DECEMBER 2015
TABLE OF CONTENTS 4
WELCOME
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BOZEMAN HEALTH BOARD OF DIRECTORS & SENIOR LEADERSHIP
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BIG SKY MEDICAL CENTER BOARD OF MANAGERS
10 BIG SKY MEDICAL CENTER LEADERSHIP 12 HISTORY 17 MEDICINE IN THE MOUNTAINS 20 FACILITY DESIGN 22 CONSTRUCTION 28 ESSENTIAL SERVICES 30 ECONOMIC IMPACT 32 SYSTEMS OF CARE 33 COMMUNITY HEALTH 34 PHYSICAL THERAPY 35 THE FUTURE 38 THE FACILITY 44 GENEROUS PHILANTHROPIC SUPPORT 46 BUILDING CONTRACTORS
WELCOME
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WELCOME TO BOZEMAN HEALTH BIG SKY MEDICAL CENTER It is with great pleasure that we welcome you to Bozeman Health Big Sky Medical Center. This is an exciting direction for Bozeman Health to enhance locally based healthcare services for residents, employees and visitors of central and southern Gallatin County. This facility has been a long time coming – in fact, more than a decade. In 2007, recognizing the need for expanded healthcare services in Big Sky and southern Gallatin County, Bozeman Health purchased land in Big Sky Town Center. Plans at the time were to construct a smaller, two-story facility comprised of a two-room inpatient unit, emergency services, primary care clinic, and pharmacy. However, the subsequent economic downturn and population decline delayed the project a few years, which in hindsight, proved opportune. By 2013, the regional economy had strengthened and the Big Sky area experienced a strong resurgence in population and visitor
David Chen, MD, Interim Dyad CEO and President
Gordon Davidson, Interim Dyad CEO and President
growth, jobs expansion and a robust business climate. All this pointed to the need for a larger healthcare facility offering a more comprehensive scope of services. Today, we are honored to open Bozeman Health Big Sky Medical Center, a facility that brings 24/7 year-round emergency medicine, a four-bed medical inpatient unit, primary care clinic, procedure suite, diagnostic imaging and lab services, physical therapy, and an expanded retail pharmacy to Big Sky. All of this would not have been possible without the community’s enthusiastic support, spirit of collaboration and philanthropic giving. On behalf of the governing boards of Bozeman Health, Big Sky Medical Center, the Bozeman Health Foundation and, most importantly, our health system’s 1,900 employees, grateful patients, and forward thinking foundations, we thank you for being our partners in bringing Big Sky Medical Center to reality.
Julie Jackson, Bozeman Health Board Chair
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Taylor Middleton, Bozeman Health Big Sky Medical Center Board Chair
Scott Levandowski, Bozeman Health Foundation Board Chair
BOZEMAN HEALTH
BOARD OF DIRECTORS OFFICERS
Julie Jackson
Brian Brown
Katie Daughenbaugh
Dane Sobek, MD
John Murdoch
Chair
1st Vice Chair
2nd Vice Chair
Secretary
Treasurer
TRUSTEES
Kerri Brown
Dave McConnell Dennis Munson
Kerry Petitt
Rob Watson
Walt Sales
Trustee
Trustee
Trustee
Trustee
Trustee
Trustee
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BOZEMAN HEALTH
SENIOR LEADERSHIP ADMINISTRATION TEAM
Gordon Davidson
David Chen, MD
Elizabeth Lewis
Vickie Groeneweg
Darci Bentson
Interim Dyad President & CEO, Chief Financial Officer
Interim Dyad President & CEO, Chief Medical Officer
Chief Operating Officer
Chief Nursing Officer
Vice President & Chief Legal Officer
James Loeffelholz, MD
Chris Darnell
Cheryl Ridgely
LeRoy Wilson
Jason Smith
Vice President Medical Group
Chief Strategy & Business Development Officer
Vice President of Senior Services
Executive VP of Philanthropy
President, Medical Group
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BIG SKY MEDICAL CENTER
BOARD OF MANAGERS
Renae Schumacher, Hans Williamson, Taylor Middleton, Elizabeth Lewis, Steve Karl, Loren Bough, Kirk Weber, MD (not pictured)
Taylor Middleton - Chair
Loren Bough
Taylor is a longtime advocate for the medical center and has worked with the Bozeman Health leadership for many years on this initiative. Taylor has been General Manager of Big Sky Resort since 1995. He became President in 2011 following a decade of leadership in the resort’s sales and marketing operations transforming the resort into a nationally recognized destination. Big Sky Resort now serves over 8,000 guests during peak visitation periods with a total of 450,000 visits yearly and employs 1,500 staff. Beyond his professional experiences, Taylor has a deep history of civic engagement including leading legislative initiatives, founding community organizations, and serving on multiple civic and corporate boards. A full-time resident of Big Sky for 35 years, Taylor was presented the Chet Huntley Lifetime Achievement Award by the Big Sky Chamber of Commerce in 2015.
Loren Bough was raised farming and ranching in Highwood, Montana. Upon completing his degree at Harvard, Loren worked as a trader in New York, London, and Moscow. Loren has been an active entrepreneur and philanthropist in Russia for the past 20 years with a focus on investment banking, retail, and real estate. Since moving to Big Sky in 2004, he and his wife, Jill, have focused on local educational and philanthropic issues. Loren currently serves as Chair of the Big Sky School District Board of Trustees, President of Friends of Big Sky Education, Chair of the Warren Miller Performing Arts Center Board, Chair of the Board of Property and Environment Research Center, Vice President of the Yellowstone Club Community Foundation and a Trustee of the United States Olympic and Paralympic Foundation.
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Stephen (Steve) Karl, MD
in Hawaii where he was emergency department vice chair at Hilo Medical Center. Dr. Weber completed his residency in emergency medicine at the University of Oklahoma Health Sciences Center in Oklahoma City. He earned his medical degree at Loma Linda University School of Medicine and completed an internship at Blodgett Medical Center in Michigan. He is board certified in emergency medicine.
