Hospital board approves flooring project, hears strong financial report

The North Big Horn Hospital District Board of Trustees approved a major flooring replacement project, reviewed a strong financial outlook and heard updates on future facility planning during its May 26 regular meeting.

The meeting began with a patient-care story, something CEO Eric Connell said the hospital intends to make a regular part of board meetings.

“We want to put our focus on quality and patients,” Connell said.

The story came from a patient who recently underwent a colonoscopy at the hospital and praised staff members for professionalism, compassion and kindness.

“From the minute I walked back to the OR until the time I left after the procedure, I was just amazed about how I was treated and the kindness you all showed me,” the patient wrote.

The patient said staff helped turn an embarrassing and stressful procedure into a positive experience.

“I would be the first to tell anyone that would listen that coming and having a colonoscopy at our facility is such a great experience, and there is absolutely no need to feel hesitant, embarrassed or worried,” the patient wrote.

Connell said the hospital plans to continue sharing similar stories.

“We intend to do that every month, so we’ll bring a safety story or a quality success,” he said.

Financial reports presented during the meeting showed the district continuing to perform well. Connell said the hospital is on track to finish the year with an operating margin of about 5 percent.

“We should end the year right around 5% operating margin, which is a good thing,” Connell said.

He noted that the board had previously pushed management to move from a negative operating margin to at least break even.

“The board said, no, no, we’re going to hit zero,” Connell said. “The budget last year came in just above zero, and we’ll end up around 5% operating margin.”

Connell said that marks a significant improvement from previous years.

“Historically, if we went two years ago, we would have a negative operating margin, which means the organization is being sustained by other revenue sources, and so that’s a change,” he said.

The hospital expects to end fiscal year 2026 with about $56 million in revenue. The proposed 2027 budget shows both net revenue and operating expenses increasing by about 12 percent.

“We are not spending more than what we’re bringing in, what we expect to bring in, essentially,” Chief Financial Officer Darcy Robertson told the board.

Connell said the hospital is trying to sharpen its budget process during a period of growth.

“The board has challenged us that over time we hone in on that budget,” he said.

He added that growth has made budgeting more complex.

“In a period of growth where we’ve added some pretty significant services to the organization, that’s just a growing learning curve for the management team,” Connell said.

The board also discussed days cash on hand, a measure of how long the hospital could meet financial obligations using current cash. Connell said the organization once operated with roughly 45 to 50 days of cash on hand before COVID and before the current leadership team arrived.

The district now expects to end fiscal year 2026 with about 209 days cash on hand and fiscal year 2027 with about 245 days.

“That provides no value other than being able to perpetuate the mission of the organization, reinvest in salaries and wages and benefits, and help the organization continue to move forward,” Connell said.

The board approved the expanded flooring project from FloorX, with a bid of approximately $1.13 million. Connell said the project will replace carpet throughout the facility, including areas that have become a concern.

“This is replacing carpet throughout the facility,” he said. “It’s an infection prevention hazard.”

Connell said some older areas of the building are badly in need of attention.

“I can show you a room or two and you would say, this is unacceptable; this is duct tape on the seat, and we need to replace this,” he said.

The State Loan and Investment Board is expected to contribute about $350,000 toward the project. Connell said hospital leaders initially limited the scope of the project but later decided the expanded version made sense.

Connell said the expanded project is affordable and included in the hospital’s capital projections.

“We prefer to do that,” he said. “And we can afford it.”

The project is expected to take six to eight months and will be completed in phases.

“It’s not going to be very convenient because we have to do it in about 10 phases,” Connell said.

He said the work will require infection prevention barriers and the movement of residents during portions of the project.

“But it’s a good and worthy project, and we’d like to move forward,” Connell said.

Trustees also approved the purchase of a new blood gas analyzer for the laboratory. Hospital officials said the current analyzer has reached the end of its useful life and serves as the hospital’s only blood gas analyzer.

Connell also highlighted a $100,000 grant request submitted by the North Big Horn Hospital Foundation to support an oncology nurse navigator position.

“That’s pretty significant,” Connell told trustees.

He said the position would help patients work through insurance, reimbursement and access-to-care issues.

“There’s a lot of complexity and nuance with oncology, and so we’re very enthusiastic about that grant,” he said. “That would be a significant piece for us.”

Connell also updated the board on facility planning. Architects have provided early “bubble diagrams” with several concepts for future campus improvements.

He said hospital leaders expect to narrow the options and return to the board with possible directions and cost estimates.

Connell described the discussion as part of a larger question about whether the hospital should pursue a major long-term investment.

“Are we pursuing some things that are going to benefit our community for the next generation or two?” Connell said.

The hospital is also moving forward with clinic and bistro/cafeteria projects. Connell said bids are expected back in June, with the goal of completing those projects by the end of the calendar year.

He said successful completion of the smaller projects could give the board confidence in the hospital’s ability to manage larger construction efforts in the future.

Provider recruitment remains active. Connell said Dr. Joel Robertson is expected to begin work in family medicine on August 10. Recruitment is also ongoing in cardiology, and the hospital has made initial contact with a urologist interested in part-time work.

“We’re in a good place with Joel at this point,” Connell said.

The meeting ended with trustees entering executive session to discuss confidential personnel matters and a potential real estate transaction.