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Almshouse , also called poor house or county home , in the United States , a locally administered public institution for homeless, aged persons without means. Such institutions radically declined in number in the second half of the 20th century, replaced by other means of subsistence and care. Dating to colonial days, the almshouse was used as a dumping ground for the mentally ill, the epileptic, the mentally retarded, the blind, the deaf and dumb, the crippled, the tuberculous, and the destitute aged, as well as for vagrants, petty criminals, prostitutes, unmarried mothers, and abandoned and neglected children. Operated often in conjunction with a farm, with emphasis on meeting costs through the sale of farm produce, the almshouse, or county home, incurred widespread criticism after the turn of the 20th century for its failure to provide differentiated treatment for the varying problems presented by residents, the minimum character of medical and nursing care offered, the low sanitation and safety standards, and the physical and mental deterioration of residents caused by neglect and the incompetence of the management. These evils were gradually but not altogether eliminated by the shift of the sick, the handicapped, and the young to specialized state institutions, a process that began in the middle of the 19th century, and the transfer out of able-bodied aged who could qualify for old-age assistance under the Social Security Act of
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Elizabeths Hospital is a psychiatric hospital in Southeast, Washington, D. It opened in with the name Government Hospital for the Insane,  the first federally operated psychiatric hospital in the United States. Housing over 8, patients at its peak in the s, the hospital had a fully functioning medical-surgical unit, a school of nursing , accredited internships and psychiatric residencies. Department of Homeland Security personnel and serves as its headquarters.