2. The hospital was modernized following the First World War
Until the First World War the hospital on Tiber Island operated as a hospice rather than a modern medical care facility. In the early 1920s its leaders began a plan to modernize the facility. The Brothers of St. John at the time owned the island, having purchased it from the Kingdom in the early 1890s. Such a practice was common for the brotherhood, they had by then established several hospitals throughout Europe. Their ownership of the island upon which stood the hospital made it an enclave within the City of Rome. The hospital had in its employ Jewish staff members, many of whom lived in a largely Jewish community on the opposite bank of the Tiber.
In 1934 the hospital welcomed a new director, Dr. Giovanni Borromeo, the son of a prominent Roman physician. By that time the Fascist regime of Benito Mussolini was well established, though laws restricting the Jews had yet to be enacted. Borromeo was a Catholic, trained in medicine at the University of Rome, and was a veteran of World War I. In Fascist Italy, party membership was required to move up in the ranks in the professional field, and Borromeo chose to work at the Catholic hospital on Tiber Island rather than more prestigious positions, such as at his alma mater, rather than become a member of the Fascist Party.