Guards at the National Leprosarium walked a dozen checkpoints several times a day.

Watchclock keys hung from chains attached to the buildings at each checkpoint. The guard, who had the watchclock hanging across his chest suspended from a leather carrier, would insert the key into the clock and turn it, imprinting a circular paper disk inside of the clock unit, marking the time and checkpoint.

In the evenings, the guard walked his security route at 8 PM. When he got to the patients dormitory area, he performed double duty, also offering patients freshly baked bread and milk from the Carville dairy as an evening snack before curfew.

Patients were to be in their designated dormitories by 9 PM and their own rooms by 10 PM. These rules eventually became non-existent as leprosy quarantine laws were reformed in the 1950s and 60s.

By the 1970s, treatment at Carville was voluntary, and, by the 1980s, Hansen's disease was treated as an outpatient diagnosis.