BSMC Blog

On October 1, 2024 we welcomed Dr. Daniel Davis to the Big Sandy Medical Center Team as our Medical Director. He completed his doctorate in medicine from the University of California in 1995 and has been working in various capacities of emergency medicine since. A bulk of his career has been spent in research and teaching. In fact, he has been published in almost 200 articles, and written text book chapters on 26 occasions. He is also a Fellow of the American College of Emegency Physicians (FACEP). To become a fellow, one must be board certified and actively involved in Emergency Medicine, and involved in leadership for at least three years. Dr. Davis certainly fits the bill. He has spent a majority of his career in California, but has in recent years began working with Logan Health. He is the Medical Director in Chester and works closely with the EMS services along the hi-line. In fact, those connections are how he learned about the position at BSMC. Ron Wiens, CEO, had reached out to the Montana Health Network expressing an interest in filling a Medical Director position. Those who have worked with Dr. Davis on the hi-line felt he would be a good fit for our facility.

After visiting the area, he states, "My initial impression is that the culture of Big Sandy is ideal to accomplishing the goal of clinical excellence. Leadership seems to embrace innovation, the providers and nurses are eager to learn more to provide outstanding patient care, and the patients seem engaged and supportive of the institution. I guess that I'd call it "innovation with a heart", which is an ideal environment in which to work." His initial impressions ring true. Big Sandy Medical Center stands by their mission to provide innovative care to the community. After his time in Chester, he feels he is well equipped to help Big Sandy residents receive medical care that is as good as-or better than- anywhere else. His passion is in bringing cutting edge science and new approaches to clinic care to rural areas, like ours, that wouldn't normally have this information.
Professionally, he sounds like a welcomed addition to our facility. Personally, he feels a kinship to our rural community as his father grew up on a corn farm in Iowa. However, with a smile, he does ask that the local wheat farmers not hold that against him. His wife is a Wound Care Nurse Practitioner and they have three children, one of whom just started school at the University of Montana in Missoula (Go Grizzlies!). They have five dogs and seven horses as well. Dr. Davis also enjoys spending time fishing, wine tasting and photography.

His role here will be to oversee the mid-level providers, help educate the staff, and offer any guidance that is requested of him. He will mostly be working remote, but does plan to be in town about once a month. We look forward to his wisdom and expertise. Welcome to the team, Dr. Davis.

October 5, 1963 the ground was broke to begin the construction of the Big Sandy Medical Center. At that time, the desire was to provide a facility for the town doctor to see his patients and possibly tend to them overnight if they were too ill to be at home. By 1965, the building was complete, including the inscription: built by the community, for the community. BSMC has remained an independently owned, community ran organization since it originated in 1965. Changes have been made over the years to accommodate the needs of the community. The addition of the nursing home in the 80s, the transition to a critical access hospital in 2019, and now the addition of a stand alone clinic building.

The grand opening of the BSMC Rural Health Clinic was held on October 4, 2024. Almost 61 years, to the day, since the start of the project that started it all. At least 4 generations of patients have been treated within the walls of the Medical Center, effectively holding true to the founding ideal of a facility that was built for the community. We see this in action as the ribbon is cut at the Clinic, by the members of the Elsie Pavlovick family, who so graciously donated the land for the clinic building to reside. The Dora Mahood Estate also donated $25,000 to the project, helping it come to fruition. The facility, and the community will always be grateful for these beautiful gifts, honoring the idea that, even 60 years later, as the facility expands, it is still done so by the community, for the community.

The Grand Opening was well attended. Ron Wiens, CEO gave consistent tours of the clinic for just over two hours to multiple members of the community. Often expressions were heard such as, "wow," "nice," and "roomy!" Harvey Keller, who was the Chairman of the BSMC Board of Directors when the project started, joked that the facility was large enough, navigating your way in and out could be a component of a dementia test. There is space for the Chiropractor, Dr. Pat Kadrmas to see his patients, as well as, Cheyenne Feltz, the Psychiactric Nurse Practitioner. There is room for specialist services, and of course the routine visits with our practitioners, Krystyl Kubleck, PA-C, and Heath Horton, FNP. It will be exciting to see what other services become available to the residents of the community and surrounding areas.

As you wait for your appointment, take a look at the photos hanging in the waiting room from the Big Sandy Cultural Center, some of which include Dora Mahood. You can also appreciate images from Craig Edwards, and even some photos from the CEO, Ron Wiens. With a close eye, you'll likely recognize the areas where the photos were taken from. Those small touches make all the difference in how comfortable people are while receiving their medical care. Dana Darlington said it best when he said, "it doesn't have that cold hospital feel." We hope you get to experience it for yourself, when you make your next appointment to be seen at the Clinic. Your primary care visits, pre/post op visits, chiropractic care, and mental health appointments can all be made by calling 406-378-2189.

It's no secret, the Big Sandy Medical Center is expanding! For the entirety of the Medical Center's existence, the building has housed all entities under one roof; clinic, lab, xray, hospital, Emergency Department, and the long-term care. As advancements in medicine continue and changes are made to the rules and regulations from the Centers of Medicare and Medicaid, American Disabilities Act and other regulatory agencies, the need to expand became clear. A 5000 square foot modular clinic building was purchased to solve the need for more space. A very gracious donation from the Peterson Family allowed the building to be located just across from the hospital itself at 225 McNamara Avenue. We again offer thanks to Lance Peterson, Michelle Kaufmann and their families for that donation. We also extend gratitude to the Big Sandy Medical Services Foundation, and the Dora Mahood Estate for their generous donations to help make this project possible.

The building was delivered in January of 2022 and ground was broke in the Spring of 2023. The ground was prepared. Water, sewer and electric hook ups were prepared. The flooring in the building was replaced. The sidewalks were poured, a parking lot created, stairs/ramp were installed. The furniture was arranged. The walls were decorated and the rugs rolled out. Now, finally, on October 4, 2024 the Big Sandy Medical Center is pleased to invite you to the Grand Opening of the Rural Health Clinic!

The event will be held from 2-4 pm on the Friday of Chili Feed. Stop on over after Punt, Pass, Kick and explore the building, enjoy some refreshments and if the weather holds, some yard games. There will also be two door prize drawings to be entered in, just for showing up! Watch the ribbon cutting and then you can head on over to the Chili Feed to support the local Volunteer Fire Department and EMS crew, and continue your hometown pride at the football field to support our Pioneers!
We look forward to seeing you at the Grand Opening, October 4, 2 pm-4 pm!

Dr. Carley Robertson has been working at the Big Sandy Medical Center since 2007. Originally, she worked as the backup physician for Ms. Laura Hillis when Dr. Gold was on the Medical Staff. When his time at BSMC ended, Dr. Robertson became the 'default' Medical Director as there was no other MD on the staff at the time. She said, "I offered to be the Medical Director until they could find a new one, to keep the doors open." It has taken over 15 years to do that! Over the years, Dr. Gladys Young and Dr. Cameron Parham have been on the Medical Staff to help cover for Dr. Robertson while she did mission work in Tanzania, East Africa. Neither Dr. Young, nor Dr. Parham, was in a position to consider becoming the Medical Director, but Dr. Young will remain on the medical staff to help in times of need.
Dr. Robertson says some of her favorite memories about her many years serving our facility are the people she got to work with. She states,

"I really enjoyed working with Harry Bold, and getting to know him and Pam Bold some. I enjoyed working with Sam Allen the Interim CEO who made it possible for Leah (Grubb) Griffith to learn her way as a new CEO. She was great to work with through the very challenging time of the COVID Pandemic. Leah was a good leader, and understood medical care... I miss her.

I enjoyed working with Del Simon in the Lab in particular, too. I learned a lot from her about antibiotic management, antibiograms, and her steady hand in the lab was invaluable. The Nursing Staff was always ready to step in and care for patients, even in the most difficult situations with Amber Beaudette as DON. Ashley Jacobi, our current DON, is doing a wonderful job as she gets to fill some big shoes. She is working hard to develop a nursing staff who understand patient care.

Lisa Genereux RN SW, has been a great patient advocate; and, she and Pam Gasvoda RN have been reliable sounding boards for me. Reggie Jappe and Helen Richter made the place run! What more can I say?!?

