In the wake of the Second Battle of Fredericksburg and the Battle of Chancellorsville in May 1865, Bishop Amadeus Rappe made a proposal to the Cleveland City Council. Bishop Rappe, the first bishop of the Diocese of Cleveland, proposed the building of a hospital to care for the streams of wounded soldiers returning to the city. The city council appointed a committee to investigate the proposal, and the committee immediately encountered resistance. Newspaper editorials attacked the idea of a Catholic-run hospital in a city that was nine tenths Protestant. Bishop Rappe made his proposal a second time, and this time he specified that the Sisters of Charity of St. Augustine would provide nursing care if the city would provide funding. Despite continued anti-Catholic rhetoric, the Sisters emphasized that they intended to care for patients of all faiths and those who were unable to pay would have their care paid for by the city. Eventually, city council agreed to the proposal and a site was purchased on Perry Street (now East 22nd) for $10,000. Taxpayers paid $42,000 of the $72,000 building cost. On October 5, 1865, St. Vincent Charity Hospital opened its doors.
A century later, St. Vincent undertook a project that for some undermined its relationship to the community. The hospital had outgrown its space, and the only place to expand was into the surrounding low-income neighborhood that city officials had come to see as urban blight without value. St. Vincent greatly expanded its campus in the early 1960s at the same time the city inaugurated the Erieview urban renewal project. Some 1,800 mostly low-income households were displaced over several years to build the Erieview Tower, One Erieview Plaza, and the Federal Building. The hospital campus was almost entirely rebuilt in the St. Vincent Urban Renewal Area. Only 600 of the 1,800 families received public assistance to relocate. The hospital that was created to serve the poor ironically displaced the people it served. Progress and urban renewal were defined as the removal of low-income families.
Although the history of St. Vincent Charity Hospital has not always been rosy, the Sisters of Charity of St. Augustine have remained committed to providing compassionate medical care to anyone in need regardless of religion or race for 150 years.