The ‘Waterfall Sanatorium’ opened in April 1909 as New South Wales’ first purpose-built Hospital for Consumptives, in an elevated site chosen for its quietness and isolation from the general community.

Consumption, now referred to as tuberculosis or TB, is a highly contagious disease with few options for treatment. The first patients were 230 males transferred from the overcrowded Liverpool Asylum, and in 1914, an accommodation building for 120 women was added.

The hospital was self-sufficient with a vegetable garden, orchard and pig and poultry farm. In 1914, it became the Waterfall State Sanatorium for Tuberculosis, and around this time, small ‘chalets’ for the isolation of patients were built on the grounds.

The hospital continued to serve tuberculosis patients until 1957.

From 1958, the Garrawarra Hospital functioned as a facility for the aged and chronically ill until 1991, when the old buildings were seen as unsuitable for modern hospital requirements. After this time, it became Garrawarra Centre for Aged Care, with new buildings constructed on another part of the site in a heritage style.

Once the older section of the hospital closed, the ward buildings soon fell into disrepair and have become vandalised over time.
The earliest buildings on the site are the most interesting with some attributed to Government architect Walter Liberty Vernon.

These include the administration and kitchen block, staff cottages and the entrance gatehouse. Nearby, on the original alignment of Illawarra Road, is the hidden and overgrown Waterfall Cemetery, where around two thousand TB victims are buried and lay forgotten.