This paper describes the current progress in the development of a structural health monitoring and alerting system to meet the needs of the U.S. Department of Veterans Affairs to monitor hospital buildings instrumented in high and very high seismic hazard regions in the U.S. The system, using the measured vibration data, is primarily designed for post-earthquake condition assessment of the buildings. It has two essential components – sensing and analysis. The sensing component includes all necessary firmware and sensors to measure the response of the building; while the analysis component consists of several data processing modules integrated into an open source software package which compresses a large amount of measured data into useful information to assess the building’s condition before and after an event. The information can be used for a rapid building safety assessment, and to support decisions for necessary repairs, replacements, and other maintenance and rehabilitation measures.