The PAs and NPs I got to work with here have been marvelous human beings and talented providers in a challenging environment... Edna Streit, Steve Arnold, Rod Hickman, Melissa Borkowski; and currently Paul Bradbury, Amber Groves, Krystyl Kulbeck, and Heath Horton... Krystyl and Heath have kept the place going for the past couple of years..." It is clear she has been impacted by many of the staff that have been employed at BSMC and she has impacted them as well. In these halls comments such as, "great to work with" "a wealth of knowledge" and "a passionate caregiver" have all been used to describe her.
Her plans in medicine do not end with her employment at BSMC. She will continue to work at Sweet Nursing home in Chinook; be the Medical Director of the Blaine County Ambulance Services, care for patients at the Havre Care Center and Care & Comfort Assisted Living facilities, and remain a back-up Pediatric Hospitalist for Northern Montana Healthcare. As if all of that won't keep her busy she will continue to be a part of the Montana Medical Association, the Montana Board of Medical Examiners, travel, volunteer, and stay active in her church. She is also learning to play the piano! With a laugh she says, "who knows, maybe I'll sleep some?"
Dr. Roberston was gracious enough to take some time to share some parting words for BSMC patients and the families: First - THANK YOU for the opportunity to have spent time in Big Sandy, and at Big Sandy Medical Center, and to have participated as much as I have. All of you have been a great source of encouragement to me. Thank you. Second - Take responsibility for your own health - DO WHATEVER IT TAKES to become more healthy... no one can do it for you! NO ONE!! If you need to, lose weight... eat less food! (One of my father's doctors used to say: "If you can't skip the snacks between meals, skip the meals between the snacks!" Not the best of diets, but eat less food!) If you do this over a period of years, you WILL lose weight... it is simply the opposite of how you got bigger... one bite at a time. IF you need to, quit smoking... Almost every disease of the circulation and most cancers are made worse by cigarette smoking... and vaping is not "a healthy alternative"! IF you need to, exercise more... just walking 20-30 minutes a day, 4-5 days a week makes a difference! IF you need to, rest more... some people just need to NOT DO something. Third - DRINK MORE WATER!! It's good for your skin, and your kidneys, and your bowels, and your eyes, and... and... and...You get it! Fourth - PRAY like your life depended on it... it does."
We thank you for your 17 years of service, Dr. Robertson. Our facility, our community, and our patients will miss you and the care you have provided!

It's been years since Big Sandy had a full-time doctor attending to the medical needs of our community. Why is that? The simple answer is the need for doctors exceeds the supply of doctors in the country. This allows doctors the privilege to be particular about where they want to live, if they wish to take call overnight on weekends and/or holidays, and how much they want to be paid for their services. The challenge for communities trying to recruit in this highly competitive market becomes justifying a move through pay, activities, spousal employment, housing and daycare options, and of course, an inviting community. Even though this sounds daunting, I believe there is hope, especially now that we have more space in the new clinic building and will have a CT Scanner soon. These additions should be attractive to a physician wanting to practice family medicine in a small rural community.

With the physician shortage, most rural (and even urban) communities have relied heavily on what we call mid-level providers. This includes Physician Assistants (PA) and Nurse Practitioners (NP). Both providers have specialized training in primary and emergency medicine and can provide nearly all services that a family medicine physician typically provides. At BSMC, we have both PAs and NPs on our medical staff. They are overseen by a part-time physician, either employed or contracted, to provide them with supervision, mentoring, and assistance with patient care.
Even though it is not as challenging to recruit mid-level providers to Big Sandy, the community is faced with many of the same struggles in recruitment. Competitive pay, housing, daycare, activities, and spousal employment all play a part in bringing a provider to the area. Once they are here, it can be challenging to retain them for the long term. We have seen three providers come and go over the last 5 years. Big Sandy is a great community to call home but imagine being on call to respond to the Emergency Room or the needs of the patients 24 hours a day for a week or two at a time. Coming in for a couple of hours in the middle of the night, and then still working a full day in the clinic, or sometimes getting interrupted in the clinic to care for someone in the Emergency Room certainly wears on a person. Even if the volume of calls is low, the constant awareness of the call radius (must be able to get to the facility in 30 minutes) takes its toll. Even something as simple as preparing a meal for the family or attending a sporting event must be thought through to ensure the ability to get away at the drop of a hat or in this case, the ring of a phone. While all medical professionals know this is, 'the job' we value our staff and our patient experience.

That's why we're making some changes among our providers. Starting in mid-September, our long-time Physician Assistant, Krystyl Kubeck, will become a clinic-only provider. By not taking ER call, she will have more time to devote to her clinic patients, continuing to provide the thorough and complete care that she has brought to the community for the last 10+ years. She will be in the clinic four days per week (barring holidays/vacation etc) and ready to serve you and your family. The ER will continue to be covered by employed or contract mid-level providers allowing us to continue to bring excellent ER and inpatient services to the Big Sandy Community. This is a win-win scenario, bringing focused, thorough care in the clinic and in the ER/hospital as well, ideally with less interruption in patient care in either setting. If you need a primary care provider, a DOT physical, sports physicals, or assistance with your chronic conditions and medication management, please make an appointment at the clinic today!
In the meantime, I'm still looking for that one physician who wants to call Big Sandy home.

On August 6, the Mix, a Billings radio station, posted an article stating that two of the fastest ERs in the nation were located in Montana. A law firm in Georgia, compiled in and out times of over 4000 hospitals in the nation, and discovered the McCone County Health Center in Circle, MT has the 10th fastest time. And your local facility, the one that was built for the community, by the community, the facility that has been standing for over 65 years, the Big Sandy Medical Center, has the 4th fastest in and out time in the NATION, with an average of 53 minute visits.

Someone questioned if that meant the care was sub-par. To the contrary. That means that the small but mighty, team at BSMC is efficient, well organized, and ready for whatever may come through those doors. The ER is usually staffed by a mid-level provider, currently, Krystyl Kulbeck, PA-C, or Heath Horton, NP, and one RN. They are supported by staff from the Laboratory and Xray when needed. Due to the facility's small size, most nights, this group of staff are at home on-call, when someone comes to the ER for treatment. When you consider the average response time of each of these staff members is 10-20 minutes, having you in, treated, and out in under an hour is truly impressive.

Staff often hear comments like, "I can drive from Havre to Big Sandy, get treated, and drive all the way back home before I would have even been placed in an ER room at another hospital." And they are not wrong. While there are always exceptions to the rule, most of the time, a patient is taken directly into a room. There is not a triage nurse or admitting desk. It's a one-stop-shop if you will. Your nurse will likely be the one to do everything from register you as a patient, to performing your vitals, assessment, and tests like an EKG, and call in other necessary staff. Your Provider will perform their assessment, and utilize the other data gathered to make an informed decision about the course of your care. If that includes a transfer to another facility, that process is started immediately. The ER staff are supported by the Big Sandy Volunteer Ambulance crew as well. Their rapid response times help aide in the ability to get a patient in and out so quickly.

168 patients were seen in the BSMC ER from January 1 to July 31, 2024. Most get to return to their home, some stay in the hospital for a short time, and some are transferred out to a higher level of care. Patients who need a higher level of care in transport, or who just need to get there quickly, are usually transported by air. Mercy Flight out of Great Falls, or MedFlight out of Billings are often utilized as well. If they cannot fly due to weather or flight team availability, a nurse will often accompany the EMTs in the ambulance to Great Falls. No matter the outcome, processes are in place to make transport arrangements quickly, preventing as much lost time as possible.

Big Sandy will never be known for it's size, but great things come in small packages. The next time you're in need of Emergency Care, rest assured, the team at the BSMC ER will get you in, treated, and out as quickly as possible.

After weather delays, parts delays, contractor delays, and a myriad of other barriers, the Big Sandy Rural Health Clinic opened its doors to patients for the first time Monday, August 5th. The long awaited soft opening came with a few expected hiccups that morning. There were some issues with the telephones and the computer system that caused the biggest stress. Clinic Manager, Suzy Labuda, with her team Abbey Sandlin and Morgan Simpson, and providers Krystyl Kulbeck, PA-C and Heath Horton, FNP and a few other helpers on the BSMC staff all worked hard to mitigate the issues. Suzy stated, 'The priority was, and continues to be, the patients.' They were successful in keeping their eye on what truly matters in those first few days.

Despite the expected stress of moving and getting settled into the new place with many new routines, the patients who came for clinic visits had nothing but good things to say about the new building. Words like sleek, roomy, spacious, and nice were all used to describe the inside of the Rural Health Clinic. One patient shared thoughts that there should be a mural on the outside of the building. She felt the outside appearance just does not do justice to how nice the building is inside. One should never judge a book by its cover.

The clinic staff all mentioned the benefit of the added space, even laughing about how they must walk down the hall to talk to one another instead of feeling like they are walking on top of each other in the daily hustle and bustle. They also mentioned the word, peaceful. When the clinic operated out of the original building, they were the main entrance for everyone. So they saw every patient visitor, interviewee, supply rep, contractor, etc as they came and went. Being in a stand-alone building has reduced that traffic to only the patients with appointments and their families. That certainly changes the foot traffic!
Another perk they were excited about was the ability to perform what is called, point of care tests. If you come in for a clinic visit, the clinic girls are able to perform urine screenings, blood sugar tests, rapid swabs, and also draw blood for your labs right there in that building. You will still have to go to the main building if you were to need an X-ray, but blood work will be handled in your clinic room!

