Hospital plans for growth while protecting stability

Board begins master planning process to address space, services and future demand

With a full agenda and a wide range of reports presented, the North Big Horn Hospital District Board of Trustees covered a great deal of ground at its March 17 meeting. The overall tone of the evening was clear: steady growth, cautious optimism, and deliberate planning aimed at meeting the long-term healthcare needs of the community.

Board members and hospital leadership returned to a central idea throughout the meeting. The hospital is growing, but that growth must be managed carefully. As services expand and patient demand increases, space within the current facility is becoming more limited.

To address that challenge, the board has engaged A&E + SMA Design to lead a comprehensive facility evaluation and master planning process. The firm will assess current space, identify limitations, and develop options for expansion and improvement.

Early priorities identified through that process reflect both immediate needs and long-standing challenges. Among the most pressing are the hospital’s operating rooms, which are now more than 40 years old and lack adequate space for modern surgical preparation and recovery. Leadership noted that these limitations have created a bottleneck for growth, even as surgical services remain an important contributor to the hospital’s financial stability.

Inpatient rooms were also identified as an area for improvement. Plans include modernizing aging spaces and converting some double-occupancy rooms into private rooms to improve patient comfort and privacy. Similar upgrades are being considered for the care center, including converting rooms to include private bathrooms and expanding dementia care capacity.

Other priorities include improvements to cancer care services, particularly in the infusion area, as well as expanded space for administrative functions and storage across the facility.

The planning process will unfold in phases, beginning in 2026 with analysis and development of a long-term master plan. Future phases could include design, funding, and construction, with a potential timeline beginning as early as 2027. Board members emphasized that each phase will include clear decision points to ensure projects align with both community needs and financial realities.

CEO Eric Connell highlighted several immediate projects that reflect the hospital’s phased approach to growth.

“Engineering work is still in process,” Connell noted in his report, adding that the clinic shelled space project is moving forward.

One of the first visible improvements is expected to be a long-awaited upgrade to the hospital cafeteria, informally referred to as “The Bistro.” The project is designed to serve not only as a food service area, but also as a gathering and break space for employees, visitors, and families.

“We hope that the project will be under construction this summer and completed by the end of the calendar year,” Connell said.

Connell also pointed to additional near-term improvements already in motion.

“Facility planning priorities… will serve as the foundation for the detailed master planning process with A&E Architects,” he said, noting that those priorities were developed through recent engagement and leadership discussions.

Following the cafeteria project, attention is expected to shift to remodeling and improving upstairs exam rooms, another area identified as needing updates.

Connell’s report also highlighted continued growth in clinical services.

“Dr. Groover is doing well in his practice and maintaining a steady, busy schedule. Patient feedback has been very positive,” Connell said.

The Rural Health Clinic continues to see strong patient volumes, with 1,371 visits recorded in February, exceeding the monthly goal of 1,300. Clinic staff were also able to accommodate 138 same-day appointment requests during the month.

“We were able to accommodate 138 same day requests in February,” Connell noted.

Staffing levels across the district remain steady at approximately 272 employees, though recruitment continues in key areas such as nursing, radiology, and respiratory therapy.

Financially, the hospital continues to show stability. Connell emphasized the importance of maintaining that position while planning for future growth.

“This provides context as we consider facility improvements over the coming months,” he noted in reference to performance metrics included in his report.

Beyond major expansion projects, hospital leadership outlined a broad list of additional needs that will factor into future planning. These include updates to admissions areas, expansion of lab and rehabilitation space, improvements to emergency services, and continued investment in infrastructure such as flooring, air systems, and equipment.

Enhancements to staff and patient amenities were also discussed, including improved break areas, expanded kitchen services, and more comfortable spaces for patients and families.

Taken together, the discussion reflected a hospital that is actively preparing for the future while remaining grounded in practical realities.

Board members acknowledged the challenges that come with growth, particularly in a rural setting, but expressed confidence in the hospital’s direction and leadership. The emphasis throughout the meeting was not just on expansion, but on thoughtful, sustainable progress.

As the master planning process moves forward, the goal remains clear: to build on a strong foundation, make smart investments, and ensure that North Big Horn Hospital continues to meet the needs of the community for years to come.