Dr. Stephen Karl has been visiting Big Sky since the early 1990s. His professional experience includes starting pediatric surgery programs at Dartmouth Medical School in New Hampshire and at the University of South Dakota School of Medicine. His family’s love of skiing frequently brought them to Big Sky where they have had a residence since 2001. Dr. Karl oversaw the federal Emergency Medicine Services for Children grant for the state of South Dakota from 1994 until his retirement. This led to his role as the Academy of Pediatrics’ representative to the Committee on Accreditation for the Emergency Medical Services Professions. Dr. Karl was the medical director of the paramedic program in Sioux Falls and is a licensed paramedic in Montana. Dr. Karl and his wife, Rhonda, are very involved with the Big Sky community in weed management, trail maintenance, and river cleanup. Dr. Karl worked part-time as a pediatric surgeon and volunteered as a ski patroller at Big Sky for three years before fully retiring. He is now in his fourth year as a professional patroller and has trained with the Big Sky Fire Department.
Renae Schumacher Renae Schumacher moved to Big Sky in 1993 from Sturgis, South Dakota. She began working at the Big Sky Conoco and soon became its owner. Renae has been an active community participant and business leader. She has served on various community boards through the years including the Big Sky Resort Tax Board, Big Sky Chamber of Commerce, Big Sky Arts Association, and homeowners associations. Currently she serves on the Big Sky Fire Board. Renae and her husband, Steve Schumacher, enjoy raising their three teenage boys while skiing, hiking, biking and taking full advantage of this spectacular place. Big Sky is home and Renae takes great pride in being involved with these active boards that help shape this community.
Elizabeth S. (Liz) Lewis, RN, MSN, JD Elizabeth S. (Liz) Lewis is the Chief Operating Officer for Bozeman Health and is an Executive Dyad Partner with the Chief Medical Officer providing executive leadership and oversight for Big Sky Medical Center operations and clinical quality. Liz has held various leadership roles at Bozeman Health since 1992, including VP of Clinical Services, VP of Support Services, and Chief Legal Officer. She earned a Doctor of Jurisprudence from Willamette University College of Law in Salem, Oregon. Before law school, Lewis served in nursing leadership roles at facilities in Montana, Mississippi, Oregon and Louisiana.
Hans Williamson
Kirk E. Weber, MD, FACEP Dr. Kirk E. Weber recently joined Bozeman Health Big Sky Medical Center as an emergency medicine physician. Dr. Weber is a fellow of the American College of Emergency Physicians. He previously practiced emergency medicine
Hans Williamson is Vice President of Operations and General Manager at Yellowstone Club. Located on 13,600 acres in southwestern Montana, Yellowstone Club is the world’s only private residential ski and golf club. It includes 2,200 acres of private powder skiing and a Tom Weiskopf-designed golf course. Hans leads the Yellowstone Club Operations Team comprised of 1,100 members in winter and 425 during the summer. The team provides an unprecedented level of amenities and service to members, their families and guests. Hans graduated from Cornell University in 1983 with a bachelor of science in hotel administration. Hans’ wife of 31 years, Kim, is a yoga instructor. They live in Big Sky and have two sons.
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BIG SKY MEDICAL CENTER
EXECUTIVE LEADERSHIP Elizabeth S. Lewis, RN, MSN, JD, VP
David P. Chen, MD, FHM, FACP
Bozeman Health Chief Operating Officer
Bozeman Health Chief Medical Officer and Interim Dyad President and CEO
Liz Lewis has held various leadership roles at Bozeman Health since 1992, including VP of Clinical Services, VP of Support Services and Chief Legal Officer. She earned a Doctor of Jurisprudence from Willamette University College of Law in Salem, Oregon. Before law school, Lewis served in nursing leadership roles at facilities in Montana, Mississippi, Oregon and Louisiana.
A graduate of Loma Linda University School of Medicine, Dr. Chen completed his residency in internal medicine at Kettering Medical Center in Ohio. Prior to joining Bozeman Health, Dr. Chen was VP of medical affairs at MultiCare Health System in Tacoma. His previous experience includes medical school instruction and hospitalist medical directorships. Dr. Chen is board certified in internal medicine and is a Fellow of Hospital Medicine and a Fellow of the American College of Physicians.
ADMINISTRATION Tracy Reamy, RN
Philip A. Hess, MD
Big Sky Medical Center Administrator
Big Sky Medical Center Medical Director
Tracy Reamy joined Bozeman Health in 2011 as a clinic manager and was named director of clinic operations for its Medical Group in 2014. Reamy brings both operational and clinical experience to her new role at Big Sky Medical Center where she is responsible for day-to-day oversight of all departments including inpatient and outpatient services. She has been a clinical instructor for LPNs, a clinical nurse supervisor and nurse manager of primary care. Her hospital experience includes medical, surgical, pediatrics, newborn home care, pediatric cardio-intensive and neonatal intensive care, and labor and delivery. - 10 -
Dr. Hess attended medical school at Temple University and completed his family medicine residency at Lancaster General in Pennsylvania. Most recently he practiced in Anchorage, Alaska, where he also provided oversight as medical director for two rural health clinics. Before going to Alaska, Dr. Hess had a private practice in Helena for several years. He later worked for 10 years at St. Peter’s Hospital also in Helena. Dr. Hess is board certified in family medicine.
BIG SKY MEDICAL CENTER
MEDICAL PROVIDERS Maren Dunn Chandler, DO
Jeremy Mitchell, DO
Dr. Dunn Chandler has been practicing in Big Sky since 2011 when she opened Gallatin Family Practice specializing in family medicine, women’s health, prenatal care, pediatrics, adult wellness, sports injuries and physicals. Dr. Dunn Chandler’s clinic joined Bozeman Health in 2015. A graduate of Kansas City University of Medicine and Biosciences, Dr. Dunn Chandler completed her residency at Idaho State University Family Medicine, then practiced in rural communities in Idaho and Oregon. Dr. Dunn Chandler is board certified in family medicine.
Dr. Mitchell, a family medicine physician, earned his medical degree at Kirksville College of Osteopathic Medicine in Missouri and completed a residency at Family Medicine Residency of Idaho. After working in urgent care in Boise, Dr. Mitchell moved to Polson, Montana, where he provided inpatient and outpatient care at the local hospital. Dr. Mitchell is also proficient in gastrointestinal endoscopy. He is board certified in family medicine.
