1880
Renovation begins to convert the building into an asylum for the Chronic Insane. Isaac Perry designs and supervises the renovation. July, Dr. MacDonald resigns, Dr. Theodore S. Armstrong is installed as superintendent.

1881
Re-opens October 19 with 298 patients suffering from chronic insanity transferred from asylums at Utica, Poughkeepsie and Middletown. Within four years the patient population grows to 580.

1890
The institution is renamed Binghamton State Hospital.

1891-1892
Dr. Armstrong dies December 27, 1891. Dr. Charles G. Wagner is installed as superintendent on February 8, 1892. School of Nursing is begun.

1893
Electric lighting plant is installed, replacing gasoline plant.