Originally built in 1846, St. Louis City Hospital was destroyed by a fire in 1856, rebuilt, and destroyed again by a tornado in 1896; it was rebuilt again in 1907. Other buildings were constructed on the ten-acre site with 18 buildings ultimately in the complex. Located just south of downtown, City Hospital operated for nearly 140 years and closed in 1985; for the next 15 years it faced threats of demolition until the City of St. Louis established a redevelopment plan. City Hospital was placed on the National Register of Historic Places in 2001. The site is undergoing rededevelopment by Gilded Age.
An environmental site investigation was completed to identify possible environmental contaminants, revealing the presence of asbestos, lead-based paint, and underground storage tanks. A combination of incentives was used to offset asbestos removal and other cleanup costs for entire City Hospital complex: Brownfield Remediation Tax Credits from the Missouri Department of Economic Development, Brownfield Economic Development Initiative Grant from the Department of Housing and Urban Development (HUD), and Section 108 loan funds from HUD.
Phase I included restoration of the administration building and its east and west wings, which were built in 1912. The renovated building has 102 loft-style condominiums and was renamed "The Georgian" in reference to its distinct Georgian architectural design.