Mark A. Siemer, DO
Kirk E. Weber, MD, FACEP
Dr. Siemer practiced sports, emergency and family medicine in Colorado for more than 15 years, in both private practice and health centers, before joining the medical staff at Big Sky Medical Center. Dr. Siemer has been a team physician for a variety of sports teams at high school, college and professional levels. A graduate of Southeastern University of the Health Sciences in Florida, he completed his internship and residency in family medicine at HealthONE Center of Health Sciences Education in Denver and a fellowship in primary care sports medicine at the Denver Center of Sports and Family Medicine. Dr. Siemer is board certified in family medicine.
A fellow of the American College of Emergency Physicians, Dr. Weber previously practiced emergency medicine in Hawaii, where he was emergency department vice chair at Hilo Medical Center. He completed his residency in emergency medicine at the University of Oklahoma Health Sciences Center in Oklahoma City. Dr. Weber earned his medical degree at Loma Linda University School of Medicine and completed an internship at Blodgett Medical Center in Michigan. He is board certified in emergency medicine.
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HISTORY
BOZEMAN HEALTH & BIG SKY AREA HISTORICAL TIMELINE
Native American peoples hunt and gather along Gallatin Crest for at least 9,000 years.
Sam and Josephine Wilson settle 160-acre Buffalo Horn Ranch on the Gallatin. Clinton Wilson (Sam’s father) homesteads adjacent 160 acres.
Yellowstone National Park created.
Early History
Lewis and Clark explore three rivers that form the Missouri River, including the Gallatin River.
Buffalo Horn Ranch hosts first-known dude ranch guests to visit area.
1898-1900
1872 1806
Train and Union Pacific Dining Hall Courtesy of the Yellowstone Historic Center
1883 Northern Pacific Railroad extends to Bozeman.
Sacagawea with Lewis and Clark at Three Forks
Frank Crail, circa 1920
1905 1901-1905
First train arrives in West Yellowstone (then Riverside) on Union Pacific.
Burgeoning ranch owners meet to fix room, board and saddle horse rates at $18 weekly.
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1910Early 1920s
1908 1906
Augustus Franklin Crail purchases one-room cabin and 160 acres in Gallatin Canyon Basin from Daniel Inabnit for $150. Builds 2-story house for his family. Grows ranch to 960 acres.
Many dude ranches open in canyon including Nine Quarter Circle, Elkhorn, Rising Sun, Rainbow, Bucks T-4 and B-K (now Lone Mountain Ranch).
1909 Ophir School gets started in a oneroom schoolhouse where Ketherine Cape is paid $20 to teach five children. Post office opens in West Yellowstone.
Luke Brown and Partners buy Wilson ranches naming it 320 Ranch for the number of acres it encompasses.
1925 1911 Bozeman Deaconess Hospital is born as a community non-profit hospital to serve the people of the region.
1936 Montana’s first female physician, Dr. Caroline McGill, buys 320 Ranch.
The Bozeman Deaconess governing board and management recognizes the growth that would come to the area, and purchases 500 acres of land on the east side of Bozeman for future facility needs.
1956 1955 Soldier’s Chapel constructed by Col. Nelson Story III and his wife, Velma, to honor Montana troops who died in World War II.
Gov. Forrest H. Anderson and retired TV news anchorman Chet Huntley announce plans for 11,000acre resort at base of 11,166-foot Lone Mountain. Huntley named chairman of development company Big Sky of Montana.
Cattleman Sam Smeding sells Crail Ranch to Big Sky of Montana. West Yellowstone incorporated. (1966) Bozeman Deaconess builds the Hillcrest Retirement Community.
Big Sky’s four lifts begin operating for first season of skiing.
1971 Meadow Village and golf course construction begins, much to chagrin of “a posse of conservationists who have been nipping at the plans like coyotes around a sheep herd,” Huntley tells The Milwaukee Journal.
1976 1974 Chet Huntley dies from lung cancer just days before Big Sky’s official opening.
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1983
1981 1977
Chet Huntley, 1986 Soldier’s Chapel, 2011
Big Sky Resort purchases first snowmaking equipment. Gallatin Canyon Historical Society founded.
Everett Kircher of Boyne Resorts buys Big Sky Resort for $7.5 million.
1973
1970 1960’s
Big Sky Resort
West Yellowstone cross-country ski shop owners, Bob and Vivian Schaap, buy Lone Mountain Ranch Cross Country Ski area.
Bozeman Deaconess Board of Trustees formulates a long range development plan to construct a new facility on Highland Boulevard.
1982 Crail Ranch listed on the National Register of Historic Places.
Big Sky Resort Area District created to implement resort taxes for local funding needs. Arts Council of Big Sky (then Big Sky Association of Arts) founded.
1989 1986 The new 86bed Bozeman Deaconess Hospital opens with 60 physicians on the medical staff.
Bozeman Deaconess builds medical office building Highland Park II.
1992 1990 Bozeman Deaconess builds medical office building Highland Park I.
HISTORY Town Center’s first commercial building opens. Bozeman Deaconess builds medical office building Highland Park IV.
Big Sky Owners Association obtains title to two-acre plot where Crail homestead is later restored and opened to public.
1993
Moonlight Basin opens. Bozeman Deconness builds medical office building Highland Park III.
Yellowstone Club, a private ski and golf resort, is established.
1998 1995 Big Sky Resort opens tram to Lone Peak.
2000 1999 Summit Hotel opens at Big Sky Resort. Bozeman Deaconess Foundation incorporated with philanthropic mission to support healthcare initiatives of Bozeman Deaconess.
U.S. Forest Service and Big Sky resisdents build official trail to Ousel Falls.
Bozeman Deaconess Health Group partnership was formed to support continued access to essential medical services throughout the region.
Bozeman Deaconess begins planning a medical facility in Big Sky in consultation with resort and business owners in the community.
Bozeman Deaconess Big Sky Pharmacy opens in Meadow Village Center.
Bozeman Deaconess rebuilds its retirement living community facilities -- Aspen Pointe and Birchwood completed.
Lone Peak High School opens.
2004 Spanish Peaks Mountain Club offers residential properties with private golf course and access to Big Sky Resort skiing. Bozeman Deaconess Board of Trustees approves plans for development of retail pharmacy in Big Sky in response to community needs assessment.
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2007 Bozeman Deaconess was named Business of the Year by Prospera Business Network. Bozeman Deaconess begins planning a community-wide Electronic Health Records system. Bozeman Deaconess purchased lot in Big Sky Town Center for future medical facility.
Lone Peak Cinema
Movie theater in Town Center opens.
