settings. During the 1970s Broughton underwent changes in its housing procedures. Up to that time, its population had been drawn geographically, meaning that patients were being housed according to where they were from, rather than by age or disability. On March 28, 1973, Broughton Hospital received its first survey by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the hospital received a one-year accreditation. The Broughton Hospital Main Building was designed by architect Samuel Sloan and built in 1877. It was listed on the National Register of Historic Places in 1977 as the Western North Carolina Insane Asylum. The Broughton Hospital Historic District was listed on the National Register of Historic Places in 1987 and encompasses 60 contributing buildings and one contributing site. The period from the 1980s through 1990s was especially difficult for Broughton. Facing increased costs and increased oversight from various organizations, Broughton encountered severe budget problems. In December 1992, the Broughton Hospital Foundation was formed. Its goal was to enhance the lives of the patients at Broughton Hospital through donations, endowments, activities, etc. Today Broughton serves approximately 800 patients per year and employs approximately 1200 staff members, with a $98 million annual operating budget. In 2011, Broughton began hiring temporary and contract staff to help control overhead costs. Broughton completed a new facility in 2017 that houses the hospital departments and patient divisions under one roof, on the existing grounds. The main building is now preserved as a historical landmark that is used as office space. Asylum Cemetery The cemetery on the grounds was opened in the Spring of 1883 and was by 1884 enclosed by a simple fence. It now contains the remains of 1583 people including several infants born at the asylum to women in care there. Every grave is marked, every person buried there known, something not all asylums can claim. The asylum's first Superintendent, Patrick Livingston Murphy, M.D. refused to allow any patient's remains to be given over to the North Carolina Anatomical Board for dissection and disposal during his tenure from 1883 to 1907 saying that if a patient's family could not provide for burial the asylum would. There were times that weather precluded transport of a person's remains home and burial took place in the asylum cemetery. Other patients had been in care at the asylum so long they had no one left back home to claim their remains