Today, Barlow's agents are taking care of the duties that would have fallen to a developer in a typical land deal -- conducting traffic studies at intersections; leading efforts to ease zoning restrictions at City Hall and making sure there aren't any endangered animals on the site that require special protection.


"It's incumbent on everyone associated with this to do the right thing," Jensen said.

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Designing the new hospital, a three-story facility that will bump the bed count to 56, was the fun part.

An industrial engineer on Jensen's team followed nurses with a pedometer and determined that some walked five miles a day without finding the time to see many patients; the new design is expected to cut in half the time nurses will have to spend retrieving supplies and doing paperwork.

Every room will be private; currently there are just 10 private rooms.

Every patient will have a direct sight line to Barlow's campus, which -- even while many of its 42 buildings have fallen into disrepair -- remains leafy and well-maintained.

"It's hard to make any hospital feel homey and normal," Nelson said. "But we are trying."

The new hospital will take up about four acres, leaving 20 or so to go on the market.

Those overseeing the project are still putting together ideas for what the site might look like.

But with a hospital as an "anchor," Jensen said, the most natural development would be a "wellness community" incorporating senior housing and more traditional residential development.

Other possibilities include a boutique hotel, a senior center and a community recreation center.

Barlow is connected intimately to the area's residential neighborhoods.

It is, for instance, where locals hold their community meetings and where they vote.

None of that will change, Crane said; the new hospital has been designed with a secondary front door that residents can use to walk inside for community meetings, so they won't have to pass through the main treatment areas.

Crane said she is also pushing to preserve some of the historic buildings, even if they have to move them around to make room for new development.

Many, however, are crumbling relics, unused for decades, and they will probably be demolished.

Inside one old patient cottage, vandals had ripped a mirror from the wall in the bathroom and left behind empty packs of cigarettes and graffiti -- "DRUNK BUMS," it said -- on the walls. In another, there was a heap of documents from slip-and-fall lawsuits and a room full of chest X-rays that no one had looked at in 25 years.

"I can't even tell you how far back it goes," said Stephen L. Packwood, Barlow's executive director for strategic planning and business development. "I'll bet you haven't seen many hospitals like this."

scott.gold@latimes.com