Hopemont, West Virginia's first tuberculosis sanitarium, met a pressing public health need, because in the early 20th century 1,000 West Virginians died annually from the disease. Getting tuberculosis was practically a death sentence. Nurses and physicians were brave to treat TB patients, often contracting the dread disease themselves.

The Anti-Tuberculosis League of West Virginia lobbied a bill through the legislature in 1911 to build a sanitarium. In those times, physicians believed such hospitals should be in high, cold places, and the site chosen was a farm near Terra Alta in Preston County. Hopemont started with a receiving building with offices, kitchen, dining room, and apartments. Two patients' cottages followed, one for each sex. As decades passed, larger hospitals were built on the spacious grounds. A separate institution for Black patients was established at Denmar, Pocahontas County, in 1917. The living quarters at Hopemont had long porches, exposed to the weather. The theory was that patients benefited from fresh air year-round, though superintendent E. E. Clovis said it was "difficult to keep the patients from the bright and cheerful fire" in winter.

Patients were not forced into sanitariums. Rather, they came to Hopemont by choice, often after infecting their families. In good times, TB sufferers avoided the hospital so they could work and provide for their families, but in economically depressed years, staff had a hard time getting cured patients to leave.

As years passed, fear of tuberculosis lessened as medical research, early detection, and thoracic surgery brought people back to health. In 1965, Hopemont became a personal care center. Many of its numerous buildings have been razed or left empty.