Surge plan nearing for Bozeman Health’s Deaconess Hospital

Big Sky Medical Center impacted by full regional hospital

On the afternoon of Sept. 15, Bozeman Health representatives called a press conference to alert the public that Deaconess Hospital, for the first time since the COVID-19 pandemic started, was preparing to enter a surge stage with all of its beds at or near 100% capacity.

According to Kallie Kujawa, the COVID-19 Incident Commander for Bozeman Health, “We know that hospitals right now across the state are full as well as across the country. We have been coordinating with other hospitals to see if other patients can be transferred. The majority of other hospitals are on divert.” 

Currently, Deaconess Hospital’s critical care unit is 100% full. Six of those twenty people are COVID-19 cases. Their medical unit, which is for people requiring fewer intensive resources, is 95% full. The hospital’s surgical unit is also at 114% capacity.

With the current limitations on providing care and beds, the hospital is preparing for crisis standards of care and the implementation of a surge capacity plan. This can look like increasing patient to staff ratios, rationing equipment and resources, putting patients in areas they wouldn’t normally, and turning people or elective procedures away.

According to Deaconess Hospital, 15 in 20 of the COVID-19 patients who have needed critical care have been unvaccinated. Despite the introduction of the Moderna and Pfizer vaccines earlier this year, Gallatin County is experiencing a high rate of community transmission and the majority of those cases are among those are unvaccinated, according to the Gallatin City-County Health Department.

Kallie Kujawa, Bozeman Health’s ICS Commander, relayed some of the feelings about the situation during the press conference: “It’s scary, challenging, and emotional. It’s hard seeing the staff having to make such difficult decisions and make crisis standards of care. No amount of time can prepare you for what we are about to experience or planning to experience.”

The hospital and local health department are urging folks who are medically able to get vaccinated. Additionally, they are strongly recommending for everyone—regardless of their vaccination status—to wear face masks indoors, contact physicians for assistance on mild cases to alleviate stress on the hospital, stay home if you feel sick, utilize local testing options, and support our tireless healthcare workers.

“What we are trying to do is share with everyone the current situation. I don’t know if everyone is aware of the capacity, the crisis staff, the fact that we are preparing for a surge unit, the piece of many hospitals being on divert, and being unable to accept patients from other hospitals. I’ll let everyone determine their level of feelings around that. I’m here to give people all of this information so it can perhaps shape their behavior and thought process about how they want to be a part of preventing the spread of COVID-19 around Gallatin County,” told Kujawa.

With over 400 job openings currently listed on the Bozeman Health website, Deaconess Hospital is actively looking for licensed medical professionals to support the local health care system and help fill the void. Staffing shortages have been a constant issue for businesses across the county and the medical field is no exception. Deaconess Hospital is currently relying on 30 to 40 emergency staffers with ongoing conversations about bringing in the National Guard for support like nearby Billings.


Big Sky Medical Center, which is a part of the Bozeman Health system, is a critical access hospital that serves the Big Sky community. They currently have eight beds but are not designed to take care of severely ill patients. If someone needed intensive care, whether that’s related to COVID-19 or another serious medical condition, BSMC would transfer them to a regional hospital like Deaconess. At the moment, however, they cannot.

Taylor Rose, the Director of Operations and Clinical Services at Big Sky Medical Center, explained, “We knew this was coming. Given the trending cases of COVID in Gallatin County, Deaconess Hospital reaching or exceeding capacity was an expected outcome. We have been planning for this situation since the pandemic started.”

Full regional hospitals and the inability to transfer patients has a domino effect for small communities like Big Sky or Ennis with less resources and fewer staff. “As can be expected there is fatigue and frustration that it has come to this point... Our biggest concern is having a facility that is able to take our patients that are too sick for us to keep here in Big Sky. Having other hospitals full means that our staff is required to spend more time with those who are very sick,” told Rose.

Despite the challenging news and preparations to enter a surge capacity plan across Bozeman Health, Big Sky Medical Center remains available for testing seven days a week, hosts vaccine administration clinics every Wednesday, and offers the recommended COVID-19 treatments for patients. They are also equipped with four ventilators.

Prompted with a takeaway message to the public, Kallie Kujawa of Bozeman Health urged folks as members of the community to exhaust all ways to prevent the spread of COVID-19 and understand that severe illness is potentially preventable. Please wear a mask indoors regardless of vaccination status, get tested and stay home if you feel sick, and obtain a vaccine if medically able to do so, per Gallatin City-County Health Department.

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