Ascension St. John plans to end inpatient care at Nowata hospital. Residents are fighting back.

Ascension St. John is seeking federal approval to turn its NWATA hospital into a rural emergency facility, which would mean ending inpatient care. The nonprofit health system says the move will support the viability of local health care. But as State Impact Jillian Taylor reports, many residents are opposing it. In March 2025, NWata resident Joe Thornbrough ended up at Ascension St. John Medical Center in Tulsa. Delayed treatment for what turned out to be a kidney stone had led him to experience a life-threatening condition called sepsis. They say if I had gone when I did. I wouldn't be here. While hospitalized, Joe developed bedsores, making it impossible to walk. For several months, he bounced around hospitals in Broken Arrow, Fairfax, and Bartlesville. But he says it wasn't until he landed in Nowada's Critical Access Hospital that he started to get better. I'd see my grandkids every day or my wife every day. I thought I want to go home. I want to get better. Joe spent 100 days at Ascension St. John Nawada through its swing bed program, which can be used to provide acute or skilled nursing care. He was two minutes away from his wife, Krista. After receiving wound care and physical therapy, she got to see him walk again. It was just one of the best things that I don't know if we would have ever been part of anywhere else, and I'm just so thankful. I couldn't imagine them losing the ability to have the kind of care that Joe had. Ascension St. John Nawada could lose acute inpatient and swing bed services if it is approved to become a rural emergency hospital. Congress established the designation in 2020 to help maintain local access to outpatient and 24-7 emergency services amid growing concerns over hospital closures. Rural emergency facilities receive a monthly payment of around $295,000 to do this. This is a way to stop the bleeding and to keep the doors open. That's Tanner Holt, the president of Ascension St. John Jane Phillips in Bartlesville in an interview with Bartlesville Radio. According to tax records, the hospital had some profitable years over the past decade. But it lost about $1 million in fiscal year 2023, and most recently, around $200,000 in both fiscal year 2024 and 2025. State Impact requested an interview with Ascension St. John officials and received statements from a spokesperson. They say the rural model better reflects the community's needs, citing declining inpatient admissions and increased emergency department visits. Critics like Harold Miller from the Center for Healthcare Quality and Payment Reform say an increase in emergency visits doesn't mean the rural emergency model is better for the community. So one of the challenges many hospitals have faced is when they look at this.

Closing the inpatient services actually makes them worse off financially. Critical access hospitals get paid by Medicare based on cost. If Nowada became a rural emergency facility, it would lose out on this benefit. Dr. David Coggle, a medical staff member at Ascension St. John, Nawada, called this transition short-sighted. He says he wishes the hospital would invest in more services for Medicare patients so the hospital could benefit from its current status as a critical access facility. If I had anything to say about why this decision to REH is because it feels easy and they don't have to come up with any capital to invest in the critical access format, even though you get a whole lot more back for the community. Three words, three times. Stay in our hospital. Say no. Savar Hospital. Dozens of people filled the bleachers of the Nowada Middle School gym on a sweltering Sunday afternoon in mid-July for a rally hosted by a newly formed group called Save Our Hospital. It is collected about 1,000 signatures around Nauta County in favor of the hospital maintaining inpatient care. Joe Thornbrough, who relies on his wheelchair, couldn't make it to the event. I don't know what to do. I'm frustrated. I can't go up in marching protest because I would. I know what this hospital did for me, but I know other people can and will. Community members who oppose the rural emergency designation say they want transparency on what the money will be spent on. And if they do lose their inpatient care, they hope it returns one day. For State Impact, I'm Jillian Taylor. State Impact is a collaboration of NPR member stations in Oklahoma. You can find and follow State Impact on Facebook, Instagram, and X at State Impact OK.