The hospital tradition that gave rise to today's Bürgerspital and its associated foundation dates back to the late Middle Ages.

• The Katharinenspital was first mentioned in documents as early as 1237, but this does not rule out its earlier existence. Its existence can be traced back to the wealthy citizen Konrad Tockler, who donated his house behind St. Martin's Church for the purpose of establishing a hospital.
• According to the foundation deed of 1330, the Elisabethenspital im Sand was founded by the Bamberg citizen Konrad Eßler and later named after the Church of St. Elisabeth in the Obere Sandstraße. The founder's intention at the time was to provide accommodation and care for the poor, the elderly, and the sick. The civic founders ensured that this purpose of the foundation would be fulfilled for all time with real estate, financial assets, and other income.

In the early 19th century, the 800-year history of the Benedictine abbey on Michaelsberg came to an end. In the course of secularization, the monastery was dissolved and the secularized abbey was awarded to the new civic hospital foundation. As a result, the former “United Civic Hospitals” moved with their residents and their belongings from Bamberg's city center to the now vacant monastery complex.

In 1818, fourteen years after the welfare homes moved to the new civic hospital on Michaelsberg, the city of Bamberg took over the administration of the civic hospital foundation and numerous other charitable foundations. In 1880, it commissioned the Order of the Sisters of Charity of St. Vincent de Paul to manage the civic hospital. In addition to them, the curate was responsible for discipline and pastoral care as the house father. However, the annual accounts at that time also listed payments to the hospital cook, the foresters, doctors, gatekeepers, and the economic administrator.

The Bürgerspitalstiftung survived the most severe financial crisis of its existence during the Great Depression in the 1920s. Through a conservative asset policy and the expansion of the hospital forest and real estate, the foundation's administration had created a basis that ensured the foundation's continued existence independently of the capital markets.

Over the years, the use of space and residential structure at the Michaelsberg Hospital changed, as did the residents' expectations of their accommodation. Care in large halls was gradually restructured into single or small group accommodation. At the beginning of the 1970s, there was a capacity of 145 places, and eight nurses and one additional caregiver were recorded in 1973.

In 2002, the last nuns left the Bürgerspital. In recent years, the convent building has been converted into assisted living facilities. Various offices of the city of Bamberg were housed in the economic wing in 2013, which was renovated in 2012 in accordance with historic preservation guidelines.