Campaigners for a new 60-bed hospital and nursing home say they now face a "very tight timetable" after councillors voted to defer their planning application.
The facility, which would be run by housing association Sanctuary Care, is planned for the site of the former Watlington Hospital, which was closed in February 2000 despite intense local opposition.
Watlington Hospital Charitable Trust has "priority purchaser status" to buy the site from the NHS for £1.4m - £400,000 has been raised.
But that status runs out in October and trustees fear South Oxfordshire District Council's decision last night to defer could cost them the chance to rebuild the site.
Trustee Donald Chivers said: "If we haven't got permission by then, everything is lost. We're up against a very tight timetable."
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