“I think the experience is going to be much, much more elevated — literally,” joked Dustin Strandell regarding the towering new medical facility reshaping the skyline in Billings.
Intermountain Health’s new St. Vincent Regional Hospital project is currently one year into a four-year build that will replace the organization’s existing five-building campus on North 27th Street. Once completed in 2029, the massive healthcare facility will span 737,000 square feet and stand 285 feet tall, making it what could be the largest building in Montana by both square footage and height.
Building Billings’ New Medical Giant
The ambitious $900 million construction effort eclipses the sprawling 518,379-square-foot Montage Big Sky ski resort, which has been widely reported as the largest building in the state.
Meanwhile, the 18-story First Interstate Center in downtown Billings reaches 272 feet, holding the title of Montana’s tallest building until the hospital project reaches its full height. According to spokesperson Mike Paquette, the new hospital will feature 14 stories, though each floor is roughly one-and-a-half times the height of a regular story.
Contractors broke ground in 2025 and aim to wrap up work by 2029. The site currently employs about 250 construction workers each day under general contractor Layton Construction, with peak operations expected to draw between 600 and 700 workers.
Project officials note that the monumental build requires 82 miles of plumbing, 1.5 miles of cabinets, and enough steel to equal the weight of 2,700 cars. The electrical wiring needed for the building would stretch from Billings to Bozeman six times over.
Hospital administrators point out that modernizing the current campus—whose oldest building dates back to 1918—would have proved both cost-prohibitive and impractical while maintaining continuous patient care.
“Every time we open up a wall to do work, we have to bring it up to code. And if we had to do that throughout all five of the buildings that we have, it adds up to hundreds of millions of dollars,” Strandell explained.
Redesigned Facility Improves Patient Care
The redesigned facility will feature 243 private patient rooms equipped with floor-to-ceiling windows offering views of the Rims and the Yellowstone Valley. The new facility will be an upgrade from the current building, where windows are often small and face the backs of adjacent structures.
Administrators emphasize that the new layout is designed to cultivate a superior healing environment while cutting down the number of steps nurses take per shift by up to 50%.
In addition to room improvements, every single room in the new building will be equipped to serve as an Intensive Care Unit, providing critical flexibility for future public health needs. Tyler Wiltgen, executive director of the St. Vincent Healthcare Foundation, noted that the facility will incorporate separate entrances and elevators for staff, patients, and visitors to protect patient privacy during sensitive moments.
“These nurses and physicians, they’re seeing some tough stuff throughout the day,” Wiltgen said. “So I think for them not to have to be in an elevator next to a family who’s going up to visit a loved one” helps lighten their load.
The majority of the $900 million project will be financed through bonds, alongside hospital reserves and a dedicated fundraising campaign led by the foundation. Beyond the main hospital tower, Intermountain Health is also opening a separate 93,000-square-foot warehouse south of the Interstate to distribute medical supplies and handle regional laundry operations.
Old Buildings to Become Parking Areas
Once the new tower opens in 2029, the old hospital buildings will be demolished and converted into parking lots and green spaces. Hospital staff are already undergoing training for the patient transition, which administrators estimate will take approximately 12 hours based on similar moves at other Intermountain facilities. Logistics teams are also coordinating with local ambulance services to establish protocols for routing emergency traffic to the brand-new emergency department.
St. Vincent currently operates Eastern Montana’s only pediatric surgery program and pediatric intensive care unit, and it continues to expand specialty pediatric care through a partnership with Intermountain Primary Children’s Hospital in Salt Lake City, which brings doctors to Billings for two-week rotations.
“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.”
