Yes — but it is important to understand the difference between standard Montana Medicaid and the Medicaid Home and Community-Based Services (HCBS) Waiver. These are two separate programs.

Long-term care at BSMC requires the Medicaid HCBS Waiver. Standard Medicaid alone does not cover long-term nursing care stays. This is the single most common source of confusion for families.

If your loved one currently has Medicaid, they may still need to apply separately for the HCBS Waiver through the Montana Department of Public Health and Human Services. The application process can take time, so we strongly encourage families to begin this process as early as possible — even before a bed is available.

Our staff can help you understand the difference and connect you with the right contacts at DPHHS. Call us at (406) 378-3910.

Assisted living provides help with daily activities like meals, bathing, and medication reminders in a residential setting. Residents are generally more independent and do not require around-the-clock skilled nursing care.

Long-term care at BSMC is 24-hour skilled nursing care in a hospital-based setting. Our residents receive medical care from licensed nurses around the clock, with on-site providers, lab, radiology, and emergency services — all under one roof. This level of care is for individuals whose medical needs go beyond what assisted living can safely provide.

If you are unsure which level of care is right for your loved one, our team can help you evaluate the options. In many cases, assisted living may be a good interim step while waiting for a long-term care bed.

The cost of long-term care varies based on room type (private or semi-private), level of care, and insurance coverage. Here is a general overview of how payment typically works:

• Medicare — may cover short-term transitional care stays for post-acute rehabilitation (typically after a qualifying 3-day hospital stay), but does not cover long-term stays.
• Medicaid HCBS Waiver — covers long-term nursing care for eligible individuals. This requires a separate application through the state (see the Medicaid question above).
• Private pay / Self-pay — families pay the daily rate directly. Payment plans may be available.
• Long-term care insurance — if your loved one has an LTC insurance policy, it may cover some or all of the daily rate. Contact your insurer for details.
• VA benefits — veterans may have additional coverage options. Contact your local VA office.

For a personalized cost estimate or to discuss payment options, contact our billing department at (406) 378-2189.

This is one of the most important things for families to understand: we do not simply call the next person on the list when a bed opens.

When a bed becomes available, our clinical team reviews the entire active waiting list and evaluates each applicant based on:

• Medical acuity and care needs — how urgently does this person need 24-hour nursing care?
• Current living situation — is the person safe where they are, or is their situation deteriorating?
• Readiness — does the person have their financial arrangements in place (Medicaid Waiver, insurance, private pay)?
• Clinical fit — can our facility safely meet this person's specific care needs?

This means being first on the list does not guarantee being the next person admitted. A person with more urgent medical needs or a less stable living situation may be prioritized over someone who is currently safe and well-cared-for at home.

If you are on the list but do not need care right now, we strongly encourage you to stay on the list — but understand that we cannot simply "hold your spot" and call you when it is convenient. Every bed opening triggers a full clinical review.

We understand this can be frustrating, and we want to be transparent about how admission decisions are made.

Admission to our long-term care program is based on medical need, clinical acuity, and readiness — not geography alone. While we are deeply committed to serving the Big Sandy community, we are also a licensed healthcare facility with a clinical and ethical obligation to prioritize individuals based on the urgency of their care needs.

A person from another community who is in a medically urgent situation may be admitted before a local resident who is currently stable and safe in their current living arrangement. This is a clinical decision made by our care team, and it is the same standard used by long-term care facilities across Montana.

We know this is difficult. If you have concerns about your loved one's position on the waiting list, please call us — we are happy to discuss their situation directly.

Submitting an application places you on our waiting list, but it does not trigger an immediate response unless a bed is currently available.

There are a few important things to know:

• Applications must be resubmitted every 6 months to remain active on the waiting list. If we have not received an updated application within 6 months, your loved one's application may be considered inactive.
• If there has been a change in your loved one's condition, living situation, or insurance status, please submit an updated application or contact us so we can update your file. Changes in condition can affect priority.
• We review the full waiting list each time a bed becomes available. If your application is active and current, it will be reviewed.

Our recommendation: set a reminder to resubmit or update your application every 6 months, even if nothing has changed. This keeps your loved one's file active and ensures we have the most current information when a bed opens.

If you are unsure whether your application is current, call us at (406) 378-3910 and we will check.