2011
2009
2005
2003 2001
Bozeman Deaconess Board of Trustees approved purchase of land in Big Sky for future medical facility.
President Barack Obama takes family vacation in Big Sky.
2010 Community Health Partners, with support from Bozeman Deaconess, opens the West Yellowstone clinic. Town Center Park and Center Stage built.
Warren Miller Performing Arts Center
Big Sky Resort and Moonlight Basin merge to create “The Biggest Skiing in America.”
Bozeman Deaconess breaks ground on a new medical office building in Belgrade for the Bozeman Health Belgrade Clinic. Bozeman Deaconess Health Services is renamed Bozeman Health, an intergrated health delivery system leading healthcare advancement in southwest Montana.
280-seat Warren Miller Performing Arts Center opens.
2013 2011-12 Bozeman Deaconess expanded its Emergency Services Department, with the support of the Bozeman Deaconess Foundation’s $9 million Cornerstone Campaign.
2015 2015
2014 Construction begins on Bozeman Health Big Sky Medical Center.
Bozeman Health Big Sky Medical Center opens.
Medical office building Highland Park V construction begins. Bozeman Deaconess Hospital was named one of the nation’s 100 top hospitals.
Bozeman Deaconess Hospital is a Level III Trauma Center.
Hospital construction, November 2015
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Bozeman Health - providing more care for more people in more places. For more than 100 years, we have always been, and continue to be, dedicated to providing quality medical care and helping to improve your health and quality of life
THE SIMKINS FAMILY: HELPING BRING BOZEMAN HEALTH TO BIG SKY It's Thursday evening and a cool summer breeze blows over the mountains surrounding Big Sky's Town Center. People are moseying into the park where The Brothers Comatose are slated to play. People chat amiably as they spread blankets and picnics readying for an evening of rocking music. The scene repeats each Thursday in the summers in Town Center Park where the Arts Council of Big Sky offers free concerts. Wednesdays, the Big Sky Farmers Market draws enthusiastic crowds. Annually, Town Center hosts the Professional Bull Riders show and Big Sky Classical Music Festival. But all this is relatively new in Big Sky. About 10 years ago, Big Sky Town Center was a grazing meadow. But the landowners envisioned a pedestrian-oriented, commercial and residential development anchored by parks, trails and a thriving downtown. “Big Sky didn't really have a central organizing place, a 'Main Street,' if you will,” says Tom Simkins who, with his family, is developing the 165-acre Town Center. In 2004, Big Sky Western Bank began constructing the first commercial building to rise from the meadow in the shadow of Lone Mountain. But the Simkins family's concept harkens back long before backhoes began digging. Shortly after news anchorman Chet Huntley announced plans in 1970 to develop 11,000-acre Big Sky Resort, Tom's father, Bob Simkins, acquired the Town Center land.
The Simkins brothers: Mitch, Bill, Tom
“There was a fair amount of skepticism,” he adds. “There were plans but nothing was built yet.” Today, despite early doubts compounded by recent recession, the Town Center has surpassed 35% build out. In the past few years, new businesses opened including Lone Peak Cinema, Roxy's Market, Beehive Basin Brewery, and a handful of retailers, restaurants and galleries – totaling more than 50 businesses.
“My dad was quite a visionary,” says Tom, the oldest of Bob's children.
Today Bozeman Health is excited to open the Big Sky Medical Center.
Over the years Bob leased the land for grazing and frequently enjoyed the wilderness and outdoor adventures it afforded.
The center wouldn't have been possible without the Simkins family's help, says Cheryl Ridgely, Bozeman Health chief strategy and business development officer.
“He would drag anyone along who would go with him,” Tom says.
Bozeman Health purchased two acres in Town Center in 2007. But as the community grew, Bozeman Health and Simkins principals recognized the property wasn't sufficient for the medical center's future expansion that would likely be needed. That's when the Simkins offered to swap a 7-acre parcel for the hospital's two.
Tom and his brother, Bill, recall riding dirt bikes up into what is now Big Sky Resort's bowl. They rode horses, hunted, fished and camped on the property that stretched north across what is now Lone Mountain Trail. From the 1980s into the 1990s, a series of permitting, a land purchase and a land swap with the National Forest Service set the stage for Big Sky's West Fork development. “It took literal acts of Congress” to make it happen, says Bill, who moved back to Bozeman as things began to heat up – albeit slowly.
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They say the medical center will help Big Sky's growing community thrive. “We often think about how proud our father would be seeing what the Town Center is now,” says Tom.
BIG SKY MEDICINE
BOZEMAN HEALTH BIG SKY MEDICAL CENTER LIFTS HEALTHCARE TO NEXT LEVEL When Chet Huntley dreamed of creating a world-class, year-round resort in Big Sky, he may not have considered its distance from medical care. After all, Huntley was born in Cardwell, Montana, in 1911, so he was accustomed to living with limited medical resources. And even in the 1960s when Huntley was formulating his plans, healthcare in rural Montana communities was still nearly nonexistent.
The economy was down in 2011, but “the town was full of young families who were sticking around,” she says. And many were driving to Bozeman for routine medical care.
The opening of Bozeman Health Big Sky Medical Center represents important healthcare enhancements for people who live, work and visit Big Sky and Southern Gallatin County.
Gallatin Family Medicine joined Bozeman Health in January as an affiliate provider and Dr. Dunn Chandler will be one of five doctors staffing Big Sky Medical Center and its family medicine clinic. She is eager to put the hospital's ancillary services to use. In addition to emergency, advanced imaging and lab facilities; the hospital will have a procedure suite initially intended for gastrointestinal studies.
For the first 20 years, save for Big Sky Resort's ski patrol, medical care was more than 50 miles away. Dr. Jeff Daniels became the community's first local physician when he opened Medical Clinic of Big Sky at the base of the resort in 1994. Through the years Dr. Daniels and his staff have been available around the clock for emergencies. But, the doctor says, having Big Sky Medical Center within shouting distance of his second office in the Town Center will be helpful. “The advantages of having a hospital open in our community cannot be overstated,” he says. With the hospital's services, the number of ambulance rides to Bozeman will be drastically reduced. And the onsite laboratory will provide faster test results for his patients. “It's going to be nice having that emergency department here,” he says. Dr. Maren Dunn Chandler brought family medicine to Big Sky in 2011 when she opened Gallatin Family Medicine.
