Located on the border of the Manhattan neighborhoods of Chelsea and Greenwich Village, St. Vincent’s Medical Center has been at the forefront of care in treating New York’s tragedies, epidemics, and crises since it opened in 1849. But now, as the city reels from recession, the legendary hospital is on the verge of closing its doors permanently, leaving thousands of people living with AIDS without their primary care facility.

“St. Vincent’s shutting down leaves a huge hole in New York City,” said Ken Fornataro, the director of the AIDS Treatment Data Network. “This is one of the major places in the city where anyone can get AIDS care.”

In addition to treating Titanic survivors and those injured in the September 11, 2001 terrorist attacks, St. Vincent’s was the epicenter of care for New York’s HIV-positive gay men during the early ’80s. The Sisters of Charity, the Catholic nuns who established St. Vincent’s, insisted their teaching hospital take anyone who needed care, regardless of financial circumstances.

But as gentrification changed New York in the 1990s, local residents skipped over the aging St. Vincent’s in favor of better funded hospitals like Memorial Sloan Kettering or Lennox Hill Hospital; at a landmarks preservation hearing in 2008, actress  Susan Sarandon said she wouldn’t even bring her children there. St. Vincent’s has been in such dire financial straits lately that it was forced to take several multi-million dollar loans from the state. A proposed deal in February to have a hospital network take over St. Vincent’s failed, resulting in the facility preparing to close its inpatient and emergency room care, and possibly shut down completely.