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Garfield County Health Center reports near-completion of conversion to Rural Emergency Hospital
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Summary
County health center leaders and state partners told commissioners March 11 that facility upgrades, staffing plans and licensing steps for Garfield County Health Center(GCHC) are largely complete and that REH licensure is effective Jan. 5, 2026; Medicare/Medicaid certification and payer rules remain pending.
Garfield County Health Center administrators and outside technical partners reported substantial progress March 11 on the facilityconversion from a Critical Access Hospital to a Rural Emergency Hospital (REH), a change county officials and partners say will help preserve local care.
Krista Wright, GCHC administrator, and partners from the Rural Health Redesign Center, the Montana Hospital Association and Montana Health Network told the Garfield County Board of Commissioners that multiple infrastructure upgrades and operational steps required for REH designation have been completed. The memo presented to the board lists completed work including a full update of the facility sprinkler system, replacement of the interstate fire alarm panel, a new nurse-call system, a remodel creating REH nursing stations and patient rooms, and a staffing plan to provide two nurses 24 hours per day with at least eight hours of RN coverage for the long-term care unit.
The memo, prepared by Ken Harman (RHRC), Jack King (MHA/MHREF), Ward VanWichen and Nadine Elmore (MHN), notes that the REH license was made effective Jan. 5, 2026, and that the monthly REH facility payment for calendar year 2026 is estimated at $295,051.54 (with sequestration deducted). The group said Medicare and Medicaid reimbursement will follow once federal and state certification steps are completed and once Montana DPHHS develops Medicaid payment rules for REHs. The memo identifies some approvals as pending, including final Medicare certification paperwork and any state Medicaid rule changes.
The team also recorded steps taken to convert the facilitylong-term care unit into a distinct-part skilled nursing facility, including completion of a Certificate of Need application and issuance of a temporary SNF license in December 2025; full Medicare/Medicaid certification for that unit remains pending state survey and approval. The presenters said that with provider numbers and payor credentialing complete, commercial insurers should be able to begin processing claims.
County commissioners were asked to consider a Quality Assurance and Performance Improvement (QAPI) plan that was described in the memo as complete pending final county approval. The county-level action recorded at the meeting was receipt of the updates; commissioners did not record a separate vote to adopt the QAPI plan at this session.
The memorandum emphasizes ongoing technical assistance commitments: RHRC, MHA/MHREF and MHN said they will continue to provide operational support, revenue-cycle assistance, regulatory compliance help, mentorship for the administrator of record and educational resources for governance and management.
Next steps identified in the memo include completion of federal/state certification steps, Montana DPHHS rulemaking for REH Medicaid reimbursement, and county review/approval of the QAPI plan. The commissioners recessed the meeting for lunch and continued the agenda after reconvening.
The update was informational; no separate formal county action adopting new contracts or changing county policy was recorded in the minutes at the March 11 session.