“So I saw a need for my skills,” Dr. Dunn Chandler says.
“I'm excited to have the ability to care for my patients in the hospital as well as in the clinic,” she says. “Before Big Sky Medical Center opened, I had to send my patients to Bozeman for hospital care. Now I will be able to offer that care locally.” Big Sky and West Yellowstone’s emergency, law enforcement, and rescue personnel are also primed for the hospital's opening. Several units collaborate throughout the region when emergency incidents occur including: Gallatin County Sheriff’s Office, Montana Highway Patrol, Big Sky Search and Rescue, Hebgen Basin Fire District, Yellowstone Club Fire Department, Big Sky Fire Department, and Big Sky Resort ski patrol. Because of the distance to definitive care, Big Sky Resort ski patrollers are trained in advanced life support, says Bob Dixon, ski patrol director. His staff stabilizes patients before they are transported by ambulance or helicopter to a hospital at least 50 miles away.
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BIG SKY MEDICINE And when an ambulance is dispatched, it's typically one from Big Sky Fire Department. The fire department responds to about 650 calls annually, says Big Sky Fire Chief William Farhat. But with a growing community and tourism industry, so too are the number of emergency incidents. In August 2015 alone, Big Sky Fire responded to 104 percent more calls than in August 2014— almost as many as the previous two Augusts combined, Farhat says. Having a hospital down the road to take patients to is expected to improve the fire department's response times. It's better than sending two staff and an ambulance out on a three-and-a-half-hour adventure to Bozeman, he says. “We've always been understaffed,” Farhat adds. “The hospital allows us to stay in the district. It should reduce response times and be a vast improvement for us and the community.”
Chief Farhat says having a locally based emergency department will also benefit his staff's medical skills as they will have more opportunity to work alongside and learn from the hospital's medical staff.
That's important, Dixon says. In emergencies, delivering definitive medical treatment as quickly as possible is proven to improve medical outcomes.
“When our emergency medical staff takes patients to Bozeman, they don't have time to hang around,” he says.
“Big Sky Medical Center upgrades the medical capabilities that we have in the community,” he says. “It could be limb-saving or even life-saving.”
And it is clear the region is experiencing huge growth. Both Big Sky Resort and Yellowstone National Park reported record visitation numbers in 2015.
In an emergency, having family and friends nearby for support is also key. But when the hospital is an hour away and includes a sometimes treacherous canyon drive, that may present obstacles.
People worldwide recognize the rare beauty and outdoor opportunities the area offers. For most, the hospital will provide peace-of-mind if they need it— and then, only if they do.
Many Big Sky visitors do not rent cars. Having the hospital here will allow many patients to be treated locally. “That's huge for our guests,” Dixon says. “It's pretty inconvenient for guests to have to travel through the canyon.” - 18 -
“If a child or loved one is sick in the middle of the night, medical care is readily available without having to drive the canyon to Bozeman—particularly when those roads might be unfamiliar to guests,” says Liz Lewis, Bozeman Health’s Chief Operating Officer.
“This is a fun place to play,” says Charles Stephenson, whose Charles and Peggy Stephenson Family Foundation donated funding for the hospital's MRI. “It's fun ... until it's not. And when it's not, you want to have someplace like this take care of you.”
MEET DR. PHILIP A. HESS
Bozeman Health Big Sky Medical Center Medical Director Though he moved here from Alaska, it wasn't exactly a huge leap for Bozeman Health Big Sky Medical Center's director to land in southwest Montana.
Dr. Dunn Chandler agrees. “I'm excited about the hospital,” she says. “We need it. It's just the right thing to do. It will support our community's development by building on the foundation of care already available in Big Sky and advancing it to the level necessary for the long term.” It has always been Bozeman Health's mission to improve the health of the community and opening this hospital is building on that goal. “The Big Sky Medical Center will provide extensive bandwidth and access throughout the community,” says Lewis. “We have now tripled the number of clinical providers in the community, which extends coverage and backup when needed.”
Before pursuing a healthcare career in rural Cordova, Alaska (population 2,316), Dr. Philip A. Hess had a family practice in Helena and co-owned a condominium in Big Sky. “It's where I learned to ski,” Dr. Hess says. “And where my kids learned to ski.” Now that his two daughters are attending Montana State University, the Big Sky position seemed uniquely opportune. “It's a privilege,” Dr. Hess says. “It's like a dream job.” Being well-acquainted with Montana was only one reason Dr. Hess was chosen for the position, says Dr. David Chen, Bozeman Health interim dyad president and chief executive officer. “Dr. Hess is a seasoned clinician trained in family medicine with comprehensive experience spanning the full spectrum of clinical care from acute emergency and inpatient care to outpatient care and chronic disease management,” Dr. Chen says.
Being the closest 24/7/365 healthcare facility to West Yellowstone, the medical center also provides support for Gallatin County's southernmost town.
“He also has considerable experience as a medical director having previously led a physician group. The constellation of this exceptional skill set, combined with his calm, professional demeanor makes him the ideal medical director for the challenges and opportunities of leading Big Sky Medical Center physicians.”
“Our medical providers work very closely with the staff at Community Health Partners clinic in West, which helps coordinate care,” Lewis says.
Dr. Hess says he is passionate about access to adequate, quality medical services, particularly in rural places. He was pleasantly surprised by the scope of the Big Sky facility and is enthusiastic about the staff that has been assembled.
Dr. David Chen, Bozeman Health's chief medical officer and dyad executive senior leader for Big Sky Medical Center, also notes the necessity for improved medical care in the region.
“I'm really excited to see the staff come together as a brand new team,” he says. “We come from unique areas of expertise that will be valuable in terms of learning from each other and the services we are providing.”
“It is providing a need that is really critical for a community like that, not just Big Sky, but also Gallatin Gateway and West Yellowstone where historically there's minimal healthcare,” he says. “It's really helping to solve a statewide problem of limited access to medical care.”
Dr. Hess says he brings “a balanced approach to both leadership by example and the ability to build consensus.” But, he adds, in the end medical care should focus on patients. “Most of medicine is about relating to people – listening, reading between the lines, presenting options, because there's never just one answer,” he says. “It's human art above all.”
