Construction on Frederick's new critical access hospital just got a $21 million lift, months after Tillman County families marked a decade of driving an hour or more just to reach emergency care. The funding, delivered through New Markets Tax Credits, keeps the long-stalled rebuild of a hospital that shut its doors in 2016 moving toward a planned reopening in November 2027.
J.P. Morgan contributed a $3 million tax credit allocation, while MetaFund, an Oklahoma City-based nonprofit community development financial institution, provided $18 million of the allocation, according to The Journal Record. J.P. Morgan's overall commitment to the project totals $6.3 million in tax credits, per the same report. The New Markets Tax Credit program, administered by the U.S. Treasury Department's Community Development Financial Institutions Fund, is designed to encourage private investment in economic development projects in underserved communities.
The original Frederick hospital closed in 2016 after 63 years of operation, leaving what the Journal Record describes as a healthcare gap in southwest Oklahoma, a region classified as a medically underserved area. Memorial Health System of Southwest Oklahoma, based in Lawton, partnered to develop the replacement facility at the site of the former hospital, and Memorial Health of Tillman County Critical Access Hospital is now under construction.
A Rebuild Eight Years in the Making
Comanche County Memorial Hospital CEO Brent Smith said the investment will expand healthcare services for Tillman County and surrounding communities. Smith has also pointed to state policy as a foundation for the project's long-term finances: he has said that the 2020 voter approval of Oklahoma State Question 802, which expanded Medicaid eligibility to adults earning up to 138% of the federal poverty level, was critical to ensuring the hospital would be financially sustainable, according to the Southwest Ledger.
State Rep. Trey Caldwell, the Republican who represents Frederick and chairs the House Appropriations and Budget Committee, said the project demonstrates collaboration among government agencies and private partners. Caldwell has also described the effort in starker terms, calling it an oasis in a healthcare desert. The Southwest Ledger reports Caldwell held over 300 meetings to coordinate local and state partners and has noted that Frederick's rebuild marks the first time in 50 years that a closed U.S. rural hospital has been fully rebuilt and reopened, aside from a Kansas hospital rebuilt after a tornado.
The project broke ground in August 2024 and has already required more than eight years of work behind the scenes. Evan Fay said the rebuild is expected to restore quality care in and around Frederick, according to the Journal Record's reporting.
Stacking Federal, State and Local Dollars
The $21 million tax credit allocation is only one layer of a much larger financing stack. U.S. Rep. Tom Cole, who represents Oklahoma's 4th Congressional District and chairs the House Appropriations Committee, secured approximately $6 million in direct federal congressional appropriations in 2024 to help finance construction, according to a press release from Cole's office. The project also received American Rescue Plan Act funding tied to a $25 million Rural Hospital Rebuild grant program the Oklahoma Legislature passed in 2022, using the Frederick facility as its initial blueprint for restoring rural healthcare access statewide, per the Oklahoma House of Representatives.
The Oklahoma Department of Commerce chipped in $1.8 million through its Public-Private Partnership program, administered by the agency's CORE division, alongside rural development loan backing from the U.S. Department of Agriculture, the Oklahoma Department of Commerce has said. Local officials also scheduled a January 2025 special election asking Tillman County voters to approve a 1% sales tax on personal property, utilities and hired transportation to help fund medical facilities under the Frederick Hospital Authority, spanning both construction and ongoing operations, according to KGOU. Whether county voters approved that tax remains an open question in available reporting.
Even the hospital's federal eligibility required a regulatory fix. The Centers for Medicare & Medicaid Services updated its Critical Access Hospital distance rules in 2022, removing a primary-road proximity restriction that had previously blocked the Frederick facility from receiving federal critical access designation, according to Investigate Midwest. U.S. Sen. James Lankford advocated for that CMS rule change. As recently as this year, the Oklahoma Legislature enacted Senate Bills 1132 and 1133 to appropriate $22 million from state recovery accounts to plug remaining budget gaps across the Rural Hospital Rebuild Program, according to the Oklahoma State Senate, with Caldwell co-authoring the measures.
What the New Hospital Will Offer
Once complete, the new hospital will include five emergency treatment rooms, 10 inpatient beds, physical therapy services, radiology, electrocardiology and laboratory services, per the Journal Record. Planners project the facility will serve about 8,850 patient visits annually, aiming to provide high-quality healthcare close to home for a community that has been without a local hospital since 2016.
The need is well documented locally. Southwest Oklahoma's healthcare access has been limited by provider shortages, limited services and patient travel challenges, and Tillman County families had to drive an hour or more for hospital care after the 2016 closure. U.S. Census data show Tillman County had approximately 6,780 residents in 2025, with 16.7% of residents under 65 lacking health insurance and a doctor shortage ratio of one primary care physician for every 7,076 residents, according to the U.S. Census Bureau. Frederick is the largest municipality in the county, with around 3,300 residents.
Bucking a National Trend
Frederick's rebuild stands out against a broader pattern of rural hospital contraction. Research from the Cecil G. Sheps Center for Health Services Research indicates that 10 rural hospitals in Oklahoma closed or converted between 2010 and 2025, part of a nationwide wave in which more than 150 rural hospitals closed across the country during the same period, according to Harvest Public Media.
Whether the layered public-private financing model behind Frederick's rebuild can be replicated in other rural communities facing hospital closures remains an open question, as does how staffing will be sustained amid the region's documented physician shortage. For now, the project is intended to support long-term economic development in the region while restoring healthcare access for Tillman County and its surrounding communities.
