Montana
St. James hospital in Butte losing surgeons, union raises concerns about workers, patients – Daily Montanan
St. James Healthcare in Butte appears to have lost more than half of its surgeons in the last year, and the Montana Nurses Association is urging Intermountain Health — which runs the hospital following a 2022 merger — to prioritize retention of critical health care providers.
Roughly one year ago, the hospital counted nine or 10 surgeons, and it has just four after Intermountain failed to retain three in contract negotiations and two others retired, according to the Montana Nurses Association.
“This is a really big impact” for surgical services, said Robin Haux, labor program director for the Montana Nurses Association.
St. James counts 67 beds in southwest Montana and is the only acute care facility in the region, according to information from Intermountain Health. A story about the merger from NBC Montana said it served nearly 40,000 members of the community in 2022; Intermountain did not provide an updated figure.
In an email Friday, Intermountain Health did not dispute the union’s count of the more than 50% decrease in surgeons in the last year. In response to a question about plans and a timeline for filling positions in Butte, Intermountain emailed a statement with remarks from an interim president.
“We are excited to welcome several new providers across various specialties to St. James and Intermountain Health in the coming months,” said Pam Palagi, interim president of St. James Hospital, in a statement from an Intermountain media relations manager. “Those specialties include neurosurgery, orthopedic surgery, general surgery, endocrinology and walk-in care.”
Intermountain Health’s corporate offices are based in Utah. Its website says it works in seven states including Montana and at 33 hospitals and 385 clinics. It touts that it is “reimagining health care,” offers “pioneering research,” provides personal and affordable care, and is a partner with the Las Vegas Raiders.
The merger between Intermountain Health and SCL Health created the 11th largest nonprofit health care system in the U.S., according to NBC. At the time, the former president of St. James said patients would see a logo change as a result, but they could expect to see a high level of care continue.
“The great quality care that you are used to receiving will stay the same, and how you access and utilize our services will not change,” said then-President Jay Doyle in 2022 to NBC.
Friday, however, Haux and Montana Nurses Association labor representative Emily Peterson said patients already are seeing impacts from the departures of providers. The lost doctors who have not been replaced include a urologist and gastroenterologist.
Peterson said the hospital recently had to reschedule three weeks’ worth of procedures for patients after Intermountain lost one surgeon. She said it canceled two weeks of appointments after it lost another.
“That is one big concern for our nurses,” Peterson said. “They know these patients need help, and it was more upsetting to them that the patients that needed procedures weren’t getting them than it was for them to not get their hours.”
However, the union is seeing employees have hours cut or have to take eight to 12 hours of paid time off a week. And without needed providers and a full schedule, they worry about the potential for staff cuts in the future.
“It is causing a lot of concern with the nurses and the surgical techs,” Peterson said.
A petition launched Friday asks Intermountain, a nonprofit healthcare system that describes itself as the largest in the intermountain West, to address the crisis by prioritizing the retention of providers, strengthening their contracts, and keeping registered nurses and other staff in Butte.
The Montana Nurses Association has roughly 25 nurses in surgical services at St. James and 132 members at the hospital altogether. The Teamsters of the Montana AFL-CIO represent additional staff such as CNAs, or certified nursing assistants.
“This is really about protecting the ability to provide high quality care and really vital services and vital care to the community,” Haux said.
To fill one gap, a traveling doctor is slated to help temporarily, but at a high cost, Peterson said.
Dr. Nathaniel Readal, a urologist, said Friday he declined to sign a new contract with Intermountain because he believes some of the language in the agreement put him at risk legally.
Most surgical specialists are generally required to take seven to 10 days a month of being on call, but in Butte Readal said he took an average of 270 to 300 days a year. That means staying within 30 minutes of the hospital and being available to deal with an emergency; in other words, it means no skiing, fishing, beer or golf.
“I take more call because there’s nobody else to do it. We have a pretty large patient base,” Readal said.
But he said he interpreted some of the language in the contract to suggest he would have to be on call and available basically around the clock and every day for existing patients he had cared for in the past.
If such a patient came in with an acute issue and Readal was, say, skiing and unreachable, he said he could be at medical legal risk as the agreement was drafted. He didn’t quibble with compensation, he said, but he requested language in the contract that would protect him legally, and Intermountain did not provide it.
“That was the thing they were unwilling to change and why I would not sign the contract,” said Readal, who had signed previous contracts before the merger.
A story about Readal in the Montana Standard in 2018 said he completed his medical degree and residency at renowned Johns Hopkins Hospital in Baltimore and was working to make healthcare better and more accessible at St. James. In a way, the story said he represented the “future of Butte.”
The story said he and his wife were already a part of the community. Friday, however, Readal, said he is evaluating all his options for the future, in part because standard healthcare contracts make it difficult to remain in a community and care for patients if a provider doesn’t want to work for the medical group that staffs the hospital, or Intermountain in this case.