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FACILITY DESIGN
FUNCTIONAL AESTHETIC: MAKING BEAUTIFUL WORK Its roof jauntily sloping; windows irregularly patterned. The design of Bozeman Health Big Sky Medical Center is intended to play off the rugged, mountains that surround it, says Amy Douma, design principal with Minneapolis-based HGA Architects and Engineers. With exposed steel, stone, wood and glass and a warmly lit, high-ceilinged lobby complete with fireplace and mountain views; the building pays homage to a certain Montana aesthetic akin to ski and hunting lodges. “We wanted it to blend in with its surroundings,” Douma says. “A building that is appropriate to the Big Sky area, but still has modern overtones to illustrate the up-to-date technology inside the hospital.” HGA was selected based on their extensive experience designing rural medical facilities, says Cheryl Ridgely, Bozeman Health chief strategy and business development officer, who was the project lead through the planning and design phase. Along with Senior Construction Superintendent John Sommer and Bozeman Health Chief Operating Officer Liz Lewis, who managed the construction and operational startup, this core team combined their experience and vision to bring this new hospital to life. The goal was to create a healthcare facility with a modern Montana architectural style that would sustain and grow with community service needs far into the future. Big Sky Fire Chief William Farhat and Summit Air Ambulance personnel helped design some of the most functional parts of the building.
The size and approach of the ambulance bay allows inbound patients to be unloaded in a protected area. And Summit’s pilots conducted test maneuvers to pinpoint the optimal location for the helipad.
The emergency department is adjacent to the inpatient unit with nurses’ stations visible to one another enabling nurses to help each other in either area when needed.
Environmental efficiency and sustainability were also paramount.
Separate corridors are designated for employees or the public so support staff can be as efficient as possible while the public experiences a calm environment enhanced by lots of natural light.
The primary heating and cooling source is geothermal with supplemental propane. Emergency diesel generators provide backup given the nature of a 24/7/365 hospital operating with northern-tier climatic conditions. Form follows function as illustrated with the north portico—designed at a height to accommodate buses and other public transportation vehicles at the main entrance. But at the heart of all functionality is concern for patients. The inpatient wing on the south side of the hospital was situated for quiet ambience taking advantage of serene views of the South Fork and West Fork of the Gallatin River. A private courtyard also incorporates nature as part of the healing environment. The 51,625-square-foot facility includes a six-room emergency department with two trauma rooms, four-bed inpatient unit, outpatient procedure suite, medical clinic, pharmacy, diagnostic imaging with CT and MRI, and laboratory services. The medical center also leases space to a local physical therapy practice. Tracy Reamy, Big Sky Medical Center’s administrator, says there was a lot of thought given, not only to the building’s look, but also to how the design can provide an efficient, effective and pleasant working environment for staff, which translates to optimal patient care. - 20 -
The lobby provides a centralized area for accessing all the medical center’s departments and services. It is a comfortable place for families and visitors to gather and includes a quiet meditation/privacy room with easy access to the emergency department and main lobby. Two distinct registration desks are designated for outpatient clinic patients and emergency and procedure services making registration private and efficient. The retail pharmacy is also easily accessible from the single main entrance. As wife of a career military man, Reamy worked as a nurse for more than 25 years all over the country and, she says, she’s never seen a nicer medical facility. “A lot of forethought went into how this will look 10 to 15 years from now,” she says, adding she thinks the design balances beauty and practicality perfectly. “While we wanted to build a facility that fit the aesthetics of the community, our main focus was on safety, quality and patient experience,” Reamy says. “It does blend in and looks pretty when you’re driving down the road. But more importantly, for the staff and patients, it’s extremely functional.”
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CONSTRUCTION
NUMBERS
HELIPAD
PARKING
(with heated surface)
43,307 SQUARE FEET
PIPING
for heated handicap and drop-off area pavement
22,000 LINEAR FEET
CONCRETE 1,800 CUBIC YARDS
1,600 SQUARE FEET
BIG SKY MEDICAL CENTER BUILDING
51,625 SQUARE FEET
4 BEDS (with 4-bed expansion capability)
BUILDING SITE 5.91 ACRES
COMMUNICATION CABLE 21 MILES HEATING + COOLING PIPES 48,000 LINEAR FEET HEATING + COOLING DUCTS 65,585 POUNDS WATER PIPES 36,000 LINEAR FEET
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ELECTRICAL WIRING 47+ miles
THE BUILDING IN SQUARE FEET:
First floor clinic: 11,840 First floor hospital: 26,090 Second floor reserved for future expansion: 8,940 Top floor mechanical penthouse: 4,755
60 GEOTHERMAL WELLS each ~ 400 feet deep
2 AIR HANDLERS
circulating air at 53,500 cubic feet/minute
PROPANE TANK 18,000 gallons
EMERGENCY GENERATOR 550 kilowatts all LED
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CONSTRUCTION
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ESSENTIAL SERVICES
THE TIPPING POINT:
Hospital brings peace-of-mind to Big Sky Having a healthcare facility the caliber of Bozeman Health Big Sky Medical Center is monumental for Big Sky and southern Gallatin County, according to people who have promoted and lived in the area for years. The tourism industry has played a key role in the development of the landlocked mountain town located amidst some of Montana's tallest peaks. But until recently, Big Sky's growth has been focused on vacation homes and tourism. Kitty Clemens, executive director of the Big Sky Chamber of Commerce, says the area's entire economy has been based on travel and tourism. “Were it not for tourism, there would be no Big Sky,” she says.
“None of these businesses could be open without visitors.” The ski slope couldn't afford to operate with only local skiers, Clemens adds. But with the medical center's round-the-clock services, Big Sky is poised to become an honest-to-goodness community. “The community didn't really exist before the 1970s,” says Taylor Middleton, Big Sky Resort's general manager. The opening of the resort, Ophir School and Lone Peak High School, the first bank, hardware store, movie theater and the Warren Miller Performing Arts Center “created the fabric of our community weaving it into a livable place,” he says. “And adding a hospital is core to having a livable community.”
Paul Robertson, general manager of Lone Mountain Ranch, agrees that with a hospital in town, Big Sky is more established with less of a “boom-and-bust, seasonal economy.” “It's like Big Sky has arrived and doesn't have to rely so heavily on surrounding communities,” he says. “It feels like Big Sky is in control of its own destiny now.” Hans Williamson, Yellowstone Club vice president and general manager, says it was evident years ago that a local medical facility was needed. “Having been involved with the committee when we were trying to get one of the healthcare providers to develop a healthcare facility in Big Sky, I can tell you that this facility certainly exceeds my expectations of what we were going to have,” he says. All four agree the hospital's presence provides a sense of security and are thankful its time has come. It will have a major impact on residents who no longer need to take a harrowing canyon drive for a middle-of-thenight emergency, Clemens says.
