The Ruby Valley Hospital (“RVH”), located in Sheridan, Montana was organized in 1956. RVH became a public hospital district in 2003 as a governmental hospital district under Montana Code Annotated “Title 7 Chapter 34 Part 21 – Hospital Districts”.  The operation of RVH is a ten bed licensed acute care hospital, which is located in the Ruby Valley (Sheridan) of Madison County, Montana.

The current hospital building was originally constructed in 1964 and began operations as an acute care hospital. The Sheridan Clinic was built and added on to the hospital in 1978. Additions and remodeling to the building were completed over the following years.

Effective September 2001, RVH was designated as a Critical Access Hospital (CAH) for Medicare reimbursement. Under this designation, RVH receives cost-based reimbursement for services provided to Medicare beneficiaries.


RVH is a designated Montana Trauma Receiving Facility Level 5 providing the following services:

1.  Acute care for adult and pediatric patients (inpatients);

2.  Swing bed (skilled care);

3.  Respite care;

4.  Emergency care staffed 24 hours by medical providers which are employed by the hospital;

5.  Additional medical services include the following:

a.  Cardiac care;

b.  Radiology;

c.  CT Scans;

d.  Laboratory;

e.  Pulmonary Function Studies;

f.   IV Therapy;

g.  Physical Therapy;

h.  Speech Therapy;

j.  Post-op and Stroke rehabilitation.


6.  RVH also operates two designated rural health clinics, one in Sheridan and one in Twin Bridges.

Community Impact

RVH is an independent Critical Access Hospital (CAH) located in the Ruby Valley of Madison County, in the southwestern part of Montana. RVH serves the medical needs of the 2,500 residents and visitors in our valley. As a leading employer, RVH employs 55 dedicated staff committed to providing high-quality health care to the residents who make this area their home. RVH is also committed to delivering high-quality personalized care to people of all ages.

Health care reform continues to be a major topic of discussion at both state and national levels. While the details of reform initiatives are still being debated, everyone does agree that health care costs must be contained and quality must be improved. In the future, new models of health care delivery will increase providers’ accountability for both quality and cost, putting hospitals at increased financial risk for the care they provide. This changing environment of health reform means the Board of RVH will continue to carefully study options as plans are developed for the future of RVH. The future success of RVH will require strong, committed partners to provide a collaborative team approach to patient care.

As a Critical Access Hospital serving a rural population, RVH provides medical and emergency services, 24 hours a day, 7 days a week, to the people in the Ruby Valley, bringing quality health care close to home.

RVH continues to strive to meet the health care needs of the rural communities it serves in Sheridan, Twin Bridges, Silver Star, Laurin, Alder, Nevada City and Virginia City as well as providing the most efficient ways to deliver the care and provide needed services.


RVH progresses in its commitment to the health care of its communities through the development of new services, advanced training for staff and introduction of new technology.

Some of our achievements and proposed changes include the following:

  • RVH has been designated as a Level 5 Trauma Hospital;

  • Installation of a CT unit which is anticipated to reduce transfers to other hospitals to rule out specific medical provider concerns. This will reduce the burden on our volunteer ambulance service for transfers to other hospitals and possibly allow the patient to remain at RVH or return home.

  • Electronic Health Records will become a reality in the “new” Ruby Valley Hospital, Sheridan Clinic and the Twin Bridges Clinic.

  • The “new” Sheridan Clinic, attached to the new RVH hospital will have additional space, i.e. exam rooms and office, for visiting specialists to practice.

  • Psychiatric “Telemedicine” service will be available for our patients. This new service will fill a very important needed medical service for those patients requiring evaluation and counseling.


RVH has a positive impact on the communities it serves as the major provider of health care and as a large employer. One of the biggest outreach programs for RVH is our Therapy Department. This department provides vital rehabilitation care to patients of all ages. The Therapy Department is comprised of Physical Therapists and a Speech Therapist. It has a reputation for providing the patients they serve with exceptional quality of care and compassion for all of the patients’ rehabilitation needs.​

Another department that the community depends on for its ongoing excellent care is our Emergency Department. The patients/residents of the Ruby Valley have come to expect that their emergency needs will be addressed in a timely manner with professionally trained and qualified medical providers and hospital staff.  Over 100 Ruby Valley residents and visitors seek emergency care every month.  If the Hospital’s employed emergency medical providers feel they cannot address the patient’s emergency needs, the provider will coordinate the transfer of the patient to one of three larger hospitals located in Butte, Bozeman or Missoula. These transfers will be by ground ambulance, helicopter or a fixed wing aircraft, depending on the distance and severity of the patient’s needs.

In addition to 24-hour emergency service, RVH plans on providing medical providers to be on standby at high school athletic events, parades, rodeos and other community activities, making these events safer for all participants.

The Hospital’s medical providers conduct sports physicals for student athletes at both the Sheridan High School and Twin Bridges High School. The proceeds from the student sport physical payments are then donated to the respective school libraries for health related materials for student use.

