Big Horn Senior Living to cease operations within 90 days

July 15, 2022

During a special meeting on Wednesday, July 13, the Big Horn Hospital Association (BHHA) Board of Trustees made the difficult decision to cease operations of Big Horn Senior Living (BHSL) nursing home, assisted living, and independent living services.  The closure will take place over the next 60 to 90 days.

The cost of maintaining long-term care services – including a $1.2 million loss last year – has resulted in operations that are, unfortunately, unsustainable. The decision was made after exploring numerous potential solutions and seeking assistance from local, state and federal officials and agencies on viable options for the sustainability of the long-term care services. However, that work was unable to find an option that met the unique needs of both BHSL and the residents it serves.

“It has been our great honor and privilege to care for our residents,” said Paula Small-Plenty, BHSL Administrator. “This decision has been heartbreaking for our team, and we recognize the additional challenges it places on our residents and their families. They are still a part of our family, and we will work with the same compassion and respect in their transition plans as we have in their care.”

The senior-living residents are the heart of BHSL, and staff there have grown incredibly close with each of them. Making sure that each of the 27 nursing home, 7 assisted living and 9 independent living residents can continue to receive the highest quality care is the top priority moving forward, and BHSL will work with residents and their families to find and coordinate placement in their next homes. This may include transitioning some nursing home residents to care at the hospital and coordinating with Big Horn County on options for independent living. The Montana Department of Public Health and Human Services will also help with placement and reimburse transportation costs for any residents who find a new home outside of Big Horn County.

Currently, Montana Medicaid reimbursement rates for nursing home and assisted living services – which are set by the Montana Legislature and not by BHSL or other facilities – do not make up for the increasing cost of providing these services. In order to just break even, BHSL would need reimbursement rates to double. BHSL has for many years advocated for rate increases to ensure the viability of these essential services for Montana’s elderly and vulnerable. Rapid and significant cost increases, combined with minimal rate adjustments, are now causing challenges at nursing facilities statewide, including BHSL. Additionally, mandated care protocols following the COVID-19 pandemic, nationwide workforce challenges and inflationary factors played a role in this decision.

BHSL has maintained operations over the last two years in large part due to the support of its parent organization, Big Horn Hospital. However, operating both the hospital and BHSL makes continuing its critical health care operations as a hospital unsustainable. As a critical access hospital, BHHA’s mission and top priority is ensuring that the health care services needed in Big Horn County and the surrounding area remain available.

During this time, BHHA will also work on transition plans for affected employees. Big Horn County owns the facilities where these services are housed and will determine any future uses of the property.


Paula Small-Plenty

Big Horn Senior Living Administrator / HR