The hotel was purchased by Dr. Ernest L. Bullard, a surgeon and professor of psychiatry and neurology from Milwaukee, Wisconsin. Dr. Bullard renovated the hotel, by that time at the end of the trolley line. In 1910, he opened a sanitarium for the care of nervous and mental diseases, naming it for the 125 chestnut trees on the property. For many years, Dr. Bullard was the sole physician. For more than 75 years, three generations of Bullards operated Chestnut Lodge. The private hospital became known nationally for the quality of care and treatment, based upon the Bullards' philosophy that mental illness is treatable through a combination of psychoanalysis and occupational therapy. Well-known therapists, such as Frieda Fromm-Reichmann and Otto Will, joined the staff. Through the years, the Bullards added acreage and buildings to their property, and made their home at Rose Hill.

By 1997, Rockville had changed and so had the Bullard family. CPC Health, a nonprofit corporation, purchased the portion of Chestnut Lodge facing West Montgomery Avenue, but declared bankruptcy three years later. From 2001 to 2003, Rockville's only remaining resort hotel was owned by the Washington Waldorf School. In December 2003, the property was conveyed to Chestnut Lodge Properties, Inc.

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