When a bed becomes available and your loved one is selected, you will be contacted by our team. Because bed availability is unpredictable and demand is high, families are generally given 48 to 72 hours to confirm acceptance.

If you are unable to accept at that time, your loved one remains on the waiting list — but the bed will be offered to the next eligible applicant. There is no penalty for declining, but there is also no guarantee of when the next opening will occur.

This is why we encourage families to begin financial and logistical preparation early — well before a bed becomes available. Having the Medicaid Waiver application in process, personal items ready, and family members informed can make the difference between being ready to say yes and having to pass.

Residents of our long-term care program receive primary care from the providers at Big Sandy Medical Center. Our providers are on-site Monday through Friday and on-call 24/7, which allows us to respond quickly to changes in condition and coordinate all aspects of care under one roof.

If your loved one has an existing relationship with a specialist (cardiologist, neurologist, etc.), we will coordinate with those providers to ensure continuity of specialty care. However, day-to-day primary care and medical oversight will be managed by our on-site team.

We find that most families appreciate the convenience and responsiveness of having providers just down the hall — especially in urgent situations.

In most cases, yes. Because we are a Critical Access Hospital, our long-term care residents have access to a level of medical support that standalone nursing homes cannot match:

• If a resident becomes acutely ill, they can be transferred to our inpatient unit or Emergency Department without leaving the building.
• If a resident needs post-acute rehabilitation (for example, after a fall or hospitalization), they can receive transitional care and then return back to their long-term care bed.
• If a resident's care needs exceed what our facility can safely provide (for example, ventilator-dependent care or advanced memory care), we will work with the family to coordinate a transfer to an appropriate facility.

Our goal is always to keep residents in our care as long as we can safely and appropriately do so. We do not discharge residents lightly, and any changes in care level are discussed thoroughly with the family.

Family involvement is not just welcome — it is encouraged. We believe that staying connected to family is essential to our residents' quality of life.

Visiting hours are generally flexible. We ask that visitors be respectful of mealtimes, rest periods, and other residents' privacy, but we do not impose rigid visiting restrictions. If you would like to join your loved one for a meal or participate in an activity, just let our staff know.

For any questions about visiting policies or to arrange a special visit, call us at (406) 378-3910.

Yes — but it is important to understand the difference between standard Montana Medicaid and the Medicaid Home and Community-Based Services (HCBS) Waiver. These are two separate programs.

Long-term care at BSMC requires the Medicaid HCBS Waiver. Standard Medicaid alone does not cover long-term nursing care stays. This is the single most common source of confusion for families.

If your loved one currently has Medicaid, they may still need to apply separately for the HCBS Waiver through the Montana Department of Public Health and Human Services. The application process can take time, so we strongly encourage families to begin this process as early as possible — even before a bed is available.

Our staff can help you understand the difference and connect you with the right contacts at DPHHS. Call us at (406) 378-3910.

Assisted living provides help with daily activities like meals, bathing, and medication reminders in a residential setting. Residents are generally more independent and do not require around-the-clock skilled nursing care.

Long-term care at BSMC is 24-hour skilled nursing care in a hospital-based setting. Our residents receive medical care from licensed nurses around the clock, with on-site providers, lab, radiology, and emergency services — all under one roof. This level of care is for individuals whose medical needs go beyond what assisted living can safely provide.

If you are unsure which level of care is right for your loved one, our team can help you evaluate the options. In many cases, assisted living may be a good interim step while waiting for a long-term care bed.

The cost of long-term care varies based on room type (private or semi-private), level of care, and insurance coverage. Here is a general overview of how payment typically works:

• Medicare — may cover short-term transitional care stays for post-acute rehabilitation (typically after a qualifying 3-day hospital stay), but does not cover long-term stays.
• Medicaid HCBS Waiver — covers long-term nursing care for eligible individuals. This requires a separate application through the state (see the Medicaid question above).
• Private pay / Self-pay — families pay the daily rate directly. Payment plans may be available.
• Long-term care insurance — if your loved one has an LTC insurance policy, it may cover some or all of the daily rate. Contact your insurer for details.
• VA benefits — veterans may have additional coverage options. Contact your local VA office.

For a personalized cost estimate or to discuss payment options, contact our billing department at (406) 378-2189.

This is one of the most important things for families to understand: we do not simply call the next person on the list when a bed opens.