The Grand Opening is slated for later this fall, after all of the moving bugs have been eliminated and operations are running smooth. In the meantime, we appreciate your patience, grace, and support as we continue to grow and serve the Big Sandy community. Please call 406-378-2189 for your next clinic appointment. Whether you need annual visit, aren't feeling well, or have an injury that needs looked at we are here to serve you, the people, who are the heart of BSMC.

Did you know people over 50 are encouraged to see their Primary Care Provider every year? Why would you need to go to the doctor yearly if you're healthy and feel fine? If you're not sick, don't go, right? Even if you do get sick once in a while, if some cold medicine can help, there's no reason to visit the doctor ever, right? Not quite. These visits are called preventative and are an opportunity to catch any pending issues that may lead to illness and failure in your body. Just like you change your engine oil routinely or brush your teeth daily, these habits prevent unnecessary damage and expensive, often urgent, repairs down the road.
The Big Sandy Medical Center building is experiencing that very scenario right now. The original part of the building was built in 1964-65. The Long-Term Care addition was added in 1985. Much of the building is still original. While it does have 'good bones' much of the preventative care and repairs have been deferred over the years. As all good things do, various components are wearing out, and due to the age, parts are no longer being made to fix, replace or even 'get by'. Our Facilities Manager, Chris O'Dell has been challenged with the task of getting the building back into shape. Most recently, the facility replaced its fire suppression system as well as the dated backup generator. Currently, we are replacing the IV pumps, and by September we should have a new nurse call light system in place.

A more pressing matter that has become apparent in this heat wave is the need for an overhaul of the facility's HVAC system. The chiller is unable to keep up with the cooling demands due to key component failures. Chris has been working with FICO to find creative strategies to get it back up and running properly while we look at alternatives, including the possibility of replacing the chiller. Fortunately, the chiller issues are not affecting our patient rooms, dining area and activities space. Each resident room has its own window unit so individuals can cool their space to their comfort level. There are also two units in the dining area to help offset the increased temperatures from the kitchen. These units are able to keep temperatures at a moderate level through these scorching summer months.

The need for this overhaul does not come as a surprise. Next Spring the internal controls for the HVAC system had already been slated to be replaced. The current controls no longer function and can no longer be repaired. Chris states the project will include, "New VAV boxes (that is what blends the air, when the room asks for cool air, it will divert cold air and when it wants hot air, it will switch to hot air), new thermostats, and a new mother board and operating system." Now this project may also include a replacement of the chiller too.

While it is so wonderful to see all of these improvements being made, they come with many challenges. BSMC is grateful to Chris and his team for their efforts, the Board of Directors for their support, and FICO for continuing to work with our staff to find solutions.

Take care of your body in all of this heat, drink lots of water, work outside in the morning and afternoon hours, and take frequent breaks out of the sun. Big Sandy Medical Center is here for all your needs, whether preventative (highly recommended) or emergent, you can count on us to be here, no matter the conditions. Thank you for your patience and understanding.

Late last year, Big Sandy Medical Center welcomed a new speciality to the clinic. Cheyenne Feltz is a Psychiatric Nurse Practitioner, bringing mental health services to the area. While receiving treatment for your mental health used to carry quite a stigma, that reality is changing. Seeing a therapist, counselor, or Psych NP is not something to be ashamed of or feared. You would likely not think twice about getting help from a urologist for your kidney health and well-being, or a cardiologist for your heart health and well-being. Cheyenne is the specialist for your emotional and mental well-being.

You may think that if you don't have 'depression' you don't need to see her. That is not true at all. Cheyenne not only helps with problems like depression and anxiety, but she can also offer support for grief, recovering from a trauma, managing a particular stressful situation in your life, or just getting to know yourself better so you can better manage your emotions and reactions to the various situations life throws your way. She is a professional listener and offers sound direction.

Here's something really neat. You don't even have to come to the clinic in person! She is certified to do Telehealth visits so she can work with you while you remain in the comfort of your own home! Maybe you want to begin working with her in person, but don't want to drive on the winter roads. No problem. You can do both! Maybe you are traveling for work, or your summer vacation and still want to keep your appointment. That is okay! As long as you have an internet connection and a private space to talk, you can work with her from anywhere.

How do you get set up with Cheyenne? It's quite simple. You just call the clinic and ask for an appointment. They will get you all set up on her schedule. You do not need a referral. You do not need any previous documentation. You do not need to be in crisis. You just need to make a phone call and the clinic staff will take care of the rest. Most insurance plans offer coverage for mental health appointments, but the best way to see what your plan covers is to call your insurance representative or verify with your online account. For those without insurance, there are income-based payment options for you too! Payment should never be a barrier to your mental wellness. Cheyenne is available for appointments most Mondays and Tuesdays and is looking forward to meeting with you! You can direct your questions or schedule your appointment at 406-378-2189.

We are getting closer and closer to the opening of the new Clinic Building; a long anticipated day for the staff and community alike. After many set backs due to weather, shipping delays, contractor delays, and unforeseen circumstances, caring for you from the new building is finally starting to feel real. For the last few months, special planning meetings have taken place among the staff to help ensure a smooth transition. As they continue to work through the upcoming changes, it is important you know how this changes the process for you, the patient, too.

First thing is first, you will still receive the care you are accustom to at Big Sandy Medical Center. Our team of providers, Krystyl Kulbeck, PA, Heath Horton, NP, and Joe Epperson, PA will continue to care for you in the new building. Abbey, Suzy, and Morgan will also be there, so the faces are all the same-just new spaces, and a few different routines.
For example, let's say Minnie Mouse is due for her annual check up. Like usual, she'll need some blood work done prior to that appointment. Minnie would still go to the 'old' building to get her lab work done a couple days prior to her appointment date. The lab will complete the tests and get the results on her Electronic Chart for the provider-just like they do now. The thing that is different is that Minnie will show up to the NEW building at the time of her appointment. So labs at the old building, provider visit at the new building.

What about the case of something less routine? Like if Donald Duck has a cough he just can't get rid of. Well then he would call to get an appointment and show up to the NEW building at the time of his appointment. He would be evaluated by the provider. If the decision was made to get a chest xray and lab work, he would need to go on an adventure over to the OLD building to get those tests completed, then head back to the new building to discuss the results and create a treament plan. Think of it like the scenic route. Benefis has a sky walk, elevators, and long corridors. BSMC has just a short jaunt across the street.

Now if you're Yosemite Sam, and you've woke up with a sore throat or cold/flu symptoms. You'd call the clinic and get your appointment. When you arrive there, if it is determined that a swab for strep throat, Influenza, Covid, or RSV is needed. That would be completed right there in the new building. You'd have answers and a treatment plan before you know it!

Finally, there's the case of Bugs Bunny. Bugs just hasn't been feeling himself lately and comes in to hopefully get some answers. His provider feels that some blood work is the place to start. In this case, Abbey could collect the blood work and get it over to the lab for testing. Mr. Bunny never has to leave the room and is on the way to discovering why he's feeling off; maybe he needs a more well balanced diet-his Providers are sure to find the answer.

We can't forget about Wile E. Coyote though. Wile E. Got caught under another anvil and has some major injuries. This is a case for the Emergency Room. He may need EMS to help him get there. The nursing staff will take good care of him with the direction of the provider on call. Nothing about this Emergency Room visit will look different than his many visits before. He will still receive care from the same nursing staff and the same providers in the same place.

As with all change, it will take some getting used to. The staff at Big Sandy Medical Center will do their best to keep it simple and guide you through the process, we ask in return, you remain patient with us as we adjust to the new normal too.
There is not yet a date set for the Grand Opening, but as soon as it's official, the community of Big Sandy will be aware! Shortly after that, the construction will start on the old building to prepare for the CT machine! Big things are on the horizon for the Big Sandy Medical Center and the community that supports it. As always, thanks for being the heart of BSMC.

Have you ever gotten a bill in the mail from Big Sandy Medical Center (BSMC) or another medical facility and thought to yourself, 'what in the world does this mean?' Chances are, you have probably had a thought similar more than once. The medical billing system in American healthcare is confusing from the beginning to the end of the process, but that doesn't mean it should be totally foreign to you. The billing department at BSMC has been working hard in the last few years to streamline the process, prevent errors, and make it easier for the patients to understand. It is a constant work in progress.

One of the challenges that all healthcare facilities face is the reality that service is provided long before the patient has an opportunity to make a payment. A mechanic can require payment before returning your vehicle. A photographer can not release images to a client until payment has been received. The electric company can turn off your electricity until you are caught up on your payments. But in medicine, a patient is treated without question, in good faith they (and/or their insurance) will pay for the service later.

