The former Millard Fillmore Gates Circle Hospital in Buffalo's Elmwood Village neighborhood has a history stretching back to 1872, when a group of Buffalonians opened the Buffalo Homeopathic Hospital on the city's near west side. The institution moved to its Gates Circle location in 1911, changed its name in 1923 to honor the city's most distinguished president, and served the community for nearly a century before Kaleida Health consolidated operations and closed the Gates Circle campus in March 2012. For more than a decade, three of its historic buildings stood vacant.

Now, those buildings are being transformed into 80 units of affordable housing in a $34 million adaptive reuse project that represents one of the more technically complex construction undertakings in Western New York in recent years. Developer Belmont Housing Resources for WNY partnered with Montante Construction to lead the project. Construction began in September 2024, and as of late 2025 the work was approximately 60 percent complete, according to WKBW reporting. The project is scheduled to complete in July 2026.

The Complexity of Converting a Hospital

Adaptive reuse projects are always complex. Converting a hospital into residential housing is a category of its own. Hospital buildings contain decades of specialized infrastructure — mechanical systems designed for medical use, partitioned clinical spaces, hazardous materials including asbestos and lead, and structural configurations optimized for equipment loads rather than residential living. The spaces do not convert neatly, and the regulatory requirements for residential construction differ significantly from those governing healthcare facilities.

Douglas Elia from Montante Construction described the project as "extremely complex and challenging," noting that the first year was consumed almost entirely by demolition, abatement, and structural work before finish trades could begin.

"That first year, there was a lot of demolition, abatement, and structural work that had to happen," Elia told WKBW. "Some of that's still going on now, but this past summer was a big milestone where we moved in, moved to painting, flooring, and millwork."

CJS Architects designed the project. The Buffalo Rising construction update from May 2025 confirmed that the northernmost three buildings of the former hospital are being converted, while TM Montante Development is separately redeveloping the southern portions of the former hospital campus — also known as the old Homeopathic Hospital buildings — into approximately 40 new apartments and up to 15,000 square feet of retail and commercial space.

Who the Housing Serves

The 80 affordable units are targeted at families with incomes between 30 and 80 percent of the area median income — a range that encompasses working families who earn too much to qualify for deeply subsidized housing but too little to comfortably afford market-rate rents in a tightening Buffalo market. Plans include a community room with kitchen, laundry rooms, indoor bike storage, a computer room, a fitness room, and bulk storage for each unit.

"I think we are all aware of the effects of inflation," said Brad Packard, President and CEO of Belmont Housing Resources for WNY. "We've seen housing costs begin to really skyrocket over the past three to five years, and when we look at income growth relative to that proportion, there's an imbalance there."

Future residents will have access to a community courtyard, on-site laundry, and incentivized parking rates at the updated garage associated with the Lancaster Square development.

Part of a Larger Neighborhood Transformation

The Gates Circle adaptive reuse project exists within the broader Lancaster Square development, a multi-phase reinvention of the entire former hospital campus that the Montante Group has been managing since it was selected to purchase and redevelop the site in late 2013. Lancaster Square already includes Canterbury Woods, a senior retirement community, along with a renovated parking garage and several updated auxiliary buildings.

The Montante group previously renovated a former medical office building at 50 Gates Circle into 12 apartments and a garden-level commercial space. People Inc. earlier constructed a 39-unit, three-story affordable senior development on a former hospital parking lot at the southeast corner of Linwood and Lafayette Avenues. Together, these phases represent years of incremental, coordinated redevelopment of what was once a large institutional campus.

Belmont Housing Resources for WNY has been operating in the region since 1977 and currently provides services to more than 15,000 low-income households annually across Western New York. This project, once complete, will be among the more significant adaptive reuse accomplishments in the organization's history and will add a visible, family-oriented affordable housing component to a neighborhood that is already home to several senior-focused developments from earlier phases of the campus redevelopment.

Adaptive Reuse as a Construction Strategy

Projects like the Gates Circle conversion bring housing units online through rehabilitation of existing structures rather than new construction on greenfield sites. This approach tends to be slower and more expensive per unit — the technical challenges of abatement, structural adaptation, and code compliance for a new use type add costs that ground-up construction does not carry. But adaptive reuse also preserves historic neighborhood fabric, avoids the need for new infrastructure investment, and — in the case of a building like this one — gives a dormant landmark a productive second life.

The Gates Circle project does all of this in a high-visibility location on a prominent traffic circle in one of Buffalo's best-established neighborhoods. When the building opens in mid-2026, it will mark the completion of the largest housing component in a campus redevelopment that has been underway for more than a decade.

Applications for the units are managed through Belmont Housing Resources for WNY.

Sources

Former Millard Fillmore Gates Circle Hospital in Buffalo Being Converted into 80 Affordable Housing Units — WKBW, October 24, 2025
Construction Watch: 875 Lafayette @ Gates — Buffalo Rising, May 8, 2025
50 Gates Project — Montante Construction LLC, 2024
Big Reveal: Lancaster Square Reuse Project — Buffalo Rising, November 18, 2021