NBHH moves forward with expansion project plans

New Horizons Care Center earns prestigious five-star CMS rating

The North Big Horn Hospital Board spent much of its meeting last week looking toward the future, approving budgets, recognizing employees for protecting patient safety, celebrating a major milestone for the nursing home and discussing plans that could shape the hospital campus for years to come.

Hospital leaders reported strong financial performance, continued growth in patient volumes and progress on several construction projects while also beginning discussions on a long-term campus master plan that could include expanded surgical services, additional patient space and other facility improvements.

Strong financial performance

The board approved an amendment to its fiscal year 2026 budget and adopted a fiscal year 2027 budget that reflects continued growth across the organization.

Chief Financial Officer Darcy Robertson explained that the amended budget increased from $32.986 million to $35.840 million due largely to onboarding costs for new providers and other expenses associated with growth.

CEO Eric Connell thanked the finance department for its work preparing the budget.

“It’s a lot of work, and we have a great team of people presenting to the board,” Connell said. “So thank you, Darcy.”

The board also approved a 2027 budget with an operating income target of nearly $2 million. Robertson noted that revenues from several providers exceeded expectations during April and May, prompting adjustments to the budget projections.

“A strong month, just in total revenues and volumes, very, very, very strong operating margin,” finance committee chairman Todd Simmons told the board.

Simmons reported that the hospital’s year-to-date operating margin currently stands at 5.3 percent, far exceeding the board’s financial expectations from previous years.

“There were times when a 1 percent operating margin would have been considered a really strong accomplishment,” Simmons said. Looking at both the newly approved 2027 budget and long-term financial projections, he said the finance committee believes the current performance level can be maintained.

“This is a sustainable operating margin for North Big Horn Hospital,” Simmons said, “very, very sustainable.”

Employees recognized

Board members also heard quarterly “Great Catch” recognitions honoring employees who identified potential safety concerns before they reached patients.

Leah Hansen was recognized for identifying a prescription error involving two medications with similar names and ensuring the correct medication was provided.

Tegan Lovelady was honored after discovering a medication order that appeared incorrect while helping organize a discharged patient’s medications. She contacted the patient’s provider, who agreed the order needed correction.

Amanda Schidler was recognized after discovering multiple medication doses stored incorrectly and alerting coworkers and the pharmacy so the issue could be corrected.

Hospital leaders praised all three employees for their vigilance and commitment to patient safety.

Care Center five-star rating

One of the evening’s biggest announcements came when hospital officials reported that the New Horizons Care Center had earned a five-star rating from the Centers for Medicare and Medicaid Services (CMS), the federal agency that evaluates nursing homes across the country. CMS ratings are based on factors including health inspections, staffing levels and quality-of-care measures, and are used by families nationwide to compare facilities.

CEO Eric Connell called the designation a significant milestone for the organization. He noted that when the hospital board established its long-term strategic goals several years ago, achieving a five-star Care Center rating by 2029 was considered one of the organization’s highest quality objectives.

“We recently moved from four stars to five stars in that rating,” Connell said. “That’s a significant milestone.”

Connell said the achievement reflects years of steady improvement in the quality measures used by CMS and provides independent recognition of the care being delivered at the facility. While ratings can fluctuate from year to year, he said the organization’s focus now is maintaining the top rating.

“If you see anybody that works in the Care Center, please congratulate them and thank them for what they do,” Connell said.

Employee survey shows positive trends

Connell also reviewed results from the hospital’s latest employee engagement survey.

Participation increased significantly compared to previous years, something Connell said gives leadership greater confidence in the results.

“The better the response rate, the more credible the results are,” he said.

While employees identified areas for continued improvement, including communication and professional development, overall engagement scores remained strong, and several categories approached “employer of choice” benchmarks.

“This is a good report card,” Connell said. “We need to take the qualitative feedback and continue to work on that.”

Clinic and bistro projects

The board also approved moving forward with bids for two facility improvement projects.

The clinic remodel project received a low bid of approximately $921,000, while the hospital’s planned bistro renovation came in at roughly $554,500.

Although both projects exceeded original estimates, hospital leaders said the organization remains financially positioned to complete the work without borrowing money.

“We feel very good about our ability to meet that obligation and take care of this project with cash and not having to take any debt out on this project,” Connell said.

Planning for the next decade

Perhaps the most significant discussion of the evening focused on the future of the hospital campus.

Alan Godfrey of A&E Architects presented preliminary master planning concepts designed to address future growth while improving patient flow, privacy and efficiency.

Rather than detailed building plans, Guthrie presented conceptual layouts showing how departments could be reorganized and expanded over time.

“This is what we call bubble diagrams,” Guthrie explained. “It’s really deciding where the departments need to sit so they have the right relationships to other departments.”

The concepts include potential expansion to the south side of the campus, with a two-story wing that will allow room for future surgical services, additional patient care areas and the relocation of several departments.

Hospital leaders emphasized that no final decisions have been made but said the planning process is intended to ensure the organization is prepared for future growth.

Connell said the planning effort demonstrates that the hospital has options to address future needs while making better use of existing facilities.

“There are ways to de-conflict many of those areas where conflict exists but also plan for the future and services that are and will be needed in our community,” Connell said.

For now, board members appeared supportive of continuing the planning process, viewing it as an important step toward ensuring North Big Horn Hospital can meet the healthcare needs of the community well into the future.

The board meeting as a whole painted a picture of an organization that is growing, financially stable and focused on the future. From earning a five-star CMS rating at New Horizons Care Center to planning future campus expansion, hospital leaders said the goal remains the same: providing high-quality healthcare close to home while preparing to meet the needs of the community for decades to come.