TOWNSEND — Gov. Greg Gianforte and first lady Susan Gianforte toured Billings Clinic Broadwater Tuesday in Townsend and talked about workforce shortages and Medicaid reimbursement rates with the hospital's CEO Jenny Clowes.
In the three years since Billings Clinic took over the rural hospital, previously called Broadwater Health Center, the facility got a new face and was able to stabilize long-term care in the community. About half the funding for the $6 million renovation came from the CARES ACT. The additions to the facility include 1,700-square-feet of rehabilitation space, which is brightened with floor to ceiling windows.
The space brought a place of wellness and healing to the hospital, Clowes said.
"I'm always most impressed with the people," Gov. Gianforte said. "But the facility now matches the quality of the people."
Billings Clinic Broadwater is a critical access hospital and the hospital provides primary and emergency care as well as ambulance services to Broadwater County. The hospital also provides longterm care services, something almost lost 10 years ago when the hospital was on the brink of financial collapse.
The clinic still faces financial struggles, Clowes said. The hospital gives out about $500,000 in free care each year for patients who can't afford services, she said. And Medicaid reimbursement rates, which are set by the state, pay for about 65 percent of the actual cost for services, Clowes said. Because of these factors, critical access hospitals can struggle to be "cash positive," the CEO and former CFO said.
"But some have figured it out," Gianforte said.
"Some have figured it out," Clowes acknowledged. "But those that have longterm care struggle a little bit more."
About 60 percent of the clinic's longterm patients are supported through Medicaid reimbursement, Clowes said.
In August, Montana Healthcare Association Executive Director Rose Hughes told the Legislature's Children, Families, Health and Human Services Interim Committee that Gianforte's administration needed to take action to fix the medicaid rate reimbursement gap to avoid the closure of nursing homes across the state. She also said she'd heard the Gianforte administration thought the problem was more related to the business model of skilled nursing facilities, not reimbursement rates.
"From our standpoint," Hughes said. "There is no model that is sustainable if you're not paying for the service that you're asking for."
Montana Department of Public Health and Human Services Director Charlie Brereton told lawmakers at the August hearing his department was looking for ways to help the industry.
The workforce shortage is also a struggle for the rural clinic, Clowes said. While discussing solutions, Gianforte talked about the online Certified Nursing Assistant program started at Miles Community College in Miles City.
"I was up in Conrad," Gianforte said. "And I met two or three young ladies who were enrolled at Miles City as high school juniors and seniors and they were going to have their CNA before they graduated from high school."
Clowes said the clinic could benefit from a program like that. Homegrown CNAs are ideal because CNA salaries often don't entice people to relocate, she said.
But, watching the community support the hospital the way it did 10 years ago caused Clowes to relocate to help run the hospital, she said. Having that type of buy in from the people in Broadwater County was gratifying, Clowes said. The hospital had a soft open ahead of it's official ribbon cutting where Clowes got to hear people's reactions.
"Some of the words that came through was, 'I feel so safe,'" Clowes said. "Which I thought was a neat thought that I hadn't seen before."
A ribbon cutting ceremony is scheduled for 1 p.m. Sept. 30 at Billings Clinic Broadwater in Townsend.