New $900M St. Vincent hospital in Billings under construction

What could be Montana’s largest building is in the works. 

Intermountain Health’s St. Vincent Regional Hospital in Billings, once completed in 2029, will be 737,000 square feet and 285 feet tall. 

That eclipses the sprawling 518,379-square-foot ski resort, Montage Big Sky, reportedly the largest in Montana.

The building will also have 14 stories, but each story is roughly one-and-a-half regular stories, according to spokesperson Mike Paquette. The 18-story First Interstate Center in downtown Billings, which is 272 feet tall, is frequently cited as the tallest in Montana. 

Hospital administrators tout the project as not just a state-of-the-art facility but a major economic driver and an investment in patient care. 

The project will create an estimated 500 jobs. And the new building will have floor-to-ceiling views in almost all patient rooms with views of the Rims and the Yellowstone Valley, according to Dustin Strandell, the hospital’s chief operating officer. Strandell said the current hospital’s windows are small and often face onto the backs of other buildings. The new building will provide a better “healing environment,” he said. 

“I think the experience is going to be much, much more elevated — literally,” he joked.

The new Billings campus on North 27th Street is one year into a four-year build that will replace the hospital’s existing facilities. Currently, that amounts to five separate buildings, the oldest of which was built in 1918. 

Strandell told Montana Free Press that modernizing the heating, ventilation and air conditioning, electrical and plumbing in those buildings would have been impractical, especially while continuing to use them for patient care. It also would have been too costly.

Right now there are about 250 construction workers on site each day, according to Strandell. Dressed in fluorescent safety vests, they are dwarfed by the enormous steel-and-concrete shell going up around them. National firm Layton Construction is the general contractor for the project. Project managers hope to award 50% of the subcontract work to local companies. Strandell said so far, they are exceeding that goal. At peak, there will be 600 to 700 workers on site.

The new St. V’s will feature 243 beds. The hospital currently operates with between 225 and 240 beds, Strandell said. Administrators aren’t predicting much growth in bed demand over the years, in part due to system improvements, such as increased use of outpatient surgeries and preventive medicine, Wiltgen said. 

In the new hospital, each room will be equipped to serve in any capacity, including as Intensive Care Unit rooms. That will give administrators the flexibility they would need in a future pandemic, project officials have noted. 

Unlike in the current hospital, the new rooms will serve just one patient. They’ll have big windows with views of Billings. And improved layout will cut down on the number of steps nurses take per shift by up to 50%, according to Strandell. 

The new building will have separate entrances and elevators for staff, patients and visitors. Wiltgen, the foundation director, said that would provide more patient privacy, protect “sacred moments” with family and help staff get small breaks. 

“These nurses and physicians, they’re seeing some tough stuff throughout the day,” he said. “So I think for them to not have to be in an elevator next to a family who’s going up to visit a loved one” helps lighten their load. 

Once the new building is complete, the old buildings will be demolished and turned into parking lots and green space, Strandell said. 

Staff is already being trained to transition patients to the new building once it’s ready in 2029. Strandell said it will be about a 12-hour process, based on what other Intermountain hospitals have experienced moving to new buildings. Among other logistics, hospital administrators will need to plan with ambulance drivers when to begin using the new emergency department.

The multi-year facility replacement isn’t the only big change for St. Vincent. Intermountain Health is opening a 93,000-square-foot warehouse that will distribute medical supplies and eventually replace existing laundry facilities. The facility, located south of the Interstate adjacent to the Elysian School football field, will first serve St. Vincent Hospital and other Intermountain facilities in the region before opening up those services to area competitors. 

Hospital administrators hope the new building will better position St. Vincent to compete in the regional medical care market. 

“You know, a new building’s always going to be attractive for folks to work in. And I think patients will want to come to a brand new facility,” Strandell said. 

St. Vincent currently employs 2,200 people, while neighboring Billings Clinic employs 4,500, according to their respective websites. 

St. Vincent already has the only pediatric surgery program and pediatric intensive care unit, or PICU, in Eastern Montana, according to Paquette, the spokesperson. And it is expanding specialty pediatric services through a partnership with Intermountain Primary Children’s Hospital in Salt Lake City, which brings doctors to Billings for two-week rotations. 

As nice as it will be to have sleek, modern facilities with the new building, the hospital administration believes it sends a deeper message. 

“I think it just shows the investment in the community,” Strandell said. “That Intermountain’s here to stay and really is investing in the future of healthcare for the state and region.”