The system may never be perfect as a whole, but the billing office does receive the same types of questions frequently that have little to do with the individual bill or service itself, but more of a lack of understanding of the process. To help clarify some of those things, we'll discuss them below.
Often there are questions about how long to expect before a bill, also known as a statement, should arrive. One would think it would be as easy as ringing up your groceries at the store. That would certainly simplify the process. But, between private insurances and Medicare/Medicaid there is a lot more to it than that. Everything that happens, from the time you arrive to the amount of time the provider is with you, to the size of the IV needle that is used must be documented. Providers may not always have the time to complete their documentation every day. The top priority is always taking care of the patient, so often the paperwork side of the care provided takes a back burner. When they do complete their records, then that visit can move to the next step; coding. Every service provided has to have a code attached to it. If that code is deemed not applicable to your situation by your insurance company, they will not pay for the service. There are over 11,000 codes; 24 of them could be used to list a Chest X-ray. If insurance doesn't agree with the code that was chosen to classify your X-ray, they may agree with one of the other 23. You can see how this can become confusing and time consuming real quick, so BSMC works with a billing and coding team that takes care of this process for us. After everything is coded appropriately, then the account is submitted to your insurance. Your insurance company reviews the chart and your coverage, then decides what will be paid. Then we receive payment from your insurance, also known as an adjustment. Your Explanation of Benefits can help you understand what payment was made and why. After that adjustment is received and applied to your account, then the remainder of the bill is sent to you. Provided we have the correct mailing address on file for you. The whole process can easily take two to three months.

After you receive your bill, you may immediately wonder where to find a coupon to help reduce that cost. While it would be nice to have such a luxury, there is an option to help save money! It's called the prompt pay discount. If you can pay your bill in full within 30 days of receiving the statement, you can receive a discount! There is also a charity care sliding scale fee service that is available to you for those who may need extra assistance. Further information on that program can be found on our website at www.bsmc.org/business-financial.

You might also wonder why you receive a bill from Billings Clinic for lab work you had collected here in Big Sandy. While the lab here is capable of running a large variety of tests, they do not have all of the equipment necessary to complete every test ever ordered. The ones that the BSMC lab is not capable of completing are sent to Billings Clinic to be completed. Anything they complete for you is billed through them. So you may have a bill from BSMC for your visit with the provider and a portion of your lab work, and then another one from Billings Clinic for the lab tests they completed.
You are always welcome to call up to the facility, explore the website, or come in and visit with Paula or Brittany regarding your bill. It is certainly a daunting process on our end, as well as yours. The staff are here to help, offer clarity, and continue to make progress towards a streamlined billing process.

Some people envision white dresses and nurses hats,
That classic image of nurses in the past.
Others think about the mean lady who gives shots,
The one who called you a little snot.
Then there's the nurse that was an angel to you,
The one that brought you comfort during that thing you went through.

There are nurses of all kinds, they serve in many different ways,
From at the bedside to public health, hospitals, clinics, and even as teachers,
This week we give back to them, offering uncommon praise,
The recognition they don't always get, but certainly deserve.

There are eight wonderful nurses at BSMC,
Today we tip our hats to them and say thank you for all you do,
Steph, Sam, Sarah, Amanda, Randy, Katie, Jessica, and Ashley,
This place couldn't function without you.

Thank you for working the long days and the long nights,
Thank you for missing time with your family,
Just so you can care for the community.

Thank you for sharing your knowledge, your wisdom, and your heart,
For it is those things that set nurses apart,
Your compassion, patience, and sense of humor too,
All of these things are the nursing glue.

To be a nurse is so much more than a job,
It is an honor, a blessing, and a calling in this life,
Even when it makes your heart hurt and your feet throb,
Your heart of gold prevents any strife.

This week we celebrate you, nurses of BSMC
For all you do for the folks in this community.
Keep up the good work, keep on, keepin' on,
And always remember, you're appreciated today and beyond.

Last year, Big Sandy Medical Center began offering a service called Patient Directed Testing. This is an opportunity for you as the patient, to choose which labs you'd like to have collected without needing a provider's order to do so. For example, let's say one of your longest friends just learned he has prostate cancer and it makes you think long and hard about those suggested lab tests that you should be getting done regularly. After years of avoidance, you finally call to get in with your regular doctor and they are scheduling 6 months out (popular provider!). You don't want to see someone else, but you also don't want to wait for 6 months to get caught up on your lab work. So instead, you come to Big Sandy Medical Center, register at the lab, and order the tests you'd like completed right now. The Lab will calculate your total cost, you will pay up front, then get your blood drawn and the tests will be completed. In just a few days your results will be mailed to you, or accessible on your patient portal, or they can even be sent straight to your provider so they are there waiting by the time your appointment comes around. Will you still need to keep your regular visits with your provider? Yes, that would be recommended. However, you can now walk into those visits empowered with information and even bring yourself some peace of mind in the meantime.

Maybe you have started a new nutrition plan and would like to watch your cholesterol or A1c every few months to see if there is improvement. Or you suffer from frequent UTIs and want to confirm your symptoms before starting another round of antibiotics. Do you need a Covid-19 PCR test for travel? You can walk in and get one without needing a doctor's visit! You certainly have a lot of options through patient directed testing and each of them allows you to save money, time, and be more involved with your own wellness.

Here is one of the best parts, since you pay up front, you pay less. The whole process is completed between you and the lab staff. They register you; they do the billing; they do the lab draw and complete the tests. It is a "one-stop-shop" so to speak. The simplicity of not having alternative staff that register, accept payment, bill your insurance company, wait for their payment, then bill you for the remainder, takes a lot of man hours out of the process. That means the service can be delivered for less! If you do have insurance, you can receive a receipt to submit towards your deductible, so it is a win-win!

It is important to understand that your insurance WILL NOT be billed for this service. If you want these lab tests to go through your insurance company they must be ordered by a provider. But depending on your insurance coverage, you might save money by not having them ran through your insurance. For example, a patient was recently in to have some blood work done. His fee for the day, after having some of his routine annual labs completed (CMP, CBC, Lipid Panel, Hgb A1c, and Vitamin D) came to a total of $235.00. Had he run that same set of tests through his insurance company, they would have been $776.00! As he had not met his deductible yet, the entirety of the cost would have been out of pocket for him. That is quite a savings and he can still submit that towards his deductible for the year.
The lab tests that are available to you through Patient Directed Testing include blood counts, cholesterol, thyroid tests, iron tests, diabetic screening, prostate screening, Urine drug tests and urinalysis, as well as the Covid-19 PCR. A more detailed list of the available tests can be found on the Medical Center Website at www.bsmc.org/lab. You will also find access to the form that needs completed prior to your blood draw. Having it completed prior to your arrival makes your visit that much faster but if technology is not your thing, it can be filled out upon your arrival to the facility.

The folks in the lab look forward to helping you reach your wellness goals in 2024. Come on in any time during business hours and get your lab work completed! Don't forget to celebrate our great Lab employees, Dave and Mike, this week April 14-20 is National Lab Week!

As a non-profit organization, the IRS requires Big Sandy Medical Center to conduct a Community Health Needs Assessment (CHNA) every three years. The CHNA is an opportunity for the members of the community to express their opinions about what is needed in the area, not just to help support their health, but to support the well-being of the community as a whole as well. You can view some of the current assessments from around the state at the Montana Healthcare Foundation's website. The last time this was performed, residents of the community received a survey in their mail. Just over 100 responses were received.

Ron Wiens, CEO, of the facility, has decided to take a different approach for this year's assessment. He will be hosting various meetings with specific populations in the community. On Jan 11, he hosted a meeting during lunch at the Senior Center, for the Seniors in our community. In that conversation, he learned that the group felt the three biggest factors contributing to a healthy community are having a quality education system, good health care services, and low crime/safe neighborhoods. Other areas addressed are risky behaviors, health related problems, and other opinions about life in the community. If you missed the lunch today, there are still surveys at the Senior Center so you can share your input.

Coming up on January 23, at 4 pm, at the Church of God, he will be hosting a conversation with parents/guardians of school age children. Pre-school childcare will be available during this meeting if you need it. He also intends to have a survey distributed to high school students. If you don't fall into any of those categories, there will also be surveys available for you to fill out at The Grocery Store, Pep's, The Mint, and The Bakery. If you return your completed survey to any of those businesses you will receive $5 off your purchase, as incentive for taking the time to share your opinion.

Ron is hoping to have between 100-150 responses by February 14. He will then be tasked with the duty of compiling the data, and finding three priorities the Medical Center can help to improve in the great community of Big Sandy. After those three have been identified, he must create an action plan and submit that to the Board of Directors for approval before June 30, 2024.

This is an opportunity for you to share your thoughts, opinions, and requests here in Big Sandy. Please, join a focus group, or stop at any of the above-mentioned businesses to fill out a survey so your voice can be heard. Stay tuned for more information as results continue to come in.

