Community Information – As a critical access hospital, Big Horn Hospital Association’s (BHHA) priority is ensuring that the health care services our community needs remain available. To ensure that happens we are looking at ways to maintain our organization, staffing, and operations.
BHHA has spent the past 24+ months weathering one of the most difficult storms in the history of U.S. healthcare. Up to this point, we have succeeded—with the tireless work of our dedicated staff, the support of our community, and our unwavering commitment to our patients and residents. However, the financial impacts of COVID-19, rising workforce shortages, supply, and inflationary costs combined with decades of below-cost Medicaid payments to facilities like ours, has proven to be too much of a financial burden for our organization to bear.
BHHA has always strived to have a safe and positive environment for our employees. We are faced with critical workforce challenges and the ability to be competitive to recruit and retain employees especially in our licensed/certified direct care positions. BHHA is working to keep wage rates in line to be competitive in our market. The current situation has forced BHHA to examine the sustainability of our current operations and services. One of the major considerations and options includes closing our long-term care facility—Big Horn Senior Living. BHHA expects to have a decision this summer, with the intent of creating a sustainable model that helps us continue to meet the health care needs of our community as a critical access hospital. To ask a question please email BHHA at email@example.com.
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Subject: Big Horn Senior Living Nursing Home – Possible Closure of Long-Term Care Facility
I am contacting you today because I am very concerned about the possible closure of Big Horn Senior Living which is licensed for 36 nursing home beds, 11 assisted living beds and 10 independent living apartments in Hardin, Montana. At this time, Big Horn Senior living is home for 28 nursing home residents, 8 assisted living residents, 9 independent living residents and employs 56 community members. Losing Long-Term care and Assisted Living access in our community will be devastating for the residents that call Big Horn Senior Living home and for family members who wish to remain close and visit the residents often. There has always been a high need in Big Horn County for long-term care with the need expected to grow based on the population projections of our area.
Big Horn Hospital Association which houses Big Horn Senior Living and Big Horn Hospital has spent the past 24+ months weathering one of the most difficult storms in the history of U.S. healthcare. Up to this point, they have succeeded—with the tireless work of their dedicated staff, the support of our community, and their unwavering commitment to their patients and residents. However, the financial impacts of COVID-19, rising workforce shortages, supply, and inflationary costs combined with decades of below-cost Medicaid payments to facilities like theirs, it has proven to be too much of a financial burden for their organization to bear.
The urgency to find a resolution is not only for the situation in Big Horn County, but these same concerns have been expressed by nursing home/assisted living administrators across the state who accept Montana Medicaid. It is a concern that Big Horn Senior Living may be the first of many facilities that may face closure before the next legislative session and normal budgeting/price setting process can occur. If Montana facilities are allowed to close with no effort to change how we pay for vulnerable elders in our state with advanced dementia or other health/mental conditions that cannot easily be cared for in other settings, where will we be one year from now, five or fifteen years from now? This care cannot be provided in Montana’s rural counties where these types of other settings do not even exist, i.e., home care or other waiver services. The infrastructure is not here in Big Horn County nor in most other rural counties.
In the 2021 Montana Long-Term Care Facilities Plan signed by Montana Governor Greg Gianforte and DPHHS Director Adam Meier in January 2022, it discusses the documented goal of this plan for nursing homes in Montana is “Given the belief that people are best served in their local communities, Montanans in need of comprehensive long-term care, including nursing home services, should have these services readily available and accessible and provided at the closest proximity possible.” This plan lists the “Nursing Home Bed Unmet Need Projections for 2021” projecting that Hardin actually needs 39 beds, 3 more than what we have now. If established high quality care facilities like Big Horn Senior Living are allowed to close because our state is not quickly responding to the very different environment they are forced to operate in, what happens to their communities very vulnerable elders that were once our teachers, construction workers, state government employees, ranchers, etc.
With great concern and urgency, I am contacting you to determine the possibility of any of the following: emergency funding for Montana nursing homes until at least the 2023 legislative session; a special legislative session to provide emergency funding for Montana nursing homes and determine a sustainable daily rate increase to cover the actual costs we are experiencing; use of DPHHS Civil Money Penalty (CMP) funds; reallocate unspent budgeted nursing home daily rate funds due to nonuse because of statewide lower nursing home census; use of state contingency funds; redirection of allocated but not spent American Rescue Plan Act (ARPA) or other grant funds; other options/funds.