When a bed becomes available, our clinical team reviews the entire active waiting list and evaluates each applicant based on:

• Medical acuity and care needs — how urgently does this person need 24-hour nursing care?
• Current living situation — is the person safe where they are, or is their situation deteriorating?
• Readiness — does the person have their financial arrangements in place (Medicaid Waiver, insurance, private pay)?
• Clinical fit — can our facility safely meet this person's specific care needs?

This means being first on the list does not guarantee being the next person admitted. A person with more urgent medical needs or a less stable living situation may be prioritized over someone who is currently safe and well-cared-for at home.

If you are on the list but do not need care right now, we strongly encourage you to stay on the list — but understand that we cannot simply "hold your spot" and call you when it is convenient. Every bed opening triggers a full clinical review.

We understand this can be frustrating, and we want to be transparent about how admission decisions are made.

Admission to our long-term care program is based on medical need, clinical acuity, and readiness — not geography alone. While we are deeply committed to serving the Big Sandy community, we are also a licensed healthcare facility with a clinical and ethical obligation to prioritize individuals based on the urgency of their care needs.

A person from another community who is in a medically urgent situation may be admitted before a local resident who is currently stable and safe in their current living arrangement. This is a clinical decision made by our care team, and it is the same standard used by long-term care facilities across Montana.

We know this is difficult. If you have concerns about your loved one's position on the waiting list, please call us — we are happy to discuss their situation directly.

Submitting an application places you on our waiting list, but it does not trigger an immediate response unless a bed is currently available.

There are a few important things to know:

• Applications must be resubmitted every 6 months to remain active on the waiting list. If we have not received an updated application within 6 months, your loved one's application may be considered inactive.
• If there has been a change in your loved one's condition, living situation, or insurance status, please submit an updated application or contact us so we can update your file. Changes in condition can affect priority.
• We review the full waiting list each time a bed becomes available. If your application is active and current, it will be reviewed.

Our recommendation: set a reminder to resubmit or update your application every 6 months, even if nothing has changed. This keeps your loved one's file active and ensures we have the most current information when a bed opens.

If you are unsure whether your application is current, call us at (406) 378-3910 and we will check.

When a bed becomes available and your loved one is selected, you will be contacted by our team. Because bed availability is unpredictable and demand is high, families are generally given 48 to 72 hours to confirm acceptance.

If you are unable to accept at that time, your loved one remains on the waiting list — but the bed will be offered to the next eligible applicant. There is no penalty for declining, but there is also no guarantee of when the next opening will occur.

This is why we encourage families to begin financial and logistical preparation early — well before a bed becomes available. Having the Medicaid Waiver application in process, personal items ready, and family members informed can make the difference between being ready to say yes and having to pass.

Residents of our long-term care program receive primary care from the providers at Big Sandy Medical Center. Our providers are on-site Monday through Friday and on-call 24/7, which allows us to respond quickly to changes in condition and coordinate all aspects of care under one roof.

If your loved one has an existing relationship with a specialist (cardiologist, neurologist, etc.), we will coordinate with those providers to ensure continuity of specialty care. However, day-to-day primary care and medical oversight will be managed by our on-site team.

We find that most families appreciate the convenience and responsiveness of having providers just down the hall — especially in urgent situations.

In most cases, yes. Because we are a Critical Access Hospital, our long-term care residents have access to a level of medical support that standalone nursing homes cannot match:

• If a resident becomes acutely ill, they can be transferred to our inpatient unit or Emergency Department without leaving the building.
• If a resident needs post-acute rehabilitation (for example, after a fall or hospitalization), they can receive transitional care and then return back to their long-term care bed.
• If a resident's care needs exceed what our facility can safely provide (for example, ventilator-dependent care or advanced memory care), we will work with the family to coordinate a transfer to an appropriate facility.

Our goal is always to keep residents in our care as long as we can safely and appropriately do so. We do not discharge residents lightly, and any changes in care level are discussed thoroughly with the family.

Family involvement is not just welcome — it is encouraged. We believe that staying connected to family is essential to our residents' quality of life.

Visiting hours are generally flexible. We ask that visitors be respectful of mealtimes, rest periods, and other residents' privacy, but we do not impose rigid visiting restrictions. If you would like to join your loved one for a meal or participate in an activity, just let our staff know.

For any questions about visiting policies or to arrange a special visit, call us at (406) 378-3910.