To better understand the unique challenge these two hospital boards would face in attempting to work together, it’s helpful to know that tension between Harper and Anthony didn’t begin with healthcare.
It actually dates back to the 1800s, when Anthony is said to have stolen the courthouse from Harper. Each town had built a courthouse, and there were feuds over buildings, county seals, safes, and separate records, rumored to have been brought home at night by city employees for safekeeping.
An election in 1879 was later called to decide whether Anthony or the larger population of Harper would be the county seat. Despite having only 800 registered county voters, 2,960 votes were cast, with a majority favoring Harper. When the false ballots were removed and the correct number of voters were counted, Anthony had won the county seat. Although Harper had already built a courthouse, it was later used as a college and then as a church.
More than a century later, over cherry limeades at Irwin-Potter Drug, the old-fashioned soda fountain, and around dinner tables, locals still talk about the courthouse debacle.
Harper and Anthony were distinct communities, each with their own history and sense of pride. That rival, competitive dynamic also extended to their hospitals.
Given that history, collaboration was not an easy sell.
Confronting Reality
Before delivering his letter, Neal Patterson had engaged executives at Ascension Via Christi in Wichita to help preview his proposal with members of both boards.
“We floated the idea [of Neal Patterson’s proposal to both boards] and they kind of sit there with their arms folded across their chest going, ‘we’re not real sure, you know, we think we’re doing just fine the way it is’,” said Jody Gragg, former Via Christi representative, who presented Neal Patterson’s proposal before the letter was sent.
Gragg said he felt the tension among Harper residents who felt threatened by Cerner representatives, as they thought this would be an Anthony project, since Neal Patterson’s family lived in the Anthony community and his nephew, Alan Patterson, sat on its hospital board.
“Within our Harper Hospital Board, there was a little bit of uncertainty because of mistrust,” said Lisa Mathes, former Patterson Health Center and Harper Hospital board member. “It wasn’t an ‘oh yeah, we are going to go for it’ right away, kind of thing.”
Then, on the other side, there was also hesitation among the Anthony board members because there had been attempts to merge with Harper in prior years, where, at one point, they pulled out. The Anthony board members, Hadsall said, were fearful that this would happen again.
As a result of the meeting, though, the boards formed a working group – comprised of two board members per hospital, Lori Allen, Kim Barwick and Sandra Owen-Campbell, who led as interim and co-interim CEOs after the CEOs quickly departed, and a representative from each of Via Christi and Cerner – to meet for one year to determine what right-sized healthcare looked like in Harper County and prevent the potential loss of one or both facilities.
“It leveled the playing field and showed buy-in that they were really taking working together seriously,” said Jessica Hunt, who had been assigned by Cerner to help manage the emerging project.
While some community members believed the status quo should continue, independent financial analysis conducted as part of the project began to paint a stark picture. Both hospitals were operating at a loss, and projections showed little chance of recovery under existing conditions. Declining population numbers, an aging population, and limited economic growth further constrained the outlook.
“I think one hospital was given about another three years of survival, and the other hospital was given maybe four years,” Gragg said.
The data made one thing clear: maintaining two separate hospitals was not sustainable.
Convinced of this negative trend and spurred by Neal Patterson’s letter, both boards voted to freeze capital expenditures, forgo available grant funding, and avoid investing additional money in their mostly dilapidated buildings.
As discussions progressed, workgroup members turned their attention to Harper County residents, the people most affected.
Community engagement became a central part of the process. Leaders regularly held public meetings, conducted surveys, and gathered feedback at events such as the county fair, which drew hundreds of residents. They asked what residents valued, what they feared, what extra information they needed, and what they hoped for in local healthcare.
The responses revealed some excitement, but a great deal of concern and uncertainty.
Residents worried about losing access to emergency care, losing jobs, or losing their community identity and seeing their town decline without a hospital. At the same time, many began to recognize the financial fragility of the existing system.
Project leaders also encountered skepticism. Despite consistent communication efforts, including public meetings and updates to residents through Facebook and the local paper, some residents said they weren’t aware that anything was happening.
To bridge the gap, volunteers spoke with residents directly. These conversations were often difficult but essential in building understanding and trust.
“People were just really resistant…because they felt like they were losing something,” said Lori Allen, Patterson Health Center chief operating officer and former co-interim CEO and chief financial officer (CFO) of Anthony Medical Center. “I shared that you may be losing the hospital in each of your towns, but here is what we’re going to be able to do together that we can’t do apart.”
Choosing a Path Forward
After months of analysis and community input, a clear recommendation emerged: build a new, single facility to serve the entire county.
From a financial and operational perspective, consolidation offered the strongest path to sustainability. Analysis found that combining patient volumes would support existing services and allow for the modest expansion of others. Eliminating duplication would also reduce costs. And a new facility could be designed to meet the community’s actual needs.
Still, the path forward required significant structural changes.
