OKPOLICY.ORG
Camille Landry is a writer, activist, and social justice advocate who lives in Oklahoma City. This post is part of our “Neglected Oklahoma” series, which tells the stories of Oklahomans in situations where the basic necessities of life are hard to come by. These are real people and their stories are true (names have been changed to protect privacy).
Mrs. Emma Oliver warns me, “Don’t have a heart attack in Sayre, Oklahoma.” The hospital in Sayre, about 20 miles southwest of Elk City, just closed its doors. “Don’t wreck your car or have a stroke, either. If you live out here, any medical condition where minutes count is much more likely to kill you now than it was a week or so ago.”
Sayre Memorial Hospital, in this town of 4,600 on I-40 near the Texas panhandle border, went broke. The hospital board had taken out millions of dollars in bonds and citizens raised the local sales tax to fund the hospital, but it wasn’t enough to counter the losses. The facility closed in early February.
Too many people who live in rural Oklahoma lack medical insurance, Mrs. Oliver, a retired nurse, explains. “People with no insurance often can’t go to the doctor so they wait until they’re really sick and go to the emergency room. They can’t pay those bills so the hospital has to eat the costs.”
Things had started looking up for Sayre when the oil boom provided good-paying jobs. “Good salaries but many workers had no benefits,” Mrs. Oliver explained. Nearly one out of five workers in the county were employed in the oil and gas industry. The decline in oil prices made those good jobs a thing of the past. Like much of the state, there’s no other industry offering comparable pay in the region. Some of these workers were able to purchase insurance through the Affordable Care Act or Insure Oklahoma, the state’s program for small businesses and independent contractors, but the end of the oil field jobs made it impossible for many of these workers to keep their insurance.
So far the local ambulance service is still operating. “When we had our hospital here in town we were just minutes away from medical services. It’s at least a twenty-minute drive to the nearest hospital in Elk City, longer than that if you live outside of town or you go across the border to Shamrock, Texas – and that’s after the ambulance arrives at your door, which can take a long time if you live outside of town.”
[pullquote]“Don’t have a heart attack in Sayre, Oklahoma. Don’t wreck your car or have a stroke, either. If you live out here, any medical condition where minutes count is much more likely to kill you now than it was a week or so ago.”[/pullquote]Emma Oliver worked at Sayre Memorial before her retirement. “The staff was good. We were not a big city trauma center, but we could stabilize people and transport them to a regional hospital for additional care if needed. We were all neighbors, and we looked out for each other.” She worries that the increased response time and travel distance to the hospital will result in deaths that could have been prevented. “Minutes count when somebody is really ill or badly injured,” she says. She is concerned about the effects this closure will have on the region’s remaining hospitals. “More people will come to the next closest hospitals. This will mean longer waits in the ER, more patients for the doctors and nurses to take care of.”
“It’s not just emergencies, either,” her sister Evelyn adds. “The doctors around here send you to the hospital for lab work, x-rays, tests. Now we’ll have to travel to Elk City or Texas just for routine tests.” The ladies are luckier than some. They still drive and they have good insurance. “I worry about our elderly and about people who just lost their jobs. The farther patients have to travel, the more it becomes an issue.” They also worry that the doctors in town will move closer to the hospital in Elk City.
Last year Sayre Memorial Hospital had 3,763 emergency department visits and 526 admissions. Its loss has economic consequences as well. The hospital employed about 130 people and reported $8.7 million in total revenue in 2014. The county, the city, and the state will lose tax revenue and the businesses that serviced the hospital and its staff will lose income as a result of the closing.
Nearly every Oklahoma hospital with fewer than 100 beds lost money between 2009 and 2012. Many of these hospitals are located in rural areas. Some communities have approved sales tax increases to support their hospitals. Many hospitals have borrowed extensively to make needed improvements and cover their losses, but most small hospitals continue to struggle economically. The Oklahoman listed other contributors to the budget crunch, including electronic medical records requirements, new auditing processes for Medicare billing, diminishing reimbursements from Medicaid, the general economic downturn in Oklahoma, and the state’s decision not to accept federal dollars to cover the uninsured.
Mrs. Oliver summed up the situation: “This cannot possibly be good for our community. I’m awfully afraid that this will hurt people who can’t get medical attention fast when they need it the most.”
