Cancer Care Without the Commute
John Kozyra became CEO of Avera St. Anthony’s Hospital in O’Neill, Nebraska, just over a year ago. He came from a small mountain community in Southern California just about the size of O’Neill, with one big difference.
“There were no doctors, no hospitals, no urgent care — nothing within a 30-minute drive,” he said.
John was primarily raised by his grandparents, who were farm kids from Arkansas. They were among the thousands of Americans driven by the Great Depression, drought and the Dust Bowl, who left their homes and looked to California as a land of promise.
He watched them struggle with health issues as they grew older. He saw the indispensable importance of the Medicare program for their access to care. They gave him his two passions in life.
“One, I wanted to contribute to building strong communities and, two, I wanted to make sure people could access care and the services they need,” he said. “As I think about us here in O’Neill, I think about our role as the area’s largest employer; how we can support a really strong, engaged, vibrant community; and what I can do in my position to ensure that people can access high-quality, safe and excellent medical care close to home.”
Avera St. Anthony’s Hospital is one of the largest critical access hospitals in the state. It serves a substantial Medicaid and Medicare population with more than 70% of patients relying on those programs for access to health care. Beyond having a robust primary care clinic, their specialty service strengths are what John calls the “Three O’s”: A strong obstetrics program, a robotics orthopedic program, and one of the only oncology programs in Northern Nebraska. They deliver more than 150 babies and provide upwards of 700 chemo infusions per year. They are also one of the only hospitals in the state that runs a public transportation program, which ensures patients in the community have access to medical care and other needed services.
Sara Frederick serves as the full-time oncology physician assistant for the program. She says being able to receive chemotherapy, follow-up appointments, lab and imaging close to home allows patients to take less time off work, maintain routines and continue to be present for loved ones.
“No one wants to hear the words ‘you have cancer.’ Our team is here to help,” said Sara. “We listen, encourage and provide treatment options for our patients close to home so they can continue doing things that are important and motivate them.”
The significance of the hospital and its oncology program was put to the test recently. In October 2024, an explosion in a nearby building severely impacted the hospital, shutting down many services for days to weeks until repairs could be completed. During that time, some oncology patients had to travel more than an hour and a half one way to obtain treatment.
“Our team worked closely together to get our patients the care they needed during that time. Our transportation service was vital in assisting those patients who did not have the means or funds to travel for their treatment,” Sara said.
The transportation service is funded by state and federal grants. It dramatically improves access to regular check-ups and results in fewer delays in care. That can mean the difference between treating Stage One cancer and Stage Four.
“I love rural health because I get to build lasting relationships with my patients,” Sara said. “I am here for them during a very scary part of their life journey, providing the same treatments they would get in a big city, but with a small, hometown feel.”
John agrees. “I love rural health because a strong hospital keeps a community strong and healthy.”
Sara K. Frederick, PA-C
Physician Assistant, Oncology
Avera St. Anthony’s Hospital
O’Neill, Nebraska
John Kozyra, MHA, HACP
Chief Operating Officer
Avera St. Anthony’s Hospital
O’Neill, Nebraska