2023 brought a lot of progress to the goals at BSMC. The end of the calendar year will not end our production though. 2024 will bring a continued effort to get the new building completed and begin clinic operations there, final set up of the new generator, a dining room expansion, removing the carpet from the walls of the nursing home wing, continued efforts to improve the billing process, continued improvement of our nursing care, continued development of our leadership team, more community education, and so much more.

The kitchen addition was completed and has been running smoothly. Kitchen staff are grateful for the added space and organization. North Western Energy installed the 2 inch gas line that is necessary to fuel the new generator. As soon as the Loch electric can get it hooked up we'll begin testing the functionality and make sure all is working appropriately. It can then be put into operation when the need arises. So far, this mild winter weather has certainly helped with the productivity in all the projects and updates around the facility.

The new clinic building is coming along nicely. The current hold up is an electrical panel that is making a VERY slow journey to Big Sandy, as has been the case with most electrical components lately. The facility has began to purchase furniture and equipment that will be necessary for operations at the clinic and adds to that shopping list frequently. When the day comes that operations do finally move over to the new building, you will still be greeted with the same quality care you experience now. You'll see the same clinic staff team you work with now. Abbey, Suzy, and Morgan will be able to run some blood tests, rapid tests for Strep, influenza, RSV, and Covid. Cheyenne, the new Psychiatric Nurse Practitioner, will also see her clients there. She is seeing clients now, if you would like to work on your mental health in the new year, please call 406.378.2189 to schedule with her.

When you come for routine outpatient procedures, like catheter changes, or wound care, then you'd come straight to the hospital instead to see one of the nurses there. Physical therapy will remain at the blue building. And of course, if you need Emergency Care, you'll still go to the Emergency Room Entrance like you do right now. All the staff with help guide you to the right places when the time comes.

After the clinic has moved out, we'll start construction on the current clinic rooms to prepare for the installation of the CT machine. In the meantime, planning is well under way to expand the dining room. If you've been to visit lately, or even watch the activities on the Faebook page, you've seen how crowded it gets when everyone is at a meal or activity. Even more so if their family is in for a visit for the day. One wall will be removed and a doorway expanded as well to help mitigate that problem. The carpet on the bottom of the wall will be removed and replaced with a durable tile surface that is cleanable and can withstand the inevitable wheelchair scuffs and dings. The Maintenance Department is also receiving quotes for new windows, air conditioner units, and a call light system. The 'nursing home' wing of the facility was added in 1985, there has been very few updates to the space in the last 40 years, these are all necessary and welcome changes.

Staff development continues in the New Year as well. All employees will have their BLS (CPR) training renewed and nurses will be completing their ACLS, PALS, and TNCC (these certificates prepare staff for life-threatening situations) by April. They are also implementing a NICHE (Nurses Improving Care for Healthcare Elders) care model to improve fall rates and overall care provided to our elder population.

The December Board meeting brought a favorable audit report and the approval to rent the bench outside of the bank as well as a billboard 6 miles north of Box Elder. Be on the lookout for those soon. The new Board officers will be elected after the first of the year. To gain more insight on the happenings at the Board Meetings, you can read the meeting minutes on the website. The website got a full revamp this summer, so if you haven't visited it recently, check it out at www.bsmc.org. There you will also find a list of the labs that can be completed in our facility without a doctors order. If you're ready to take control of your health and wellness in the new year, we'd love to help you. Labs, diabetic education, and annual wellness exams are all provided here at Big Sandy Medical Center. Call 406.378.2189 for more information or to scheduled your visit anytime. Thank you for allowing us to serve you in 2023, we look forward to all the growth and changes coming in 2024 and are grateful that you'l be along for the ride.

Having worked in Big Sandy for over a year now, one thing that continually amazes me is the generosity of the people who call this town home. And by generosity, I'm not just talking about money, but of time. The members of the Rotary Club give countless hours of service to this community so we can have Christmas lights to enjoy downtown and a park in the mountains to recreate, and most recently, an ice-skating rink for kids to play. The hospital Guild volunteers somehow pull together a huge rummage sale every year. Roberta Edwards volunteers countless hours inside the medical center helping to entertain the folks among other things. Even the kids volunteer through their 4H clubs, church groups, and other extra circulars. The list goes on of service organizations and individual people who give of their time to make Big Sandy a great place to live.

And when it comes to giving financially, Big Sandy must be one of the most generous communities in Montana. When a community member is seriously injured or sick, a fundraiser is organized and thousands of dollars are raised to help offset the unexpected medical and living costs.

From my perspective as the CEO of Big Sandy Medical Center, we have been the blessed recipient of this generosity in many ways during the past year starting in January 2023 with a donation of land (valued at $45,000) from the Peterson family. This is the site of our new clinic building. In April, the Big Sandy Medical Services Foundation gave the hospital $25,900 towards the kitchen remodel project. Their gift was made possible by the many community members who respond to the Foundation's annual giving letter with a donation.

In July, the hospital was the humble recipient of a $58,000 gift from Louis Beirwagen, which has been designated for updating of patient rooms. And most recently the hospital received two generous donations; one of $50,000 from the estate of Dora Mahood, half going towards the clinic project and half going to the CT project, and a gift from Lyle McKeever of $10,000 to go toward the clinic project. We have also been gifted grant money from Lippard-Clawiter and the Tordick Foundation to assist with the dining room expansion. Wow!

This facility would not be able to remain independent without your support. Whether through time, monetary donations, patronage, or even just word of mouth advertising. As we enter a new year, I want to thank all of you who have supported Big Sandy Medical Center in the past and ask for your support again this year. I wish all of you a very happy and prosperous new year.

2024 at BSMC is certainly off to a good start! The electric panel has finally been installed at the new clinic building. After waiting for over a month, progress can continue again. Hopefully, it will all work like it should and heat will be flowing this week. From there, the building needs a good cleaning and inspection, then the move in can begin! While all of that is happening across the street, inside the current building, the dining room expansion will be taking place. It should only be a 2-3 week project, but the results will prove useful for a lifetime. When this part of the building was built in 1985 the ADA rules were different, and in general the equipment was smaller. Being at full capacity with a majority of our folks using walkers or wheelchairs, and all of them wanting to eat in the dining room for meals and/or attend activities, it requires some strategic planning and a good bit of patience to get everyone into the room and positioned in a way that everyone fits. This project will remove the wall between the doorways of the main dining room and will also expand the doorway going into the adjacent space. Korb construction started on the project on February 13.

BSMC has also received a grant from AgWest Farm Credit to purchase three new AEDs. One of these will go into the new clinic building, and one will replace the device in the basement, as well as one replacing the device in the wellness center. While everyone hopes an AED is never needed, it is an important life-saving device in any emergency situation.

The facility has also filled the open Midlevel position! Joe Essperson, PA, husband of Tenley (Keller) Essperson, will begin working at BSMC in May. His backgrounds is in Adult critical care situations, so he will begin his training here with time in the clinic and the ER learning the ropes. When he has completed that training, he will begin seeing patience, as always you will ll see updates of both the dining room expansion as well as when Joe is ready to begin to build his practice.

We welcomed Cheyenne Feltz, PNP a couple of months ago and she continues to build clientelle in her mental health practice. We are so fortunate to have someone right here in town to help us with mental well being. She is still accepting new clients, and can do telehealth appointments if you'd prefer to stay home while under her care and still reap the benefits of working together!

The CEO, Ron Wiens has been conducting a Community Health Needs assessment. After reaching out to some specific focus groups, he has gathered the following data: 91% of high school students believe Big Sandy is a good place to live, despite the 62% of people that feel alcohol abuse is the most prevalent risky behavior in our community. Now that he has collected all of this insight, he will begin creating a plan of action. The idea is that Big Sandy Medical Center will help to mitigate the problems the community feels the strongest about. All of this will be available for public viewing later in the summer, after the Board has approved the 3-year plan.

In the January Board Meeting, new officers were voted into place. Bob Nelson is now the sitting Chariman, Anna Bold is the Vice-Chair, and Ann Quinn will sit as the secretary. Remember the Board meets every third Thrusday of the month and meetings are always open to the public.

Finally, the Leadership team at BSMC will begin a series of Leadership training this month. This training should help the team work better together, be stronger when working independently, and improve the working environment in the facility as a whole.

Keep an eye on the Facebook page and the website for further updates and all the recent happenings at BSMC. We look forward to all the good things that are coming this year and thank you for continuing to be the heart of BSMC.