Merging the two hospital systems before building a new facility involved navigating complex legal and regulatory challenges, including preserving critical access hospital designation, which provided essential federal reimbursement support.
Ultimately, the most fiscally responsible, data-driven solution involved merging Harper’s hospital tax district into Anthony’s tax district while maintaining critical access hospital status under a relocation waiver, found by legal counsel.
A key step in the process was securing written community approval.
To proceed, leaders needed signatures from a majority of registered voters in Harper’s hospital district. Volunteers ran a 7-month-long petition campaign, where they prepared and went door-to-door to gather support and talk with residents.
The effort was demanding. Volunteers encountered empty homes, outdated voter lists, and emotionally charged conversations, where people walked away and even slammed doors in their faces.
Mathes said she remembers hearing from some Harper residents that they feared merging their tax district into Anthony Medical Center’s would mean the Anthony hospital would take over operations. Other residents needed time to understand the proposal and the hospital’s financial situation.
“To give up their hospital for the benefit of both communities was the hardest thing to do,” said Jim Chromik, a neutral outsider with experience working with critical access hospitals and at McPherson Hospital, who was hired to locally manage the consolidation project and held offices in both towns.
Although the Cerner team had been driving weekly meetings for a little over a year, working on critical access hospital status, finding the tax experts, developing the petition campaign, marketing and work plan, and later validating all signatures for the community, Chromik helped drive local operations on consolidation, the hospital build process, and pushed for Centers for Medicare & Medicaid Services (CMS) approvals on the change of hospital ownership and relocation.
Federal rules restrict critical access hospitals to be at least 35 miles apart. However, the two local hospital districts initially received gubernatorial waivers, allowing them to establish competing facilities just nine miles apart
Given this, the workgroup had to obtain CMS permission to use a waiver to bypass the 35-mile rule, provided that a current critical access hospital is moving and building a new facility. However, this is only allowed so long as you keep 75% of staff, patients and service lines, and submit plans and gain approval to sunset one critical access hospital designation and form it into another, Hunt said.
Despite these challenges, the petition campaign succeeded. In March 2017, all necessary signatures were obtained – 776 of 705 needed, or 60% of registered voters – to merge the taxing district of Harper Hospital (District #5) into Anthony Medical Center (District #6).
With that approval, the two hospitals officially moved forward with consolidation.
The Path that Led Home
Because of the brutal injustice of cancer, Neal Patterson did not live to see the facility break ground on his birthday in December of 2017, on 60 acres of land purchased from a local farmer. A decision was made to situate it at a point equidistant between Harper and Anthony, symbolically and geographically uniting the communities.
The plan for the new facility was to reduce inpatient capacity from 50 beds across two hospitals to 16 beds, which was a more appropriate size for the population and average daily usage. At the same time, it expanded outpatient and specialty services, reflecting shifts in how healthcare is delivered.
The project brought together public U.S. Department of Agriculture funding, private investment, and community support to create a $42 million, 62,500-square-foot hospital designed for modern rural healthcare delivery. Through his estate plans and family foundation, Neal Patterson fulfilled his promise to serve as the project’s lead private donor.
In July 2019, Patterson Health Center opened its doors.
Speaking at the ceremony, Neal Patterson’s daughter, Lindsey Patterson Smith, said, “Neal set a challenge, he made some connections, and he opened some doors. He planned for a future that, at some point, he knew he would not be around to see. But it’s you who walked through the door and set out on the rocky path.”
Becoming One Team
Through the years-long process, the hospital boards and staff came to understand that to truly survive and prosper, they needed to work together rather than compete.
This was the first time two critical access hospitals had collaborated and consolidated in Kansas, preserving access to care and services in rural communities, especially as they face demographic shifts, depopulation, aging populations, and economic pressures, said Hunt, who helped manage the project while at Cerner and currently serves as chief impact officer at Patterson Family Foundation, created by Neal Patterson and Jeanne Lillig-Patterson.
“From a business perspective, it was challenging,” said Sandra Owen-Campbell, Patterson Health Center CFO, and former Harper Hospital interim CEO and CFO. “We didn’t like each other. We didn’t work well with each other. And that’s part of the success of this whole story, it’s how we came together, and we overcame those challenges. We became good business partners, and at this point, we’re all very good friends.”
During the construction process, which took a little over two years, work had been underway to unify staff and operations. Keeping a promise made to the community, the joint board chose not to lay people off and instead relied on natural attrition, such as retirements among its aging workforce.
During that period, the legacy hospitals operated as campuses of a single system. Employees worked together under a new slogan of “Together for a healthy future,” building relationships and aligning practices.
Although at first there were understandable initial struggles with change and operational inefficiencies that needed to be addressed, things eventually worked out.
“We were going to do some things differently, and it wasn’t necessarily choosing the Harper way or Anthony way, it was choosing the best way,” Hadsall said.