Note: The initial version of this post incorrectly had a reference to Sayre County (Sayre is in Beckham County) and gave the wrong distance between Sayre and Elk City.
It’s interesting that there is no mention of the lost revenue from the closing of the 2800 bed private prison and the results of the loss in revenue to the city, used in part to support the hospital. The prison lost 500 employees who in turn lost their income and health insurance too.
No one mentioned the perfectly good hospital they had n the hiring of corrupt city manager who was fired in Elk City. They would not admit you unless on death bed n if a prisoner was in the you were SOL. Shit out of luck. None of the drs in Sayre would admit you a hospital ist n they could even afford the cafeteria for anyone but patients. My dr sent me to Elk after hrs to er afford after 5. My mother was afford termites discharged in 1 day n was in Elk within 6 hrs with pneumonia n Ecole so I don’t think the the part of you might die quicker. Elk is no better my family is insured n we go to city if can. So really I’d head west if shamrock is any good because the oil industry bust didn cause this Sayre hospital management did. The prison will reopen guarantee ya then the prisoners will go to Elk then that will be bad. Sayre has money to kick people out there old homes cause poor n don’t like color so buck up you did it to yoyrself.
All the things that kept the town running and kept elk city alive is now diminishing. Those things were the hospital and doctors. The prison and the oil. It’s gonna be a ghost town one day for sure. I’m glad I moved away before this happened. I had many bad experiences with doctors and the hospital in sayre. They were shitty and everyone knew it. They should have been shit down before this happened to begin with. But I do worry now that it’s gone. I hope that something good comes of that area of Oklahoma.
Rural hospital administrators have to be be more open to new ideas and opportunities than ever before. “That is how we have always done it” kind of thinking does not cut it anymore. You simply can not turn down additional revenue opportunities and stay in business.
Having worked at the small hospitals in our area I can tell you that this is not a good thing. I have been seen at elk city hospital told that my problem was nothing and to go home. Only to be seen at sayre hospital a day or two later because I had a major infection. The biggest problem with this area is when you call to make a Drs appointment for anything it’s we can see you next week or we don’t have any openings till 2 weeks from now.so people go to the Dr to be treated and you get charged out the wazoo. I have insurance threw my current job but it doesnt cover half the medical expenses for being seen anywhere. Take a severe migraine for instance the shot alone was 500 dollars. It cost to much because healthcare has become about the money not the patient so small towns will suffer and big hospitals will charge huge amounts to tell you your fine when your not
That should say ER to be treated not Dr.
They just mentioned in passing that the Affordable Care Act ( Obama Care) had a lot to do with breaking the hospital.
Most statisics you look up are from 2010 to 2014 but google 1980’s hospital closures. For those of us in health care that long we know it started with Medicare & DRG’s (this in general means hospitals are reimbursed based on a set amount & that amount is based on diagnosis This is the reason you are rushed out of acute care). This is when towns like Okarche & Mooreland closed their hospitals. Obamacare may not be helping but Obamacare did not start this problem. Hospitals face a tremendous overhead on a daily basis in salaries alone & anyone with basic math skills can calculate it is not a money making business. Healthcare was not meant to be for profit & it should be illegal to charge $10 for a 5 cent Aspirin. Hopefully Sayer will be able to keep an ER or Urgent Care center or consider other options such as having another company come in to run it. Best of luck!
You can’t run an acute hospital in a town this size, with a PPS hospital down the road. This town had no doctors to refer patients, a surgery center with no surgeons and paid $50K monthly to a management company who couldn’t care less. I told the mayor and City Manager and no one listened.
You need to update your article. Of course there was a lot of hyperbole in it, too, but what does one expect from an “social activist”. We’re a poor town with economic woes when the prison shut down and oil jobs disappeared. Prison is back up, but hospital has been closed 2 or 3 times since this article. It has gone into receivership, with the city of Sayre considering buying it. I was in the hospital about three years ago. I was very ill. I had a very good young PA, who did a great job taking care of me. But let’s face it, a seasoned MD, who can have a better and more lucrative practice elsewhere, isn’t going to stick around this town unless he has a sentimental attachment to it. There were few good nurses, many were not. And the food out of the kitchen wasn’t good at all. They also don’t know how to accommodate, or forget about, special diets. It’s open right now, but I think it’s for emergencies only. There is a helipad there, so people needing acute or hospital care can be lifted to Elk City hospital in a matter of minutes.