The proposed “new” Ruby Valley Hospital will beneficially impact the community in a variety of ways, both short-and long-term. Some of the key community impacts are noted below:


  • Providing construction jobs for local contractors within the community during the construction process of the hospital;

  • Protecting current employment levels through improvement of hospital facilities and the opportunity to grow future employment through growth in market share and patient volume through visiting medical specialists;

  • Designing and sizing of the diagnostic department more efficiently to improve patient/resident care;

  • Allowing more space for newer technology to improve patient safety;

  • Improving emergency department flow and better access for moving and transporting patients through a designated emergency entrance with separate emergency treatment areas allowing for adequate space for staff and equipment;

  • Improving the over-all facility layout for better patient flow;

  • Increasing privacy and reducing the chance of infection for patients through 100% private inpatient beds;

  • Increasing access to services for key primary care and specialists working at RVH;

  • Increasing the lab area providing more space for specialized equipment which will allow more tests to be completed at RVH in a timely manner versus sending them to referring labs;

  • Increasing the Physical Therapy Department for additional workspace for the Speech and Physical Therapists and their patients;

  • Providing a small private enclosed area for grieving family members away from the general public.

Facility Replacement Plan

The current hospital facility has been well maintained, however, it has reached a point where it can no longer serve the changing functional needs and is currently not configured to enable staff to deliver health care at today’s standards to our patients.

The current emergency entrance is through the main hospital / out-patient entrance causing HIPPA concerns. Like many hospitals built in the early 1960s, the facility was designed to provide acute care for inpatients. Today, the majority of the care at RVH is provided in an out-patient setting. When the existing facility was built, x-rays were state of the art and there was no conception of technological advancements, such as CT scans, ultrasound, or any other commonly used diagnostic radiology tools. In fact, many of the outpatient departments such as laboratory, radiology, and our Trauma and ER are undersized, and are not located in a manner to provide cost-effective, quality patient care. In addition, these departments are limited by ceiling height, which is needed to accommodate cabling systems, greater ventilation, and other equipment. Asbestos is also above the ceiling and under floor coverings, which complicates upgrading any items located in these areas.

Patient privacy/confidentiality and infection control were not considered priorities at the time the original facility was built. This is evidenced by the fact that the inpatient unit is made up of all semi-private rooms and has a major public/staff corridor through the middle of the unit. Another issue regarding the inpatient area is that the RVH hallways are not eight feet wide per code nor is the facility fully maintained with sprinklers for fire safety.

Health care today calls for a healing environment with single patient rooms and bathrooms with showers that offer privacy and safety with the additional room space for family visits. The Hospital’s clinical areas are the departments which are the most impacted by space shortages, poor/inefficient design, and the lack of patient and staff amenities. These are all issues that were identified and specifically addressed by the facility master plan and proposed new hospital project. The new clinic will have twice the number of exam rooms as well as additional working space for visiting medical providers and a dedicated area in the clinic for telemedicine conferencing.

The Project

The Ruby Valley Hospital (RVH) intends to build a new hospital, situated on land purchased directly east of the current hospital. The new hospital facility as planned will be approximately 28,375 square feet and will create a healing environment consistent with the rural setting most of its patients prefer, with contemporary care standards. The new facility will address the current and future health care needs of the public hospital district, ensuring that the residents and visitors in the Ruby Valley will be able to continue to access quality, compassionate medical care in a modern facility close to home. The current design standard for the patient room wing is to provide 100% private inpatient beds, to improve safety, reduce infection control, create better patient satisfaction by making the area quieter and more private and utilize lean construction as much as possible.

The Ruby Valley Hospital will also provide space for the medical provider specialists. The new hospital will enhance the support of these specialists and will increase the satisfaction of its residents per the information received from the Ruby Valley Hospital District Community Health Services’ Development Survey Report dated January 2011.

The Building Site

The current location for the new Hospital is on approximately six acres which allows for close proximity to the existing Tobacco Root Mountains Care Center (TRMCC), a licensed thirty nine bed skilled nursing facilit and Home Park, a 10 bed assisted living facility. The current site is of sufficient size to provide long-term flexibility and growth for the Hospital and Clinic with potential expansion points on all sides of the building. Other alternative locations were considered for this project; however, it was felt that remaining close to the “TRMCC” nursing home and  “Home Park” was important in retaining a collaborative medical campus.

A groundbreaking ceremony for the new hospital was held on October 26, 2016 with representatives from the hospital, clinics, TRMCC, Home Park, the building contractor, the architects, the county commissioners office and the community in attendance.  Please see the Recent Activities page for photos of this special event.  


The Ruby Valley Healthcare Foundation and the Ruby Valley Auxiliary, as well as other local philanthropic organizations, have supported the Ruby Valley Hospital for many years in raising funds for a variety of special equipment projects that have benefits the patients of the Ruby Valley with improved health care.

As a critical component of funding the construction of the new Ruby Valley Hospital and the new equipment that will be needed, the Ruby Valley Healthcare Foundation commenced a campaign in November, 2015 to raise $2.5 million.  Through effective teamwork, efficient planning and generous donations, this goal was reached in record time by October, 2016!  Please visit the Recent Activities page for photos from the Fundraising Celebration that was held on October 26, 2016 at the historic Round Barn in Twin Bridges.  

The Ruby Valley Healthcare Foundation is continuing their fundraising efforts to support upcoming equipment needs for the various departments of the Ruby Valley Hospital.  Please visit their website at www.rubyvalleyhealthcarefoundation.org for more information.  

The board of trustees, administration and staff of the Ruby Valley Hospital greatly appreciates the efforts of the Ruby Valley Healthcare Foundation, the Ruby Valley Hospital Auxiliary, the generous private donors and our community philanthropies for supporting the development of the new Ruby Valley Hospital.