In Nowata, the fear is simple and blunt: if Ascension St. John gets its way, the town’s hospital could lose its inpatient beds, and patients who need to stay overnight might be in for hours-long ambulance rides to other cities instead of recovering close to home.
Ascension St. John has applied to the Oklahoma State Department of Health to reclassify the small Nowata facility, a move hospital leaders say aligns the hospital with changing patient volumes while keeping the lights on in the emergency room during the review. Residents, meanwhile, worry the change would quietly strip away a lifeline.
As reported by FOX23, Ascension St. John Nowata has asked the state to reclassify the hospital from a critical access hospital to a rural emergency hospital. The application is now under review. Under the proposal, the facility would keep 24-hour emergency care and outpatient radiology and laboratory services, but inpatient beds would be eliminated. Patients who need to be admitted would be transferred to Ascension St. John Jane Phillips in Bartlesville, Ascension St. John Owasso or Ascension St. John Medical Center in Tulsa.
Ascension told FOX23 that the shift is a response to how patients are actually using the facility. According to the system, emergency room visits increased about 12% in 2022, while inpatient admissions have dropped roughly 58% since 2020. The health system says it would pick up the cost of patient transfers and expects only minimal impact on staffing for the emergency department, radiology and laboratory.
Patients and families who have leaned on the Nowata hospital say those numbers do not tell the whole story. They told FOX23 they fear losing the very services that helped them heal.
"They got me from just being in bad shape to walking," patient Joe Thornburgh said of his roughly 100-day stay at the Nowata facility, where he received physical therapy, wound care and rehabilitation. His wife, Krista, said the fact that the hospital was in town meant family could visit often during his recovery, something she worries would be far harder if he had been sent to Bartlesville or Tulsa. She also pointed out that local workers, including two dietary employees, could be affected if inpatient care disappears.
What the rural emergency hospital label actually does
The rural emergency hospital, or REH, is a relatively new category created by the Consolidated Appropriations Act of 2021. It is designed to let small hospitals focus on emergency and outpatient care while stepping away from traditional inpatient services.
The Oklahoma State University Center for Health Sciences explains that the model can improve financial stability for struggling rural facilities but comes with significant tradeoffs, including limits on the average inpatient length of stay, loss of eligibility for certain programs such as 340B, and an uncertain path to convert back to a previous hospital classification. Communities weighing conversion are encouraged to get technical assistance and carefully consider what the change would mean locally, according to the OSU Center for Health Sciences.
Why Nowata is especially anxious about access
On paper, the reclassification is about billing categories and federal designations. On the ground in Nowata County, it is about whether people can realistically get to care at all.
Ascension’s 2024 Community Health Needs Assessment flags access to care, transportation and food security as top priorities for Nowata County and notes that many residents already struggle to make it to medical appointments. In that context, families worry that longer trips to Bartlesville or Tulsa for admission would make follow-up visits and family support much more difficult for older adults or people with mobility challenges. Hospital staff are also uneasy about what a loss of inpatient services could mean for local jobs. The full assessment is available through Ascension St. John Nowata.
The reclassification request is currently being reviewed by the Oklahoma State Department of Health’s Medical Facilities Plan Review team, which handles licensure and classification changes for hospitals and publishes application requirements and fees on its site, according to the Oklahoma State Department of Health. For now, residents and hospital officials are watching closely and waiting to see how the department rules, and what that will mean for patient transfers and outpatient services in the months ahead.
