[3] The Massachusetts Department of Public Health currently operates a Joint Commission accredited, 370-bed facility at Tewksbury Hospital, providing both medical and psychiatric services to challenging adult patients with chronic conditions.

[12] The original Tewksbury campus consisted of "large wooden buildings" which were considered "badly designed, poorly constructed firetraps.

The Almshouse had its own spur line to a freight house, and coaling station to the power plant- both of which still exist today.

[15] From February 1876 to October 1880, Tewksbury housed its most famous inmate, Anne Sullivan, best known as the teacher and companion of Helen Keller.

Her mother dead, and abandoned by her father, Sullivan was admitted to Tewksbury at the age of ten, along with her younger brother Jimmie.

Sullivan was afflicted with trachoma, which was beginning to blind her;[16] her brother was suffering from tuberculosis, which was to cause his death four months later.

[17]In October 1880, Sullivan left Tewksbury, allowed by the intervention of a state official to transfer to the Perkins School for the Blind in Boston.

[15] In 1883, Massachusetts Governor Benjamin F. Butler made headlines when he accused Tewksbury management and staff of a variety of abuses ranging from the venal, "financial malfeasance, nepotism, patient abuse, and theft of inmate clothing and monies,"[13] to the macabre, including, "trading in bodies of dead paupers and transporting them for a profit to medical schools," and "tanning human flesh to convert to shoes or other objects [...] from Tewksbury paupers.

[15] The architectural history and quality of the Tewksbury campus was a key criterion for its inclusion on the National Register of Historic Places.

[22] In the first part of the 20th century, Tewksbury combined two roles, first, as a "last resort" facility for the elderly and the mentally ill, and secondly, as an isolation and care center for patients with infectious diseases, such as Smallpox, Typhoid Fever, and Tuberculosis.

[5] Because of the variety of physical and mental conditions treated at Tewksbury, it was considered an ideal place for education of nurses.

Tewksbury Hospital's then-CEO, Raymond Sanzone said of the closure, "None of us is happy with this closing, but the school is no longer financially viable.

[...] The main mission of this institution is to treat patients, not to train nurses"[26] Tewksbury saw a second major expansion of its facilities during the 1930s under the Works Progress Administration (WPA) program.