It’s time for the tea at BSMC. What a busy couple of months down at the Medical Center! Among normal operations in the kitchen, Johnson Controls was in the building last week to finish installing the sprinkler heads in the new dry storage and walk-in cooler areas. That was the last of the items on the to-do list so the kitchen remodel is officially complete! Progress on the installation of the new generator has been less successful. Northwestern Energy pushed back the date on getting the new 2-inch gas line installed to fuel the machine. Hopefully, by mid-December, that will be done and then the generator can be connected to the new transfer switch. After that, some testing will need to take place and then, finally, it can be brought online!
The weather has been favorable, not only for the sake of not needing the bigger generator, but also for progress on the new clinic building. The lack of snow and above freezing temperatures has allowed for the pouring of the sidewalks, and the paving of the parking areas. The entry ramps and stairs were installed last week. On the interior of the building, the crew has been able to make the repairs needed after the process of transporting, storing, and moving the modular units into place. There was a wall damaged in the process, some ceiling tiles that were stained/damaged, and some general scuffs on the floors and walls from the process that have all been repaired. Next summer, the Medical Center will paint the exterior of the building, and add some trees/shrubs where needed to restore the curb appeal after construction is complete.
The Annual Board Meeting also took place last Thursday. There were 31 people present at the meeting, including the current Board and team from Cypress. CEO, Ron Wiens offered his report. Recognizing generous donors in the community that are helping to make these improvements a reality. Especially, Lance Peterson and Michelle Kaufman and family for donating the lot where the new clinic building now sits and Louis Beirwagen for donating funds for upcoming facility improvements. Upcoming projects will include the clinic space remodel and installation of the CT machine, removing two walls in the dining room area to create more space, replacing the hand railings, and removing the carpet on the walls in the patient room hallways. Other projects under consideration include updating the counters, sinks, bathrooms, and flooring of the patient rooms, and replacing all the windows and installing air conditioner units to the rooms. The facility is also considering upgrades to the HVAC system and replacing the nurse call light system in the near future. Strategic goals not only include completing those projects, but also obtaining funding and staff to get the equipment necessary to start a pain management service, adopting a new model to improve patient experience and organizational culture, provide leadership training to all Department leaders and providers, conduct a community needs assessment (be on the lookout for more details about how to get involved with that), and fully integrate new software to improve accountability, communication, and record keeping in the facility. The Medical Guild President Lisa Sipler offered her report, with the Rummage sale income surpassing previous years at over $10,000. The Guild does plan to donate monies to the dining room expansion. The Annual Financial Audit report will be presented at the December meeting as it is not complete at this time. The By Law Committee had no updates as the contracted attorney brought on to help improve and update our by-laws suggested a special meeting to discuss prior to voting. That meeting date will be announced after the new year. Finally, the nominating committee presented the candidates for the open seat on the Board of Directors. Dr. Karen Baumann, Ken Denning, and Harvey Keller were the candidates. 128 total votes were casted, 114 of them being absentee ballots. The spot will be held by Dr. Karen Baumann. Harvey, who has sat on the board since 2011 said, “It’s been a fun ride. It’s great to see more community involvement. I wish Karen and the Board success and cannot wait to see these projects come to fruition.” The officers will be voted on at the December meeting. That concluded the Annual Board Meeting. Thank you to all those who took the time to cast a vote, attend the meeting, and get involved with the happenings at the Big Sandy Medical Center. As Harvey said, it is great to see so much involvement. To maintain an independent facility, it will require community support.
Inside the facility, like everywhere else, staff are gearing up for Christmas. The holiday season is so special at BSMC. Starting at Halloween where the staff have a costume contest, judged by the Residents (Nursing staff won with “Old McDonald’s Farm” this year. “Sesame Street” and the “Price is Right” was also in the running), shortly after voting the kids are released from school and begin their trick-or-treating with the residents at BSMC. After Halloween, preparations begin for Thanksgiving. A Friendsgiving was hosted this year among staff and residents the week before the holiday, and families were invited to come have dinner with their loved ones on Thanksgiving Day. Now we’re deep into the Christmas season. The schedule of events will be posted to the Facebook page and announced in an article next week. If you or someone you know enjoys playing music or singing, we’d love for you to share your musical talents. Please contact Lisa Sipler for more information.
If your New Year’s goals are to improve your health, BSMC is still offering free Diabetic Screenings. You can also come to get lab work done without a doctor’s order, find more information on the website at www.bsmc.org. Now is also a great time to schedule your annual appointments and preventative care. We’re here to serve all your healthcare needs. As always, thank you for being the heart of BSMC.

Mark Twain said the secret of making progress is to get started. While it took longer than anticipated, the crew has begun the ground work on the site for the new clinic building. They are optimistic that they will have the foundation ready and the building moved over within the next eight weeks. After the building is in place, the modular building crew will marry the seams of the five individual pieces so it is one solid building. From there, plumbing and electric will be hooked up and the furniture installed. Weather permitting, sidewalks will be poured and a parking lot paved. Many steps, many moving pieces, but constant progress with the ultimate goal being a standalone Rural Health Clinic available to better meet your healthcare needs.
Having this new building will increase the amount of space we have to provide patient services. Not just the CT machine coming, but in bringing in specialized care, pain management services, and mental health services. We are thrilled to bring on Cheyenne Feltz Thompson, Psychiatric Nurse Practitioner. She will begin accepting clients as soon as the clinic building is operational. You will make appointments with her in the usual fashion through the clinic receptionist. We are thrilled to be offering this desperately needed service right here in Big Sandy. We will share more details about Cheyenne in the future.
The addition on the kitchen is almost complete. The kitchen crew moved into their newly finished space almost two weeks ago as the final touches are being made on storage solutions and walk-in coolers. On behalf of the kitchen staff, administration, and all of us at BSMC we wish to extend a heartfelt thank you to the Catholic Church for allowing us to use their kitchen during this process. The dietary staff handled the back and forth of cooking, hauling, and serving like professionals. Thank you to Patti, Sierra, Karla, Jamie, and Lindsey for working so hard during this transition. The kitchen has also recently seen a transition in their staff as well. The dietary manager, Star Taylor has accepted the Accounts Payable position. Filling the manager shoes will be Sierra Grimm. Aubrey Douglas has also been hired as a full-time dietary aide. There is one more dietary position still open, if you're interested in joining the team, contact Sierra or drop an application off at BSMC.
In other transitions in the facility, Brittany Sherburn has been welcomed into the Rehab and Wellness Center Manager position. As she gets settled into the role, more serious discussions about making the wellness center available to the community have been taking place. Nothing is finalized at this time, but you'll be the first to know when those details are available! For all your PT needs, please reach out to Brittany at 406.378.3931.
Other job openings currently available include Outpatient registration and Patient Accounts Representative, Housekeeping and CNA positions; we continue to look for a full-time mid-level provider. You will find more information on the NEW Big Sandy Medical Center website. While you're visiting the site, be sure to check out the Board of Directors page for information on how you can become a Board Member. There will be two seats available for election this year. One 3-year term, and one 1-year term. If you're interested in having your name on the ballot, reach out to a member of the nominating committee, Danielle Weaver, Jim Ray, or Ann Quinn. Elections will take place at the annual meeting to be held in November. The next regular Board Meeting is September 28 at 5:30 pm, the public is welcome to attend.
Don't forget the Medical Guild Rummage sale is coming up October 5th and 6th! You can begin to drop rummage off on Monday morning to the Jerry Martin Memorial Hall. All rummage must be there by 1 pm Wednesday. Volunteers are always welcome as well. Keep an eye out for future updates as we continue to make progress in and around the facility. As always, thanks for being the heart of BSMC.

As always, the summer months seem to fly by and this year is no different. Harvest is in full swing and our children are already back in school. Soon loud cheers will echo across football fields and volleyball courts. What a great time of the year!

And what a great time at Big Sandy Medical Center! In just a few short weeks, we will have a brand-new kitchen with ample food storage space and food prep areas. Korb construction has been working continuously, despite shipping delays, to keep this project moving. The addition is complete and now the "finish work" is happening on the inside of the addition and old kitchen space. The dietary staff have been working hard to keep the folks fed, making trips to and from the Catholic church multiple times a day to prepare meals and wash dishes.

By mid-September, work will begin on the installation of the modular clinic building. After the building is in place, it will take a couple of months to get ready for occupancy. Most of the furniture has been delivered and of course many items from the current space will move over. Once the current clinic space is cleared and the new clinic building is operational, the remodeling of the old clinic space will start. The completion goal is February of next year. This will give the community access to a CT Scanner and create space for additional future services.

September will also bring changes to the Wellness Center as plans are taking shape to open the gym to community memberships just in time to start an indoor exercise program. As those plans get finalized, more details will be shared. You will also be pleased to hear about the addition of a Psychiatric Nurse Practitioner to come in October. Again, more details to come as the time gets near.

August saw many young faces in the BSMC building. A Babysitter's Training class and a CPR/AED/First Aid class were hosted for children ranging in age from 8-15 years old. Both classes were well attended and enjoyed by the kids. More classes of this nature will be hosted over school breaks and next summer. Other community classes for CPR/AED/First Aid will be available over the winter as well, keep an eye out for those class dates/times in the future.

