.S. government beneficiaries.

Initially quartered at Ellis Island, when the hospitals began to receive military casualties, the nurses were moved to hotels in New York City.

There were a total of 35 doctors employed by the Public Health Service serving in 3 divisions: Boarding, Medical Inspection and Hospital.

[52] The “National Origins Act,” passed in 1924, established a 2% quota system which drastically reduced immigration from targeted countries.

[54] The 1924 National Origins Act further reduced hospital demand by requiring immigrants to have a medical examinations prior to boarding for America.

[55][54] Under the new law the staff at Ellis Island was charged with a new task, inspection of Alien Merchant sailors arriving in New York.

The Bureau of Investigation (the forerunner of the FBI) had begun rounding up immigrants across the country who had violated the terms of their admission either by becoming Public Charges, committing crimes or being identified as political dissidents – anarchists principally.

When President Franklin D. Roosevelt took office in 1933 Ellis Island was run by the Bureau of Immigration which was part of the Department of Labor.

Their mission was to evaluate the state of the facilities, to assess current immigration policy and to recommend actions to solve the problems that they identified.

In 1934 the Ellis Island Committee submitted a report to Secretary Perkins confirming that current facilities were in disrepair and they were not adequate to fulfill the therapeutic and recreational needs of the patients.

Constructed between Islands 2 and 3, it housed a full scale gymnasium and auditorium complete with stage, a film projection booth, a canteen and other recreational facilities.

[67] In 1996, the World Monuments Fund listed the hospital as one of the world's 100 Most Endangered Properties, a warning echoed by the National Trust for Historic Preservation, which put the buildings on the list of “most endangered historical places in the United States.” A study conducted by the New York Landmarks Conservancy estimated that with about $3 million of federal funding, the Ellis Island Immigrant Hospital could be stabilized for the next 15 years.

Red Cross workers also volunteered frequently, with a special focus on making the hospital more comfortable and enjoyable for the immigrant children.

[80][74] It housed 25 to 30 beds and was intended for the temporary treatment of immigrants suspected of being insane or having mental disorders, pending their deportation, hospitalization, or commitment to sanatoria.

Each of these pavilions held all the necessary service spaces to function independently, and each ward could be sealed off in order to prevent cross-contamination, the principal cause of death prior to the invention of antibiotics .

All structures were designed by James Knox Taylor in the Italian Renaissance style and are distinguished by red-tiled hip roofs, exposed rafter tails, roughcast or pebble dashed walls of stucco, and ornamentation of brick and limestone.

A hall leading to the connecting corridor was flanked by bathrooms, nurses' duty room, offices, and a serving kitchen.

[94] The administration building for the Contagious Disease Hospital is a 3.5-story structure located on the north side of island 3's connecting corridor, in the center of the landmass.

[97][98] At the extreme eastern end of island three were three separate isolation pavilions, which contained (wards I-L) and a staff house.

However, all tourists are required to stay with their tour groups and wear hard hats, and videos of the site are prohibited without prior approval.