CLINTON — Residents of this western Oklahoma town are getting a taste of life without a hospital.
For Eric Walker, that means treating the rash on his amputated leg on his own. For Eli Colston, it means an ambulance trip 15–30 minutes longer for his epileptic seizures, which occur once every three weeks or so.
For the 32 cancer patients who were receiving care at Clinton Regional Hospital, it has meant looking elsewhere for life-saving chemotherapy infusions.
“There is a huge gap in care for our community right now,” said Sarah Rose, a registered nurse who lost her job when the hospital closed in December.
“The ones this trickles down to are the disadvantaged, the home-bound, the elderly, the young, people on Medicaid — Sooner Care — people that don’t have cars and people who don’t have telephones to dial 911.”
Clinton Regional Hospital serviced a town of 8,612 people until the private company managing it pulled out on Dec. 31, citing a lack of profitability. Five urgent care clinics in Clinton and Weatherford closed with it.
Alliance Health also canceled state and federal licenses to operate in Clinton rather than transferring them the Clinton Hospital Authority or Carrus Health, another private healthcare company expected to take over operations.
Clinton’s plans to reopen the hospital hinge in part on the outcome of a March 7 special election. For now, no licenses mean no services. The hospital authority is applying for them as if the hospital hasn’t been providing care since the 1970s, prompting millions to be spent on renovations.
Also left without a hospital are the 192 people who worked at Clinton Regional and nearby clinics as physicians, nurses, radiologists and other staff. Some have found work at hospitals in Weatherford and Elk City.
Clinton Regional’s closure follows a national trend of shuttering rural hospitals. Eight have closed or drastically downsized in Oklahoma since 2005, according to a study out of the Sheps Center for Health Services Research. Among the rural towns that have seen closures are Sayre, Pawnee and Wilburton.
Signs of Alliance Health ending in Clinton first appeared when the hospital’s intensive care unit closed in 2019, followed by the downsizing of the rehab unit in 2020 and the end of the obstetrics unit in late 2021.
The Impact on the Vulnerable
Rose, 44, worked the night shift in the hospital’s medical-surgical unit, where patients were admitted directly from the emergency room or by their doctors during clinic hours. She is among those who can afford to wait, counting on a re-opening, because her husband’s life insurance brokering, music gigs and Airbnb can support their family.
“I’m in a station of privilege. I understand that,” Rose said. “But there were plenty of nurses who were not, who are the only breadwinners in their family.”
Rose said she worries about disadvantaged patients she used to see come through the emergency room who were sick and injured. She pointed out that Latino residents, who make up more than a third of the town’s population, can face income, cultural and language barriers.
“The diabetic rate in that demographic is so high and often diagnosed at early ages,” she said, “They take care of their elderly in the home too and while they need a lot of support, our Hispanic residents can be leery of seeking out healthcare in a lot of situations.”
Eric Walker is the security guard at Clinton Mission House, the city’s homeless shelter. He is experiencing a rash spreading on his amputated leg. He has no phone or vehicle to make a 28-mile drive to Elk City, where his doctor’s practice moved.
“There’s a lot of people over here that are on medication and there is no doctor for them,” Walker said, referring to four mothers staying at the shelter with 10 young children between them.
“If someone has a heart attack here and there’s no hospital, they’ll probably end up dying in the ambulance or something.”
Ambulatory response times in Clinton remain among the state’s fastest at just over three minutes last week, said Johnny Red, director of operations for Sinor Emergency Medical Service.
What’s changed is where people are taken. Depending on where in Clinton a 911 call is made, a patient may be taken to hospitals in Weatherford, Cordell or Elk City, which are all 15 to 30 minutes away.
“We use significantly more medications,” Red said, using as an example epinephrine, commonly administered every three to four minutes to someone experiencing cardiac arrest. A trip to Clinton Regional may have required one dose compared to three or four doses for trips to outlying hospitals, he said.
The need to refuel, clean and restock supplies after a trip out of town increases return-to-service time for the ambulance units, Red said.
“Bodily fluids, blood, that sort of thing, need to be cleaned out too, and maybe even a change of clothes. Our return to service time can be impacted by up to an hour,” Red said.
The 157 medical emergencies reported by Sinor EMS through Jan. 25 were normal for the first month of the year, he said.
An ‘Orderly Wind-Down of Operations’
Nationwide, 141 hospitals closed or reduced services since 2010, according to the Sheps Center data. The research points out there are multiple factors contributing to hospital closures, including failure to recover from the recession, population demographic trends, market trends, decreased demand for inpatient services and new models of care.
Alliance Health notified the Clinton Hospital Authority it would not renew its lease in January 2022. The company shared guidance and support with Clinton as the city conducted a search for a new partner, said Doug Ross, a spokesman for the company, in a statement. Multiple attempts to interview Ross were unsuccessful.
The hospital authority began meeting in executive session about Clinton Regional’s fate with city attorney Ryan Meacham in March. In June, the city hired Oklahoma City-based law firm Crowe and Dunlevy to interpret the terms of the original lease to say Alliance Health is required to transfer its federal medicare provider number to the city or the next provider.
A month later, Alliance Health sought relief from its lease in U.S. district court to begin an “orderly wind-down of its operations,” court documents show.
Alliance Health could have transitioned the licenses to the city or Carrus Health and done what every previous provider before them had done, said Clinton city manager Robert Johnston.
“We tried to have a change of ownership, but we never did get them to transfer the license to us,” Johnston said. “The only other recourse was to apply for a brand-new license as if this is a brand-new facility.”
He said the city is in the process of applying for state licensure. The next step is building inspection by the state health department to determine what renovations are needed.
Clinton residents voted in 1997 to set aside $6 million for hospital-related emergencies. With compound interest, that fund has grown to $11.3 million and can be used for hospital renovations if Clinton voters approve in a March 7 special election.
“We’ll use what we need to use for what we need,” Johnston said. “We’d prefer not to spend a whole lot of money on equipment or facilities.”
Dr. Robert Blakeburn worked at Clinton Regional Hospital for over 20 years. He and the handful of other physicians on staff rotated between positions like chief of staff and director of ER or inpatient rehabilitation. In October, Blakeburn sent Johnston an email laying out everything that needed to be done before the year’s end.
The hospital will need permits and registrations to run lab tests, operate a pharmacy, and use controlled substances, radioactive materials and equipment. Applying for these permits can take over a year.
Blakeburn, interviewed by Oklahoma Watch last month, said he never received a response from the city manager.
The hospital has been closed for a month, and Johnston can’t give a clear answer of when it will reopen.
“People want to know with drop-dead certainly exactly what day we’re going to reopen,” the city manager said. “What do I do? Lie to them in good faith?”
Lionel Ramos is a Report for America corps member who covers race and equity issues for Oklahoma Watch. Contact him at 405-905-9953 or email@example.com. Follow him on Twitter at @LionelRamos_.