BSMC received a grant from AHEC-MSU Bozeman. The monies from this grant are being used to pay for free A1C, or diabetic screenings for members of our community. This test is recommended with your annual labs, however, most insurance companies do not pay for it annually. The A1C shows your average blood sugar levels over the last three months. This information is provided at no cost to you, without needing to see a provider. That information is yours to do as you wish; take it to your primary care provider, keep it for your own records, or make an appointment at BSMC to discuss your results with a provider here.

Finally, BSMC welcomed two new employees to the team this month. Weslie Taylor will be helping out in the laundry department and Wyatt Phillips will offer his efforts in maintenance. We are grateful to have them aboard. Current open positions at BSMC include, a Full-Time Accounts Payable clerk, a part-time Outpatient Registration and Patient Accounts Representative, a full-time/part-time CNA, and full-time/part-time Dietary Aid. Job applications can be found at www.bsmc.org.

Many things are changing at BSMC, may you find just as much beauty in it as you do the leaves changing in the fall. Thank you for continuing to chose BSMC for your healthcare needs; it is you, the people that are the heart of BSMC.

What's "The Tea"? It is the 411, the low-down, the news, the happenings... it's the latest here at Big Sandy Medical Center. People have always been the heart of BSMC, so you are invited to Tea, right here, with all the latest information about your home town Medical Center.
If you've drove by the facility recently, you've seen the progress made by Korb Construction on the kitchen addition. The foundation has been poured and they are preparing the external walls. While the final touches are being made to the exterior part of the addition, arrangements will be made to move all of the equipment out of the kitchen in preparation to remove the former exterior wall. During that time, meals for the patients will be prepared elsewhere. If things continue to go smoothly, the crew should be knocking out that wall in the next couple of weeks! Right now, there is not enough space in the kitchen to store the freezers and extra supplies, so the kitchen staff make multiple trips a day to the basement to collect necessities for the day's meals. This addition will provide space for walk in freezers and open up more workspace for the staff. The kitchen provides around 70-80 meals a day for patients and staff. If you'd be interested in being a cook in the kitchen, we're hiring! You can get more information by calling Star at 406.378.3920
The warmer weather has been welcomed by the patients and staff alike! Enjoying the fresh air in the courtyard has been a daily activity for some patients. Flowers were donated by the Medical Guild and planted by the patients in the raised beds, adding a beautiful pop of color to the space. Multiple community members have also purchased things from the BSMC Amazon Wish List. Items such as a projector and screen, a karakoe machine, bingo cards, craft supplies, memory products, games and exercise items have all been purchased. The list is constantly updated and it is such a nice surprise to see something has been donated by a generous community member. Thank you to do those who have contributed to the wish list! The patients certainly appreciate it!
In other news, the website for the facility is being completely recreated. It is currently still being created, but will have new features like being able to request appointments online and pay our bill from home. Of course, you can keep doing these things with a phone call, or stopping into the facility, but for some, the ability to do it from their phone will be beneficial. You'll find photos of the happenings around the facility, job opportunities, and information on upcoming meetings and classes posted there.
For example, classes like the Babysitter's Training and CPR. There has been a lot of interest in the Babysitter's Training! A class date will be set soon, those on the list will be notified of the date first. To be put on the list for the class, please fill out the form located at https://forms.gle/8jsjBZwzUomLxdF99. You can also find this form located on the Facebook page, and when the website is live, it will be there too!
The job opportunities you'll see listed on the site include a full or part-time position in Laundry, and full- or part-time CNA positions, and the above mentioned position for a cook. All of these positions come with benefits and paid-time off. Call Karma at 406.378.3906 for further information.
Please note, there will be no board meeting in the month of July. The Board of Directors will get a month off to spend time with their families and enjoy the longer days before the hustle and bustle of the school year is knocking at our doors again. It's hard to imagine, but it is already time to be thinking about sports physicals! Call the clinic to get yours scheduled today. As always, thanks for being the heart of BSMC.

Hats off to Lisa Sipler, and all the staff at BSMC that helped make Hospital Week one for the books. The week kicked off with Neon Day. A day full of colors as bright as the smiles on everyone's faces. The patients got to participate in neon painting with Roberta Edwards and played bingo that afternoon. They were joined by many folks from the community and had a blast. Tuesday was Disney Day. Everyone enjoyed visits from Micky and Mini Mouse, Cruella Deville, Doc the Dwarf, and others. After a corndog lunch, everyone settled in the "theater" for a showing of Mary Poppins with bags full of popcorn. It was sure hard to see anyone on Wednesday, as everyone was in camouflage! The patients spent the morning playing a version of whack-a-mole, in which the moles were staff and their children! It was quite a laugh. That afternoon was spent hunting sloths, skunks, koalas, and alligators. The following day staff and patients alike were adorned in their best cowboy/farmer attire. For most, this is normal "daily" wear when not at work, but others kicked it up a notch with plastic pistols and rakes and trowels. A delicious Chuck Wagon lunch was served before the "horse races" in the afternoon. In a horse race, each patient gets a staff member jockey to ride their stick horse across the board. They roll a dice, and their horse gets to move forward the respective amount of spaces, but only after performing activities such as yodeling or bucking around the track. This year's winner was Betty, with her Jockey Dave riding the horse Betsy. The week wrapped up with Rainbow Day and the Ice Cream Social. For the last three years, due to the pandemic, a parade was held in place of the ice cream social. It was so good to bring it back and welcome the community back to the facility. We sure enjoyed getting to see everyone and share in a sweet treat and fellowship. The weather cleared up just long enough to enjoy the courtyard and was a perfect way to wrap up the festive week. Be sure to check out the Big Sandy Medical Center Facebook page for photos of all of the happenings of Hospital Week and all our other activities!
Those that attended the social were sure to notice that construction has finally begun on the kitchen remodel project. The crew began the dirt work last week and is making steady progress. The working plan for the project is to have the addition built and the shell completed before beginning any demolition on the current building. This will help ensure the least amount of disruption in how meals are prepared for the patients and staff alike. We again extend gratitude to the BSMC Foundation and the Medical Guild, as well as the other donors in the community who have made this project possible.
You may have also noticed that things are happening on the lot where the modular clinic will go. The buildings that were there were offered on silent bid to the staff with stipulations to have them removed by May 1. The purchasers honored those agreements, and now the next steps can be taken. While the snow hindered progress this spring, the goal is to have the clinic up and running before Old Man Winter returns.
The facility continues to await the arrival of the State Surveyors and remains diligent in being prepared for their appearance. There was certainly a sigh of relief when they didn't show during Hospital Week. While they of course are welcome anytime, it would have been hard to enjoy the festivities with the leadership team having to work with the surveyors. The date of their arrival is always unknown, and they are usually in the building for 2-4 days observing usual operations, interviewing staff and patients, and reviewing patient charts.
Finally, you may have noticed some new faces around at BSMC. We have welcomed Chris O'dell as the Facility Manager, Maryetta Engle and the Financial Controller, and Jeff Richter and Vesuvio Reid to our housekeeping departments. We are so grateful to have such a wonderful team of staff helping to keep the place running smoothly. As we look back on Hospital Week, Nurse's Day, and another long winter, we are reminded just how lucky we are to live in the community of Big Sandy. This medical center exists for you, the people. Thank you for being the heart of BSMC.

What's "The Tea"? It is the 411, the lowdown, the news, the happenings... it's the latest here at Big Sandy Medical Center. People have always been the heart of BSMC, so you are invited to Tea, right here, with all the latest information about your hometown Medical Center.
We're almost through February and just a little over a month from the first day of spring. We were able to come out of "outbreak" status at the end of January, and due to the low numbers of Covid cases are in a "low" risk status. This means masks are optional inside the facility! Roberta Edwards has brought some beautiful craft activities to the folks to celebrate the Day of Love. The residents also enjoyed many visitors and lots of love on Valentine's Day. Families came to celebrate with their parents and spouses, some ladies from the Methodist Church popped in for a visit, and some young men from the FFA Chapter hand delivered Valentine cards to the folks here. There is never a shortage of love and care inside these walls, but the extra smiles are always welcomed and appreciated.
Progress on preparing the new clinic building and subsequently starting the remodeling project is sitting in the hands of Mother Nature. The next step for the clinic is to survey the property and get the gravel moved in before getting the building set and put together. However, that cannot happen until the snow has melted. There was a team in the current building gathering data to create 3D images of the building to aid in creating plans for the remodel. The goal of the remodeling project will be to make room for the CT machine and provide better use of the space that will be left vacant after the clinic moves into its new space.
The kitchen remodel project is coming along at a slightly faster pace. The quotes for equipment have been received and approved. The construction quote is still pending. Plans are in the works for keeping resident meals on the table during the process. The generator continues to wait for final parts before becoming operational.
With the help of the Montana Hospital Association, the facility brought in a Compliance Consultant in the first week of February. The Centers for Medicare and Medicaid Services (CMS) requires specific standards be met by every facility who provides care to people using Medicare and/or Medicaid services. These standards include everything from fire safety to infection control to direct patient care practices. The information provided by the Consultant helps us to identify areas that require more diligence from our staff and areas where current practices are surpassing the expectations of CMS. As a Critical Access Hospital, it is expected that annual surveys will be completed. The Covid-19 Pandemic caused some disruption to that routine, but the facility does expect a survey from CMS "anytime now."
While the facility continually works at maintaining CMS standards, the number one goal is to always serve our patients in the best way possible. It has become clear that an area of frustration for you, the patient, is the billing process. To mitigate that frustration and improve our service, a Billing Specialist will be on site to help improve the process. She will assess and re-educate all staff in every step of the journey from registration to when the patients receive a statement from the facility. She has been working with the staff in the billing and medical records departments for some time now and is coming to the facility with a deep understanding of our facility, our systems, and our patients. We thank you for your patience as we continue to find ways to improve your experience here at Big Sandy Medical Center. Thank you for being the heart of BSMC.

