Three Rivers Health board approves new budget for upcoming fiscal year

The board of directors overseeing Three Rivers Health on Wednesday approved a $12.2 million budget for upcoming fiscal year that anticipates 9% increases in inpatient and outpatient revenues as well as 2% increases in employee salaries and wages.

The budget was created based on the facility’s experience in the current fiscal year and with consideration of any expected changes in services or day-to-day operations, according to a narrative presented at the meeting.

Joel Jackson said TRH has exceeded it budgeted revenues in each of the last two years — by 7% and 10%, respectively. 

Jackson and other hospital officials have fretted over the impact of the property tax reform legislation that came out of the 2025 session. “We made an assumption that we would see a reduction of $140,000 to $155,000 in receivables from that; however, while that income is reflected in our profit-and-loss statement, it didn’t impact how we approached the budget, with one exception,” he said.  “Part of the reason we’re starting is foundation is because we acknowledge that we may not have funds available through property taxes, federal grants, or that sort of thing.  We need to be thinking about how we can maintain capital.”

The new budget anticipates $5.8 million in gross inpatient revenue along with $14.3 million in gross outpatient revenue for a total of $20.1 million. With reductions for discounts and allowances, bad debt and charity care, the total drops to $12.3 million.

On the spending side, salaries and wages increased by 2% while benefits were adjusted for inflation at 2% for FICA and 4% for insurance expense and employee benefit expense; no change in contract labor is anticipated.  The budget also anticipates increases of 4% in the cost of supplies due to inflation/price changes and 3% in the cost of utilities.

Jackson said the hospital board has taken a hands-off approach with its designated account, which is where it parks tax money it receives from the county. As of last week, the balance was $1.3 million. “The goal would be to get through another year” without drawing from it, he said. If it can do so, TRH would be better positioned to consider facility master planning and longer-term growth.

Jackson added, “The public needs to be aware that we have an active financial assistance program (at TRH).  In fact, we budgeted $400,000 for it (under charity care). If folks in the community are having difficulty paying their bill, they simply need to ask for help. There’s information on statements, too.”

In other hospital board business:

• Tamara Sawyer provided an update on staffing, telling the board that in May, TRH lost its radiology manager who retired, but hired two full-time registered nurses.  The current full- and part-time employee count is 54, with six open positions — three in radiology, two for registered nurses and one for a phlebotomist.

Kelsey Sullivan, director of clinic and ancillary services, said free sports physicals are coming up in July and that its recent CRP class, on which it partnered with North Big Horn Hospital, went well. The money raised will be earmarked for the foundation. 

Sullivan added that Molly Krupa, TRH’s new travel radiology manager, is off to a strong start, and that starting in August, the mobile MRI trailer would begin stopping at the facility every week. Right now, it stops every other week.  Since January, it’s averaged about 11 scans per month. 

• Jackson said TRH has received federal approval of its foundation’s non-profit status and intends to start fundraising soon.  A presentation to the Big Horn REA board of directors is planned for sometime in July.

In his report to the board, Jackson said TRH saw a 5.5% increase in year-to-date patient encounters/registrations between July 2023-May 2024 and July 2024-May 2025.