The majority of the Fourth Division's medical facilities are practically located all underground. This idea was all the brainchild of the legendary Captain of the Fourth Division, Jousake Hiroshi. This underground hospital spans a total of 100+ acres underneath the foundation of the Seireitei. A total of three hundred years were needed to complete the building of this massive facility, but upon completion, the Fourth Division's advancement in medical knowledge has grown at an alarming rate. Given the small number of members in the Fourth DIvision including those in the Sword and Shield Initiative, they're knowledge in the medical arts has given the division the ability to serve the entire Gotei 13 in the event of a crisis.