Did you see last week's article about the generous donation of land for the new clinic building? It is so good to see the community continuing to support this locally owned facility! As the new building gets established and services begin to take place there, the folks in the lab will be making some adjustments to their locale as well. The new clinic space will allow for the current facilities to be used very differently. Dave Korkowski and Mike Mebruer will take it all in stride.
Having the lab here in town is beneficial, not just when you are injured or ill, but for your routine wellness checks as well. January is National Thyroid Awareness Month. More than 12% of people in the United States have a thyroid condition. The hormone secreted by the thyroid gland affects every other cell in the body, so it is important to monitor and maintain adequate levels. You can get your thyroid levels checked or address any other concerns you or your provider have right here at the BSMC lab! Lab hours are Monday-Friday from 8 am - 5 pm and someone is on call 24/7/365 for all the immediate needs in the Emergency Department.
Dave is the Laboratory Manager. He has been here in Big Sandy for almost 2 years and is not only working in the lab, but also shares the Infection Control responsibilities. He has been a Laboratory Technician since 1992, obtaining his training while he served in the US Army Airborne Infantry in the famed 82d Airborne Division. Among his adventures he spent 10 years in Alaska. Immediately prior to coming to BSMC he worked as the Laboratory Director at Northeast Montana Health Services in Wolf Point and Poplar, MT for seven years. When managing two laboratories became more strain and struggle than pleasure, he decided it was time for a change and accepted the open position here at BSMC. He spends a lot of time reading and enjoys shooting and camping as well. Having lived in McKees Rocks, PA, Dave is an avid Steelers, Penguins, and Pirates fan and enjoys watching them play. He says he comes to work, "because I have to... But truthfully, I enjoy making a difference in people's lives; both people I work with and the community I live in."
Dave's partner in crime is Mike Mebruer. Mike is a Clinical Laboratory Scientist who has been at BSMC for one and a half years. He is no stranger to the lab though, having worked for 29 years in the field. Mike is originally from Baton Rouge, LA but he is adjusting to the cold weather and higher altitudes of Montana living. He loves to go fishing and enjoys a good weekend adventure with his family; there's no shortage of opportunities around here for that! Mike came to Big Sandy as a traveler after having spent some time in Tucson, AZ and he decided to stay here and bring his family along! He says, "I really enjoy the people that I work with and fell in love with the kindness and generosity of the people of Big Sandy. I do like being a part of the community and taking care of the people who live here."
That's another person whose heart was stolen by the people of Big Sandy. No wonder people are the heart of BSMC!

There is always a refreshing feeling of renewal with the turning of the calendar. Starting the new year brings about renewed energy and commitment to goals, plans for the coming year, and a desire to bring about change in your daily life.
It is no different inside the walls of BSMC. There is certainly an air of change floating around and all the excitement that comes with it. One could say the facility is adopting the "New Year, New Us" motto that is so commonly expressed this time of year. With the new clinic building, the CT, the potential for new providers and services, there is a different kind of wind in the sails of BSMC. At the helm of the ship through these upcoming changes is CEO Ron Wiens. Ron is new to the facility as of Oct 2022. He accepted the position of CEO after coming on as an Interim CEO last summer and will be celebrating his 6-month anniversary with the facility on January 11. He said the environment of the facility and the town of Big Sandy encouraged him to join the crew permanently and gladly accepted the invitation to stay.
Ron and his wife, Kim currently reside in Helena, MT; he commutes to Big Sandy during the work week and home to Helena for the weekends. Prior to working here at BSMC he was the CEO at Shodair Hospital for 16 years. Mr. Wien's hospital experience does not begin and end with his time at Shodair, he also worked as the CFO for the hospital in Libby MT for 17 years. He spent about 3.5 years working at a CPA firm in Billings prior to that. His working history is a great asset to the facility as it embarks on some substantial changes in facilities, services, and appearance in the coming months.
While he is a Michigan native, he enjoys much of what Montana has to offer and is happy to call Montana home. On his time off you may find him enjoying a good hike, birdwatching, biking, or appreciating the local wildlife and landscape. He also has a 10-year-old granddaughter that occupies his time frequently, with no objections from him!
When asked why he continues to come to work every day, this is what Ron had to say,
"I often remind myself that nearly 60 years ago, a group of Big Sandy residents with a pioneering spirit of sacrifice and hard work, came together to create a healthcare organization to meet the healthcare needs of the community. At some point they passed the torch on to us to be good stewards of what they created and to continue the vision they had for this place. This is a huge honor and responsibility. So, every day that I come to work, I remind myself of this stewardship role and the accountability I have to past generations for the work being done at Big Sandy Medical Center."
What a great perspective to hold when coming into a new role in a new community! When you see him out and about, be sure to say hello and help him feel welcome. After all, it is the people that are the heart of BSMC; staff and patrons alike.

Often when people think of any medical facility, the first people that come to mind are the doctors and nurses providing care there. It makes sense as these staff often have the most contact with the patients. However, there are so many "behind the scenes" people that are involved in your healthcare. That is true at BSMC too. This week, we feature the staff of the business office. This team handles all the billing, deals with insurance, manages the phone, and keeps the facility operational!
Along with Ron Wiens, CEO and Karma Hale, HR Director, the business office is home to Brittany Sherburn and Sarah Schlepp.
Brittany is a familiar face at BSMC as she worked in medical records for four years prior to working at the school the last few years. She returned to the facility in June of this year to become the Accounts Payable Clerk. She does a great job making sure the bills are paid and the lights stay on. A Big Sandy native, Brittany loves to run, and she enjoys listening to music or podcasts. Otherwise, she is spending time with her family and friends.
The Director of Finance is Sarah Schlepp. Sarah lives in White Sulpher Springs and has been working here, whether in person or remotely, for 11 months. She has also worked as a CPA at a firm in Bozeman (She says, "Go Cats!") for two years prior to starting in her role here. How did Sarah get here from White Sulpher? She heard about the job through her local hospital and felt the call to contribute to a community, much like the one she grew up in. Her time in the office doesn't prevent her from still enjoying the outdoors. She likes to golf and ski, has two dogs to walk with and gets back to help on the ranch when she is able. She also enjoys reading and board games if the weather outside is not enjoyable. Sarah has a true passion for numbers and says, "The thing I enjoy most about my job is that I can spend all day working with numbers while helping behind the scenes to support all of the great staff at BSMC."
No office staff is complete without an HR Director. Karma Hale wears that hat these days. She handed over her role as the Accounts Payable Clerk and became the HR Director just a little over a year ago, though she has over 15 years HR experience. She has worked at BSMC for seven years and continues to do payroll and is the Credentialing Officer for the facility. Karma has lived in Big Sandy for more than a decade and enjoys crafting and creating Karma's Kandies on her days off. She also enjoys time with her grandbabies.
The facility is currently in "outbreak status." To qualify for outbreak status, there must be one positive case of Covid amongst one resident OR one employee that is involved in direct patient care. To get off outbreak status, there must be 14 consecutive days without a positive Covid test among the residents AND employees. During outbreak, visitation is still allowed, but visitors are asked to wear an N95 mask while in the building. One will be provided for you if needed. As always, if you do not feel well, we ask that you stay home. The Clinic and Emergency Room continue with normal operations. The clinic is open Monday-Friday, 8-5; appointments can be made by calling 406.378.2189. The Emergency Room is open 24 hours a day, 7 days a week.
As planning continues for the kitchen remodel and the new clinic building you will continue to get updated here at "The Tea." As always, thanks for being the heart of BSMC.