Granite County Hospital board and commissioners seek short-term support as Billings Clinic offers evaluation and aid

Granite County Medical Center leaders and representatives from Billings Clinic told the county commission on June 16 that the small hospital is in urgent need of operational support and a formal assessment to identify short-, mid- and long-term steps toward financial stability. John Barbara, co-chair of the hospital board, introduced the update and said the board and Billings Clinic have begun conversations about an affiliation and immediate assistance.

"Our operational achievement since June 1 . . . is phenomenal in terms of what we were able to accomplish with the support of all of the staff of Granite County Medical Center as well as Billings Clinic," interim CEO and board member Doris Gilbertson said, summarizing recent repairs, a lab reconstruction and temporary help to restore imaging services after the facility’s imaging contract was terminated.

Why it matters: Commissioners heard that the hospital is operating with mounting debt and tight cash flow — the board reported the district’s outstanding balance to the county at roughly $1.4 million — and that the facility needs short-term operational dollars and expert, hands-on management while it seeks larger state and federal support. Without intervention, speakers warned, the community risks losing local emergency and inpatient services.

Billings Clinic described multiple ways it can help. Jim Duncan of Billings Clinic outlined the federal Rural Health Transformation Program (RHTP) created by recent congressional legislation and conveyed that Montana’s initial allocation was sizeable; he described a state-led procurement to select a vendor that will assess at-risk hospitals and help distribute RHTP funds. "The assessment will not cost the hospitals any money," a Billings Clinic representative said, and participation would make the hospital eligible for additional funding under the state program. He urged the commission and board to proceed quickly to be considered for early rounds of the program.

Billings Clinic’s regional leader, Nicole Hobs, said her organization’s preliminary review indicates Granite County Medical Center is among the more dire financial situations they have encountered in the state but said turnaround is possible with dedicated expertise. "You have an opportunity with RHTP ... but it will take time and expertise," she said, urging an interim CEO with turnaround experience and a short-term plan that preserves reimbursement and avoids cuts that could worsen revenue.

Board figures and commissioners discussed concrete near-term items: restoring imaging services through Billings Clinic support, pursuing apprenticeship and grant opportunities, and identifying an interim CEO with turnaround experience. Doris Gilbertson provided utilization and revenue examples to illustrate incoming cash versus operational costs; she reported recent activity including swing beds, emergency visits and imaging volumes and cautioned that billing cycles mean revenue can lag by weeks.

County Attorney Blaine Branch and other commissioners asked how much additional county funding would be required; Billings Clinic said precise short-term dollar needs are unknown until an assessment and targeted due diligence are completed but estimated the facility will need operational support for "three to six months" while RHTP participation and other measures are pursued. The board reported prior discussions about an intercap loan that could not proceed without county support and said that previously discussed debt obligations to the county had been reduced but remained substantial.

Public comment and board members underscored community stakes. "This is a lifeline that we have not had before," hospital board member Lorine Jo said, urging the commission to provide short-term support if possible and to help the board explain progress to voters ahead of any November levy discussion.

What the commission did: Commissioners expressed support for moving forward with Billings Clinic’s assessment and for exploring short-term county assistance while the board pursues RHTP and other funding. A formal motion to register support for pursuing Billings Clinic’s involvement was made and seconded during the meeting; commissioners indicated they would expect to review an assessment and concrete plan before any larger county financial commitment.

Next steps: Billings Clinic said it would take the conversation to its governing board and pursue an on-site assessment, help identify interim executive leadership, and work with DPHHS processes for RHTP consideration. County officials said they expect to reconvene and review any assessment and a concrete short-term funding request before approving further county funding.

Sources: Remarks and figures quoted in this report were made by Granite County Medical Center interim CEO and board member Doris Gilbertson; hospital board co-chair John Barbara; Billings Clinic representatives Jim Duncan, Nicole Hobs and Adam Smith; and county officials during the June 16 commission meeting.