Members of the Sioux, Cheyenne, Shoshone, Arapaho, Crow, and Flathead tribes were forced into the government institution to be taught how to assimilate into European American culture and language.

The building was then converted into a massive hospital called the Sioux Sanitarium for Native American TB patients in 1939.

These years were the worst in its history, as documented by Madonna Swan, a Lakota woman who was held at the sanitarium between 1944 and 1950.

Unlike sanitaria for white people, which offered restorative environments and experimental treatments, Sioux San was a place where Native Americans went to die.

[8] In 2016, Congress appropriated $117 million to renovate the hospital, and plans were proceeding to demolish some of the historic buildings.