It will serve area employees and visitors well too, Lone Mountain's Robertson adds. “We've been fortunate,” he says. “But there's risk with the activities we offer, especially horseback riding. Having a first-class facility a mile from our gate will give us all more peace of mind.” Williamson agrees, adding that with the hospital here, Big Sky is poised to grow. “Certainly in the future, Big Sky has great growth potential,” he says. “And with that you need a medical facility that will keep up with that growth. This facility is going to do that. That's very important for all of us who live in the community.” Middleton sees the hospital's arrival as a tipping point for Big Sky. “The opening of the Big Sky Medical Center will be transformational for our community,” he says. “We will look back on this as one of the most important things that has happened in our history.”
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ECONOMIC IMPACT
BOZEMAN HEALTH BIG SKY MEDICAL CENTER THE ECONOMIC STORY The construction and operation of Bozeman Health Big Sky Medical Center has had and will continue to have an impact on state and regional economies and jobs.
CONSTRUCTION
economic impact
JOBS CREATED STATEWIDE
DIRECT: 104 INDIRECT: 45
3-COUNTY REGION
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CONTRIBUTION TO THE LOCAL ECONOMY
BIG SKY MEDICAL CENTER JOBS
economic impact
SALARIES PAID OUT ANNUALLY $2.60 MILLION
WORKERS’ ANNUAL BENEFITS $545,700
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SYSTEMS OF CARE
CONNECTING CARE ANYWHERE BIG SKY MEDICAL CENTER SERVICES • Inpatient Medical Hospital Care • Emergency Services • Diagnostic Imaging -- including CT and MRI
Bozeman Health – providing more care for more people in more places. For more than 100 years, Bozeman Health has always been, and continues to be, dedicated to providing quality medical care and helping to improve community health and quality of life.
• Laboratory • Medical Procedures -- gastrointestinal studies • Telemedicine – consultations and teleradiology links to Bozeman Health Deaconess Hospital • Pharmacy • Family Medicine Clinic • Fully Integrated and Connected Electronic Medical Record System • Specialty Outreach Clinics
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COMMUNITY HEALTH
BOZEMAN HEALTH BIG SKY MEDICAL CENTER BRINGS CONTINUUM OF HEALTHCARE TO SOUTHWESTERN MONTANA The opening of Bozeman Health Big Sky Medical Center is one of the most exciting achievements in health care in the Gallatin Valley in years. In fact, most cannot recall the last time a new hospital was constructed in the State of Montana (other than replacement facilities). The planning and development of the medical center, which has occurred over the last decade, is a testament to our board and leadership working steadfastly to fulfill our mission to improve community health and quality of life for everyone in our service area. Given the uniqueness of living in rural Montana, when local folks speak of healthcare, it is often addressing the limitations and barriers to access. Bozeman Health Big Sky Medical Center is a bold and refreshing project designed to reduce those barriers for those living, working or visiting Big Sky, and the southern Gallatin County area. The medical center, which will provide 24/7 emergency medical care by board certified physicians, as well as primary care and outpatient services, brings quality medical expertise conveniently located right in the heart of Big Sky, within minutes, rather than an hour away. David Chen, MD, Chief Medical Officer of Bozeman Health, was responsible for recruiting and hiring the five board certified physicians who will staff the medical center, and will continue to have executive oversight for quality and safety, as well as oversight of the medical staff. Dr. Chen related a story he heard from a physician colleague who visited Big Sky on a family ski vacation. The family’s young daughter fell and sustained a head injury while at the resort. The family had to drive to the Bozeman Emergency Department, where she was evaluated and given a CT scan of her head. Fortunately, she sustained no serious injuries. Her father mentioned what a blessing it would have been to have the Bozeman Health Big Sky Medical Center available at that time.
Bozeman Health Big Sky Medical Center campus includes a helipad so rapid air transport to Bozeman Health Deaconess Hospital or other major trauma centers is available. In addition to pharmacy, standard radiology services, laboratory, and a CT scanner; the medical center will also have an MRI imaging suite, thanks to the generous donation of the Charles and Peggy Stephenson Family Foundation and other generous donors. Integration with the Bozeman Health system provides connectivity for enhanced services such as the Epic electronic health record system, allowing the Bozeman Health Medical Group physicians at Big Sky to collaborate and coordinate additional specialty care services with their system colleagues. This delivers an additional convenience and enhancement for improved David Chen, MD communication and integrated Chief Medical Officer and Interim Dyad President and CEO, healthcare. Bozeman Health As the excitement and momentum of the opening in December approaches, Dr. Chen noted, “We are mindful that the Bozeman Health Big Sky Medical Center is not just an opportunity for providing urgent and emergent care for those who are sick or injured in a distant part of the valley, but a crucial venue for advancing the health and wellness of the southern Gallatin County community.” - 33 -
PHYSICAL THERAPY
LONE PEAK PHYSICAL THERAPY Lone Peak Physical Therapy, founded by John C. Boersma, MPT, OCS, FAFS, is leasing approximately 2,000 square feet in the Big Sky Medical Center building. Lone Peak Physical Therapy has operated in Big Sky since 2002 and has a staff of 2 Physical Therapists, an Occupational Therapist and a Personal Trainer serving the community of Big Sky. LPPT’s licensed physical and occupational therapists are trained in orthopedics, sports medicine and functional integration and strive to integrate clients’ health and fitness through advanced treatment and training techniques aimed at alleviating pain, correcting movement dysfunction and improving overall fitness while making the rehabilitation process as rapid, painless and convenient as possible. From left to right: Eileen Coil, OTR/L, MOT, Heidi Bowman, D.P.T., Clinic Manager, Grace Downer, Patient Coordinator, Bo Selvig, D.P.T., Suzanne Daugherty, Patient Coordinator
RETAIL PHARMACY In 2005 Bozeman Health opened a retail pharmacy in Big Sky. And with the opening of the new Big Sky Medical Center, the retail pharmacy will move to the new facility. Wendy - 34 -
Rogers, PharmD, has been the community pharmacist from its inception. She'll be leading the pharmacy team at its new location.
