The history of medical care in Hillcrest dates back to 1904, when patients from the Poor Farm in Mission Valley were transferred to the new three-story San Diego County Hospital there.

[1] The eleven-story, 623-bed Hillcrest hospital opened in 1963, and control was transferred to UCSD in 1966 for an initial lease payment of $350,000 a year.

In 1988, the creation of Thornton Hospital on the La Jolla campus allowed the regents to reduce the number of Hillcrest beds from 447 to 327.

[9] The remaining structures serve a variety of support services, including administration, housing, teaching, and transportation.

UCSD administration has been planning to replace the dated facility since 2005, as by 2030 it will be inoperable due to increased seismic regulations in California.

San Diego residents and nearby hospitals such as Scripps Health argued that the move would leave South County patients underserved, and UCSD decided to build Jacobs Medical Center as a supplement to, not a replacement for, the Hillcrest campus.

The new services include a consolidated resuscitation center on the fifth floor with four dedicated beds and a camera monitoring system, as well as instant x-rays and electronic lab results.

[12] The expansion was coupled with a $14 million remodel to the first-floor emergency department, which added 12 private beds to the facility for a grand total of 36.