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Blue Mountain Hospital is pictured Aug. 27, 2026. The hospital resides in John Day, a community of about 1,600 people.<\/p>\n
Monica Carrillo-Casas \/ OPB<\/p>\n
For nurse Doris Harper the Blue Mountain Hospital in John Day is more than a workplace. It\u2019s also where she gave birth decades ago, 90 rugged miles from the next nearest hospital in rural Oregon. <\/p>\n
Harper\u2019s daughter, Jessie Saul, grew up in their Grant County community. She too became a nurse, working alongside her mom. When the doctor who delivered Saul entered hospice care in recent years, she helped take care of him. <\/p>\n
Both women say that when it comes to staffing a rural hospital system, a tight-knit community can make the difference for patients with nowhere else to turn. But recent staffing cuts and departures are making them question whether there will be enough people, and enough time, to respond to emergencies. <\/p>\n
It\u2019s gotten to the point, Harper said, \u201cwhere the staff will come back from time off and ask what cuts have been done this week.\u201d<\/p>\n
This year the hospital has weathered layoffs, resignations of longtime doctors and financial losses likely to worsen when federal cuts to Medicaid roll out next year. Concerns about working conditions sparked a unionization effort by employees in April. <\/p>\n
Tensions came to a head during a tense meeting of the Blue Mountain Hospital District board in John Day on Aug. 26. Nearly 40 employees and residents packed the room or overflowed into the hallway. They wanted to know why caregivers were being let go and who was to blame for a vital institution shrinking. <\/p>\n
Related: A rural Oregon town lost its maternity ward. As Trump\u2019s Medicaid cuts loom, other hospitals may be next<\/a><\/p>\n District officials say the hospital is trying to survive financial hardships while meeting state staffing guidelines, pressures that are not unique to the county of roughly 7,000 residents. <\/p>\n One in five rural hospitals in Oregon are at risk of closing, according to an analysis<\/a> this year by the Center for Healthcare Quality and Payment Reform. The policy advocacy group tracks distress at rural medical centers nationwide. It found more than 40% of Oregon\u2019s rural hospitals have cut back services to make ends meet. <\/p>\n Meanwhile, Republican-backed cuts to Medicaid take effect Jan. 1. Some 200,000 Oregonians could lose their health insurance. The Oregon Health Authority has projected Oregon will lose $9.4 billion total as a result.<\/a> <\/p>\n In their \u201cOne Big Beautiful Bill,\u201d GOP lawmakers set aside a different funding source for hard-hit rural hospitals, but in Oregon, the money makes up only a fraction \u2013 roughly 4% \u2014 of cuts to the state\u2019s Medicaid plan. <\/p>\n At Blue Mountain Health District, austerity measures are already well underway. <\/p>\n The district operates a 25-bed hospital in John Day, a 40-bed elder-care center in Prairie City, two clinics and a hospice. <\/p>\n Without this safety net, locals would need to drive at least an hour and a half for care. But in emergencies like heart attacks, Harper said, minutes matter. <\/p>\n \u201cI didn\u2019t get into healthcare to watch it disappear. I became a nurse to help care for our community,\u201d she said.<\/p>\n A rural hospital under pressure<\/p>\n Soon after Blue Mountain Hospital District hired Misty Robertson as its CEO last year, nine employees were let go. At the time, Robertson cited<\/a> financial pressures and anticipated Medicaid cuts. <\/p>\n She told OPB this week the district lost $1.6 million last fiscal year, and has lost another $818,000 this fiscal year. She described the financial situation as an \u201cunsustainable trajectory that required us to make difficult changes and find new solutions for the future.\u201d<\/p>\n
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