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Group proposes critical access hospital for Big Sky

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By Emily Stifler Managing Editor

BIG SKY – This may be the only ski resort community of its caliber in the country without access to a nearby 24-hour health care facility. A group of local health care professionals hopes to change that.

“When we did our community health survey [in 2011], a big concern was access to healthcare,” said Women in Action Executive Director Lisa Beczkiewicz. “It’s something the community has said we need.”

Together with former hospital administrator Jack Eackman, WIA, a local health and human services nonprofit, is leading the charge to conduct an independent feasibility study that would determine if Big Sky could support a CAH.

Eakman started looking into the project in 2010 while working as a consultant for the Big Sky Fire Department, and he recognized how much of a toll the ambulance runs to Bozeman were taking on the department’s resources.

Initially the group thought an expanded urgent care or a 24-7 emergency room might make sense, but after Eackman, a Board Certified HealthCare Executive, did some research, he found “we were close to having the full-time, year round population necessary to support a critical access hospital.” He also found “we were the only destination ski resort community in the country that does not have at least a CAH.”

Designed to bring 24-hour medical service to rural communities 40 miles from the nearest hospital, critical access hospitals are reimbursed through Medicare and Medicaid. Depending on need and funding, a range of services can be provided, with up to 25 beds, swing beds for longer-term care, and rehabilitative, inpatient and mental health services. There are 46 such facilities in Montana, including in Red Lodge and Ennis, Columbus and Whitefish.

Community need

“From a fire department point of view it would make our lives a lot easier,” said Big Sky Fire Chief Bill Farhat of a CAH.

The department is responsible for transporting emergency victims via ambulance to Bozeman Deaconess Hospital – a trip that takes 3 ½ hours – and has been stretched thin in recent years, unable to meet basic legal requirements to respond to fires or multiple medical calls.

Farhat hopes to add five firefighters in the next couple years, something he says the department will need regardless.

“In the long term, our needs are better served by having a hospital here, rather than growing the fire department [further] to have it shuttling people back and forth to Bozeman. [We’d be] gaining ground, rather than using Band-Aids.”

Big Sky’s three practicing physicians have also voiced support for the idea.

“I sent one patient to [Deaconess] last week that we could have taken care of with a critical access hospital easily,” said Dr. Maren Dunn, owner of Gallatin Family Medical.

Dunn previously worked in Cascade, Idaho, home to 920 permanent residents and Tamarack ski area. With Boise’s hospital 70 miles away by river canyon, Cascade’s CAH was a backbone of the community, Dunn said.

“There’s plenty of illness here,” she said of Big Sky. “It would support our older residents and allow people who really want to stick around to do so without being a burden on family members or community.”

A CAH would add aspects of care that are difficult to provide now, said Dr. Jesse Coil, a physician with the Medical Clinic of Big Sky. “Ambulance transport is a huge reason in my mind – to not have to take every patient to Bozeman that goes in an ambulance.”

Both said having access to a CT scanner and lab services would be a major benefit, allowing assessment of head and spinal injuries and blood work.

Dr. Jeff Daniels owns the Medical Clinic of Big Sky and has been serving Big Sky for 19 years. While he agrees a CAH would benefit the community, he’s not sure it would be affordable.

“I have a very busy practice, but most of those people don’t need a critical access hospital,” Daniels said. “Economically, I don’t think we’re that busy.”

In the big picture, however, Farhat says such a facility could be an economic boon to the town.

“We could provide better customer service for tourism. If someone were injured during skiing, the resorts better serve them by staying here rather than going over an hour away for help. It helps the community be more attractive for investment and visiting, and it provides jobs. It’s the keystone to the future of a growing and thriving community.”

Feasibility study

Eakman and Women in Action, through a WIA subcommittee, plan to apply for $120,000 in Big Sky Resort Tax money to fund an independent feasibility study for the project. WIA estimates the study will cost $145,000.

A six-stage program, it would “precisely answer what this community can afford and support,” Beczkiewicz said in an email.

Components would include a community philanthropic assessment, a strategic program and sizing plan, long term financial forecasting, site recommendations, medical staff operations, and potential partnership assessments and recommendations.

“It will be an action document,” Beczkiewicz said, “complete in its findings and sufficiently prescriptive, that the community can proceed with the best options available …”

Prudent planning is imperative, Eakman said, to ensure the facility is the appropriate size, should it prove to be feasible.

Health care providers

Both Billings Clinic and Bozeman Deaconess – which operates a pharmacy in Big Sky and owns land in the Town Center – presented at the Feb. 11 resort tax town hall meeting.

“My preference would be to keep this discussion in Big Sky,” Eakman wrote in an email. “The agenda we hold is to explore, plan, develop and institute a higher level of healthcare access and convenience to Big Sky. It will round out our services, better invite visitors to our area, and become a magnet for other ventures that align with healthcare.”

An independent facility unaffiliated with another hospital, he said, “would not allow for strategic mistakes of even the smallest kind.”

In the town hall meeting, resort tax board member Mike Scholz told the audience of approximately 130 that “the board does not make a decision regarding hospitals. All of the functions that happen with the community start with you. We’re just here with funding … We think it’s good that we have these conversations so everyone understand the possibilities.”

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