Simkins v. Cone historical marker

Simkins v. Cone (J-120)

Landmark federal court of appeals decision 1963 involving Cone Hospital led to racial integration of hospitals in the U.S.

Location: North Elm Street alongside Cone Hospital in Greensboro
County: Guilford
Original Date Cast: 2016

Simkins v. Moses H. Cone Memorial Hospital was an important civil rights legal case that led to the racial integration of hospitals. Prior to the case, hospitals and access to medical care were segregated along the racial lines established in the “Jim Crow” era and beyond, using the “separate but equal” doctrine established under Plessy v. Ferguson (1896). As in the case of other facets of ordinary life under segregation, there was the very definite separation but no equality. Not only were African American physicians not allowed to practice within hospitals frequented by whites, but African American patients were denied access to the same medical facilities as whites. As a result, medical care for African Americans was often deficient in resources and funding, despite the valiant efforts of African American physicians to provide the best for their patients.

A group of African American physicians and patients in Greensboro, led by dentist and local NAACP chapter president George C. Simkins, filed suit against Moses H. Cone Memorial Hospital and Wesley Long Community Hospital in 1962. Dr. Simkins had fought previously to integrate the city-owned golf course and tennis courts in Greensboro. The hospital case centered on the use of federal funding for the construction of the facilities under the provisions of the Hospital Survey and Construction Act of 1946 (the Hill-Burton Act). The Hill-Burton Act provided for matching grants from the federal government to support the costs of construction of public and nonprofit private hospitals and other medical facilities. Both Moses H. Cone Memorial Hospital and Wesley Long Community Hospital had received federal funding through the Hill-Burton Act. As originally written, the act operated under the “separate but equal” doctrine.

Planned medical facilities were prohibited from accepting federal construction funding if they discriminated, unless separate facilities were also planned that were likely to give equal treatment. Of the two hospitals in Greensboro, one refused to treat African Americans at all, while the other imposed limited access. The suit filed by Simkins and his colleagues sought equal access for African American patients and their physicians and dentists at the hospitals. The suit went further than merely challenging the fact that not one of the hospitals provided fully equal accessibility for African American patients and medical professionals, however. Building on the body of casework established since Brown v. Board of Education (1954), the suit also argued that the “separate but equal” provisions should be struck down altogether, as they violated the plaintiffs’ constitutional rights under the due process clause of the Fifth Amendment and the Equal Protection Clause of the Fourteenth Amendment. The U.S. Department of Justice concurred with the latter argument, and subsequently joined the case.

The U.S. District Court for the Middle District of North Carolina ruled in favor of the defendants on December 5, 1962, determining that use of federal construction funding did not connect private hospitals to the government and that they did not therefore fall under the purview of the Fifth and Fourteenth Amendments. The plaintiffs subsequently filed an appeal with the U.S. Court of Appeals for the Fourth Circuit. The ruling was issued in a close 3-2 split decision on November 1, 1963, reversing the Middle District ruling. The appeals court found that the receipt of federal construction funding made private hospitals subject to the Fifth and Fourteenth Amendments, and thus separate but equal policies in such institutions were unconstitutional. The U.S. Supreme Court refused to hear the case in 1964, thereby leaving intact the appeals court decision. The ruling laid the groundwork for the desegregation of all public facilities in the Civil Rights Act of 1964.

Simkins v. Moses H. Cone Memorial Hospital, 211 F. Supp. 628 (M.D.N.C. 1962), U.S. District Court for the Middle District of North Carolina – 211 F. Supp. 628 (M.D.N.C. 1962), December 5, 1962, Justia U.S. Law website,…
323 F2d 959 Simkins v. Moses H. Cone Memorial Hospital, decided November 1, 1963, OpenJurist website,…
U.S. Commission on Civil Rights, “Equal Opportunity in Hospitals and Health Facilities: Civil Rights Policies Under the Hill-Burton Program,” Commission on Civil Rights Special Publication No. 2 (March 1965),
William H. Chafe, Civilities and Civil Rights: Greensboro, North Carolina, and the Black Struggle for Freedom (1980)
Robert L. Phillips, “History of Integration of Medicine in Greensboro, North Carolina Chronological Documentation” (unpublished typescript report, Greensboro Medical Historical Library and the Greater Greensboro Society of Medicine, November 1990)
P. Preston Reynolds, “Hospitals and Civil Rights, 1945-1963: The Case of Simkins v Moses H. Cone Memorial Hospital,” Annals of Internal Medicine, vol. 126, no. 11 (June 1997): 898-906
Karen Kruse Thomas, “Simkins v. Cone,” NCPedia website,

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