The hekdesh director was in charge of the spital for the sick. The spital was one of the hospitals maintained by the Jewish community. A source from 1473 describes it as a spital for 16 "lame, blind and starving" inmates. The director was a community servant accountable to the leaders of the community, the "master builders". The hekdesh director lived in the spital with his family. At the beginning of the 18th century the hekdesh director was a tailor, so it seems that the office had little status.
When the number of inmates rose the number of employees was increased as well: the director ran the home with the help of nurses. Establishing such homes was an aspect of welfare, which according to religious law is one of the most important tasks of a Jewish community and is always conscientiously provided.