The vote gives Modoc County, in the state's northeastern corner, a much-needed infusion of cash and likely means it will avoid bankruptcy.
Voters approved both measures - one to impose a $195-a-year parcel tax to keep their struggling hospital, and another to create a hospital district to oversee its operations. The tax required two-thirds voter approval.
Local officials said they needed the tax because the hospital's operating costs have overwhelmed county finances. That led them to request a $12.5 million loan from the state.
State finance officials are considering the request and said they want to be assured the county could repay the loan. The vote results makes that more likely.
"By God it passed, and by God that's all that counts, so we will keep our hospital," Modoc County Supervisor Patricia Cantrall said after the results were in.
In unofficial results, the tax measure passed with 68 percent of the vote, while the hospital district was approved by 70 percent.
The vote was not countywide, but rather was among the 3,724 voters who live within the county's existing hospital district. Among that population, turnout was nearly 63 percent.
If the parcel tax had failed, its supporters fear the end of urgent medical care in their community, nearly 400 miles northeast of San Francisco.
The nearest emergency room is more than 20 miles away, over mountain roads that are often closed due to snowy conditions in winter. Others are more than an hour's drive away.
The Modoc Medical Center has been reducing staff and services to deal with its budget deficit, including halting surgeries and baby deliveries, said Monica Derner, interim chief operating officer.
The county's dire fiscal situation stems from its practice of improperly borrowing from county funds intended for education, transportation and other purposes to pay hospital expenses. A review by the state controller's office determined the county had to repay those funds immediately.
The hospital has been in the red for more than a decade, losing between $600,000 and $2.8 million annually in recent years, and the county has racked up more than $12.5 million in debt trying to keep it afloat.