Crissa Foley, Patterson Health Center emergency department and trauma services director and former nursing director at Anthony Medical Center, said she was happy the hospitals merged before the facility was built because it allowed the independently minded nursing staff to work together, get to know one another, and cover night-shift vacancies.
“I thank God we did that,” Foley said. “Those personality conflicts that most likely would have happened out here [at Patterson Health Center] happened as we allowed them to work together and get to know each other.”
This was also helpful, Foley said, because shortly after they moved into the new facility, the COVID-19 pandemic hit, where efficient, collaborative teams were essential.
“Somehow we survived that, too.”
A Stronger System
Today, Patterson Health Center serves as a regional healthcare hub for Harper County and the surrounding counties.
The facility includes emergency care, primary and specialty clinics, therapy services, and advanced diagnostic capabilities. It has expanded services to include hydrotherapy, diabetes education, and telehealth.
Patient visits have also increased, with most of the community embracing the new facility, Allen said. “In the end, the community really stepped up and supported Patterson Health Center once we came together and they saw what we could do.”
The facility is also more financially stable.
Where Harper Hospital once operated with just 13 days of cash on hand, the consolidated system now maintains 175 days of cash reserves, said Owen-Campbell, Patterson Health Center CFO and former Harper Hospital interim CEO and CFO.
Operational efficiency has improved, and service duplication has been eliminated.
Staffing has also stabilized, with the facility maintaining its workforce, including provider and physician staff, and without relying on agency or contract nurses – a challenge many rural hospitals continue to face.
“We’re providing access to care that I’m not sure patients would have received otherwise if we had not merged,” Allen said. “A lot of those patients don’t have the means to travel to another county or facility to get those services.”
The facility has also become an important community meeting place, where residents come together to catch up over coffee and grab a bite at the café, or attend weekly community meetings in the large neighboring conference room. They’ve also held community farmers’ markets and other activities out on the front lawn.
It’s also serving a vital role in the local economy.
With more than 100 employees, the health center serves as a major employer and supports additional jobs throughout the community. Like many rural hospitals, it is a cornerstone institution, essential not only for health outcomes but also for economic stability.
“Hospitals are a strong, if not the strongest, economic driver within these rural communities, and so it’s so critical that they survive,” said Sarah Teaff, Patterson Health Center CEO.
The facility also functions as a community gathering space, reflecting a broader vision of healthcare that includes wellness, connection, and quality of life. It also provides student learning opportunities, as it sits next to the Anthony and Harper’s consolidated Chaparral Jr/Sr High School.
Neal Patterson is seen as a catalyst who inspired a divided community to reimagine what was possible together. His leadership sparked the collaboration, trust, and shared vision that empowered Harper County residents to shape their own sustainable future. It’s what led them to name the facility Patterson Health Center after him.
Although Neal Patterson wasn’t the kind of person who’d want his name on the wall or make it a requirement of accepting funds, Hadsall said “the name just felt right.”
“To be able to have a sustainable, thriving health care system is so incredibly important,” Teaff said. “I truly believe that Neal Patterson, if he did not approach two hospitals, that this county may have faced not having a hospital at all.”
Lessons for Rural Communities
Today, Patterson Health Center stands as proof of what is possible when communities come together with a shared purpose. Their journey offers valuable lessons for other rural communities facing similar challenges.
The most important thing Harper County built wasn’t a new facility – it was the trust and shared vision necessary to tackle difficult challenges together.
The process required difficult decisions, sustained effort, and a willingness to set aside long-standing divisions. It demanded transparency, community engagement, and strong local leadership with the ability to look to the future.
Above all, it required a shift in perspective, from protecting individual institutions to preserving community-wide access to care.
“All of it was a lot of work. But in the end, it was a huge success, and I’m very proud of what we have accomplished,” Owen-Campbell said. “And honestly, it was the best thing that we ever did for Harper County.”
This is the second story in a three-part series about the formation of Patterson Health Center and its transformative rural healthcare model, which continues to serve patients today. Be sure to watch the Patterson Family Foundation’s website and newsletter for the final story in the series.
Acknowledgements:
This story is written in memory of Neal Patterson, who, alongside his wife Jeanne, founded the Patterson Family Foundation and whose vision laid the groundwork for the community to create a sustainable model of rural healthcare delivery in Harper County. It is also in memory of Kimberly Schrant, who served as Patterson Health Center board member and Harper Hospital board chairman, and project working group member.
Thank you to April Martin, Patterson Family Foundation Chief Legacy Officer, for contributing to the story and continuing to honor the legacies of Neal Patterson and Jeanne Lillig-Patterson.
Thank you to everyone who was interviewed: Lori Allen, Kristen Birket, Sandra Owen-Campbell, Jim Chromik, Crissa Foley, Jody Gragg, Jessica Hunt, Martha Hadsall, Lisa Mathes, Alan Patterson, and Sarah Teaff.
