At Big Sandy Medical Center, you will have the unique opportunity to blend primary care and emergency medicine while serving the needs of a tight-knit rural community.
Our 501(c)3, critical access hospital houses 25 beds for acute inpatient stays, long-term residents and 1-2 rehab patients per month, backed by a skilled nursing team who provide compassionate care.
Critical Access Hospital (CAH) is defined as a facility that is 25 beds or less, no closer than 35 miles to the nearest critical access hospital, no more than 96-hour stay for patients, and cost reimbursement for all patients that present with no insurance or the inability to pay for services. These parameters allow CAH’s to have more financial stability than other rural hospitals without the designation.
The clinic sees 8-12 primary care patients per day & the patients are scheduled between 8am-5pm. We are currently expanding into a new 5,000-square-foot, 11 room modular clinic across the street, which will allow growth of our primary care, the opening of behavioral health services, and more frequent visiting dental care. A Psychiatric Mental Health Nurse Practitioner started on January 1st, 2024. We are also looking to bring on a therapist thereafter.
At BSMC there are x-rays, state-of-the-art lab, mobile mammography and mobile MRI is just down the road to address the patients' needs. The construction on the facility is completed and our new clinic is set to open Spring 2024.
In addition to the expansion of the primary care clinic it makes room for BSMC to continue expanding their services with hopes of bringing specialists that can come down a few days a week to further serve the community. We are also anticipating acquiring ultrasound and 2 new ultrasound technicians joining the team in early 2024 as well.
In the emergency department, you will see an average of 1 patient per day, managing stabilizations and interventions for a wide range of cases before transfer. The low volumes allow for highly personalized care. There are typically not many patient admissions – it typically will depend on the comfort level of the provider or physician onsite. Most patients that are visiting are coming back after going to Great Falls initially. There are not many motor vehicle accidents. Once the new 64-slice CT machine is up and running, the goal will be to start keeping more patients.
The local ambulances are volunteer-run – they know not to bring high trauma cases to the facility and will typically drive them to Great Falls or Havre for help unless it’s very serious then we will stabilize at BSMC. There are also air transfers that can occur in these scenarios dependent on the weather – this typically will only occur 1-3 times per year. Most of the ER patients are urgent care track. The provider on site is responsible for all patient contact on their days on.
BSMC and the local Indian Health Services (IHS) clinic just 10 minutes away from Big Sandy close at 5pm M-F. So most patients that show up between 5-10pm are urgent care. The real emergency patients are during the day or after 10pm, and those are infrequent. Once the clinic is closed at 5p, the providers can go home and will be called if a patient does present in the ER. Our providers typically can expect 1 call per day and have a 30-minute response time for the ER.
Our patient population is the heart of Big Sandy. Many of our patients, long-term elderly residents and staff are like family. We pride ourselves on providing the best care with a true community hospital feel. Some of the residents have been there for a year and they’re referred to as residents rather than patients. The providers typically help with administering their medications and checking in with the residents. In addition to the residents, there are typically 1-2 rehab patients the facility will help as well. All of the providers split coverage on the IP unit evenly throughout the month. The inpatient component of the job is very light, there are rarely any acute patients on the floor. The long-term residents only require to be seen clinically once per month and are taking up the 18-20 intermediate swing beds. They have 1-2 skilled swing beds for post-specialty care or post-op patients who are coming in after seeing a specialist for stays 3 nights or less. The skilled beds have a consistent volume. BSMC has plans for continued growth to allow for more acute patients on the inpatient floor and additional equipment for support.
Scheduling is flexible between 8 days on/6 days off, 4 days on/3 days off, or traditional Monday through Friday. When the providers are scheduled, most typically go straight to the primary care clinic since the inpatient unit tends to be very light. The following is an example of what the 8 –
Day block schedule would look like:
Wed. - Clinic, ER, Inpatient
Th. - Clinic, ER, Inpatient
Fri. - Clinic, ER, Inpatient
Sat. - ER, Inpatient
Sun. - ER, Inpatient
Mon. - Clinic, ER, Inpatient
Tues. - Clinic, ER, Inpatient
Wed. - Admin Day
Wednesday is the physicians last day of their 8-day block. It will be their admin day with the next provider starting that same day to provide an overlap. All providers are in on Wednesdays since that’s when our Medical Director comes in from Havre for our weekly staff meetings.
If you are looking for a position where you can fully utilize your skills in a rural, relationship-based setting while also shaping the future growth of care services, this is an ideal opportunity. We welcome your partnership as we continue expanding our offerings to maximize the health and well-being of the Big Sandy community.
Ron, the CEO, is eager to collaborate with the incoming provider to explore the expansion of services that will benefit the Big Sandy community. For example, he is open to leveraging solutions to increase care access and implementing chronic disease management programs. He welcomes any ideas to further improve the quality of care and population health.
One of the current advanced practitioners has spearheaded several initiatives, patient portal adoption, and improved referral processes. She is also coordinating expanded school wellness checks and ensuring local childhood vaccination needs are met.
There are opportunities to grow specialty services, such as establishing a visiting specialist program in cardiology, orthopedics, or other high-demand fields. Big Sandy is invested in value-based care programs, so there is potential to enhance these efforts. The CEO is excited to partner with the incoming provider to maximize health outcomes for the community.