ROUNDUP — Bluntly put, Roundup Memorial Hospital is struggling to keep the doors open at its aging 1954 facility.

Its lifeline could be Billings Clinic. In a "desperate call for help," Roundup Memorial has asked the thriving Billings Clinic to help keep the rural hospital afloat by assisting it with day-to-day operations.

"We realized we needed something bigger than us to keep that facility in our community," said John Pfister, chair of the Roundup Memorial Hospital Association Board.

The Management Services Agreement with Billings Clinic comes on the heels of Roundup Memorial's decision to sever ties with Brim Healthcare, a Tennessee-based hospital management company. Roundup Memorial was paying the national management company between $6,000 to $8,000 per month in addition to other charges, Pfister said. Roundup ended its affiliation with Brim as a way to save on costs and still owes it money, Pfister said.

"I would be telling you a windy story if I said we were out of the woods," Pfister said.

Neither leaders at Roundup Memorial nor Billings Clinic would disclose terms of their one-year agreement, but Pfister called it a "sunshine deal."

"They are making this first year very affordable to us so we can get ourselves turned around and going in the right direction," Pfister said. "We just keep getting deeper in the hole."

The hospital recognizes it does not have the local expertise from a governing standpoint or within the community to run its hospital in a complex and ever-changing era of health care, said Kyle Gee, vice president, regional chief financial officer for Billings Clinic.

Billings Clinic experiences those same challenges so it can bring its expertise to help Roundup, Gee said. "We are under way. We have lots of challenges and lots of opportunities to turn it around."

It is often difficult for rural health care facilities to access everything from technology to liability insurance. By partnering with Billings Clinic, Roundup Memorial can purchase these services at a significantly reduced cost, sometimes as much as 30 percent, Gee said.

One of the first things Billings Clinic will do at Roundup Memorial is build a technology system from the ground up, positioning the hospital to install an electronic records system, which gives doctors instant access to patient histories and treatments.

Billings Clinic is a regional health care organization. It caters to patients from parts of Montana, Canada, Wyoming and from the Dakotas. It sees rural health care as part of its mission.

"We want to ensure that the care of patients from rural areas in our region is well-coordinated between ourselves and those communities," said Dr. Nicholas Wolter, CEO of Billings Clinic. "Substantial numbers of patients admitted to our hospital live outside Yellowstone County."

Billings Clinic has similar Management Services Agreements with medical facilities in Colstrip, Scobey, Red Lodge, Columbus, Big Timber, Livingston, and Lovell, Wyo.

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Contact Cindy Uken at cuken@billingsgazette.com or 657-1287.