FUTURE
THE BIG SKY TIME CAPSULE What will folks 100 years from now want to know about healthcare, the origin of Bozeman Health Big Sky Medical Center and life in surrounding communities? A century from now, what items could our descendants hold in their hands to tell the story of bringing medical care to Big Sky and southern Gallatin County? Bozeman Health gathered a variety of items that were placed in a Big Sky Medical Center time capsule to illustrate what life was like and what healthcare had to offer in 2015. The time capsule is approximately 10-by-18-by-20 inches, so items chosen were fairly small. The items, ranging from stethoscopes to ski passes, cell phones to stents, were encased on site as the facility was constructed. Suggestions were solicited from Big Sky residents and Bozeman Health employees. And their recommendations reflected people's enthusiasm for celebrating the new hospital and becoming a part of history. The time capsule is scheduled to be opened in 2116. - 35 -
FUTURE
A WELL PLANNED FACILITY WITH ROOM TO GROW With room to grow, the Bozeman Health Big Sky Medical Center is designed to accommodate Big Sky and southern Gallatin County's healthcare needs for years to come. Built on a 5.9-acre site, the facility includes three potential expansion zones to support the growing community's anticipated needs. Licensed as an acute care hospital, the building comprises more space than is being used. That's intentional, says Cheryl Ridgely, Bozeman Health chief strategy and business development officer, to facilitate added capacity when needed while benefitting from today’s construction costs. The unoccupied second floor might be used for future clinic expansion, for example. And the four-bed in-patient unit is ready to double in capacity with no exterior construction needed. The emergency department and procedure area includes a two-vehicle ambulance bay, six treatment rooms, including two trauma bays and one observation room. These facilities could also be expanded using space earmarked for building expansion on the east side of the property. The facility's development will hinge on the community's growth, demonstrated need and/or medical and technical advances, Ridgely says. “As it stands, this facility will provide greater healthcare access for all of southern Gallatin County, including West Yellowstone,” she says. “As population and tourism growth happens in this region of our service area, we are committed to meeting the needs of the residents and visitors through our integrated provider network.” - 36 -
ARTIST’S STATEMENT
Visiting Big Sky, Montana, 20 years ago changed my life forever. I was so blown away, I had dreams and visions of my future as a photographer in Big Sky. Now I'm living my dream -- blessed to have lived here with my wife and two daughters for nearly 17 years, photographing along the way. As an artist, it is easy to be inspired to live the adventurous lifestyle Montana offers. I love photographing Montana because there are so many opportunities with endless beauty in its wildlife, the environment and the people who enjoy it to its fullest. From its pristine mountain streams to its highest peaks, there is always an adventure waiting. I want to share this beauty in my art and create awareness of how amazing and stunning nature is in the world around us. With a strong connection to nature, I like to capture its notso-ordinary moments and sometimes its perfection. Other times, I find often overlooked abstract images in nature. My favorite images are ones that have a magical element; something so special I may never see images like them again. Life is not always picture perfect, but I like to be taken there with my imagery. Moments of bliss and pure amazement make me feel enlightened and enriched. I hope to spread those feelings and consciousness through my photography. - Ryan Turner Ryan Turner's photographs are featured throughout Bozeman Health Big Sky Medical Center.
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FACILITY
FACILITY
MRI
BUSINESS OFFICE
HELIPAD
ADMIN
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FACILITY
BOZEMAN HEALTH FOUNDATION
On October 23rd, 2015, Bozeman Health Big Sky Medical installed a high-quality 1.5 Tesla MRI, made possible through the generosity of Charles and Peggy Stephenson Family Foundation and their $850,000 challenge grant. Steve and Robin Stephenson and Kelly and Kevin Piccardo were among more than a dozen private and corporate benefactors who made gifts to fulfill that challenge.
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Dave Chen, MD; Jay Jutzy, MD; Chris Remely; Susan Ellis; Bob Braaksma, Past-Chair; Jim Ness, Julie Jackson; Scott Levandowski, Chair; Robyn Erlenbush, Vice Chair; Rich Deming, Treasurer; Patty Hinds; Gordon Davidson; Vickie Groeneweg, Secretary
WITH GRATITUDE TO THE COMMUNITY, FROM BOZEMAN HEALTH FOUNDATION As we look to the future, we know philanthropy will play a vital role in fulfilling the promise of great healthcare at Bozeman Health Big Sky Medical Center. On behalf of Bozeman Health Foundation and its volunteer board of directors, I can say without reservation that we are honored and excited to partner with you and all those who hold your community dear as new opportunities are created to make a difference through charitable giving. Already, you and your community have many reasons to be proud.
already commemorated with plaques throughout this remarkable facility; you’ve shown clearly that you care about the future of healthcare in Big Sky. For that, we are truly grateful. The future is very bright and the Bozeman Health Foundation stands ready to help all those who want to make a difference through your philanthropy in the days, months and years ahead. Thank you to all of you who have and will continue to support this important endeavor.
From the Charles and Peggy Stephenson Family Foundation’s challenge grant to provide high-quality MRI and the gifts it has inspired, to the Simkins family’s contribution of reduced-price land, to the many gifts
Jason Smith Executive Vice President of Philanthropy Bozeman Health Foundation - 45 -
CONTRACTORS
PROJECT CONTRACTOR LIST
Bozeman Health Big Sky Medical Center Langlas & Associates
Moderne Cabinet
HGA Architects
D’s Insulation
CompuSource
Mountain Area Systems
C&H Engineers
Architectural Building Supply
Williams Plumbing & Heating
Valley Glass
Matzinger Electric
Overhead Doors of SW MT
H&H Earthworks
MCG Construction
Paradigm Contractors
McGurran Painting
Western Rebar
Matco Acoustics
Marks & Hanson Mansonry
Rich’s Flooring
Lundahl Ironworks
Stronghold Surface Solutions
Innovative Building Concepts
Dupree Building Specialties
Progressive Roofing
Fireplace Center, Bozeman
TC Glass
Kone Elevator
Air Controls
Bozeman Fire Protection
Material Flow
Landscaping For Less
Dust in Time - 46 -
BOZEMAN HEALTH'S MISSION:
To improve community health and quality of life. - 47 -
334 Town Center Avenue Big Sky, Montana 59716 406.995.6995 www.bozemanhealth.org www.bigskymedicalcenter.com