In the email from Intermountain, Palagi said the industry comes with some churn.
“Transitions in hospital leadership and physicians are common in the healthcare industry,” Palagi said. “At St. James, we prioritize continuity of care and employ robust recruitment strategies to ensure smooth transitions and maintain high standards of patient care.
“ … The bottom line is that St. James Hospital and Intermountain Health remain committed to ensuring the residents of Butte and southwest Montana have access to top-notch, patient-centered care right here in their home community.”
The Montana Nurses Association said the administration at St. James wants to protect frontline employees such as nurses, CNAs, and other staff. Haux said they know how hard it is to replace those positions.
“But we also know they will not be able to continue this without providers and without a full schedule,” she said.
Haux said the petition does not force action by Intermountain. However, the Montana Nurses Association and Teamsters of the Montana AFL-CIO may pursue other options that would put pressure on the healthcare system if leaders do not respond.
“I don’t think … that will sit well with the Butte community if they choose not to respond,” Haux said. “That’s a very tight, close-knit community.”
Montana
Rural Highway Stalker In White Pickup With Dark Windows Terrifying Montana Women
The Ole’ Mercantile is a busy place by Grass Range, Montana, standards.
The community of roughly 125 people sits along a long, lonely network of two-lane highways connecting Billings with points north along Montana’s Hi-Line.
For drivers pushing toward Lewistown, Malta or Glasgow, the store’s lights are often the first sign of anything for miles.
Of late, they may also offer a chance of identifying the person driving a truck local women say is stalking these roads.
Owner Krista Manley told Cowboy State Daily her store is outfitted with a top-of-the-line camera system that offers a 360-degree view with no blind spots. Four overlapping cameras capture her property, the Wrangler Bar and the full stretch of Highway 87 frontage running through town.
Fergus County investigators now hope that footage — and Manley’s willingness to comb through hours of it — can help identify the driver of a newer white Ford four-door pickup with dark tinted windows, no front license plate and a chrome grill guard.
The truck is at the center of the most recent reported highway stalking incident.
Lizette Lamb, a 48-year-old traveling health care worker, says she was nearly run off the road the evening of April 10.
Now a growing chorus of similar accounts from women across north-central Montana are popping up on social media.
At The Ole Merc
Travis Lamb, Lizette’s husband, took to Facebook to post about what happened to his wife on one of the loneliest stretches of highway in Montana.
Travis told Cowboy State Daily Lizette pulled into the Ole’ Merc Conoco in Grass Range between 7 and 8 p.m. to grab a drink. She later remembered a pickup was backed in alongside the cafe: a newer white Ford four-door.
“Kind of gave her the heebie-jeebies,” he said. “My wife has worked in a prison and stuff like that, so she’s used to kind of going with her gut.”
She bought a drink, got back in her Ford Bronco Sport and headed north on Highway 19 toward Glasgow.
About a mile and a half down the road, she realized the white pickup was behind her. Through the dark tint, she could make out the silhouettes of two men.
She slowed down and edged toward the shoulder to let them pass. They slowed with her. She sped up. They sped up.
By the time she reached Bohemian Corner 23 miles up the road, Travis Lamb said, his wife knew something was wrong.
There were no other vehicles in the lot, so she didn’t bother pulling in. She tried to call Travis. No service.
She tried 911. The phone beeped, displayed a red message and disconnected.
Truck Gets Aggressive
The white truck continued to shadow Lizette along Highway 191. About two miles from where the road crosses the Missouri River, coming into a construction zone, the pickup got aggressive.
Travis said the truck rode so close to the Bronco’s bumper that his wife could no longer see its windshield, only the grille.
Then it pulled out as if to pass and swerved into her, he said, in what he described as an attempted PIT maneuver — the law-enforcement technique of clipping a fleeing vehicle’s rear quarter to spin it out.
PIT stands for Precision Immobilization Technique, and this tactic is used to stop a fleeing vehicle by forcing it to turn sideways, causing the driver to lose control and stop.
“She was fortunate, kind of timed it to when they went to turn into her and hit her, she sped up,” Travis Lamb said. “And they missed.”
That’s when Lizette Lamb pulled her Springfield XDM 9mm pistol out of the center console. She didn’t point it, but she made sure they could see it.
The white pickup hit its brakes, threw a U-turn in a spray of dust and gravel, and headed back toward Grass Range.
The Video
“I thank God that it did happen to her and not somebody else, because I know my wife is more than capable of defending herself,” said Travis Lamb, an Iraq War combat veteran, who eventually reached out to Manley at the Ole Merc.
Then, when Manley reviewed the surveillance video from the Merc’s camera system, she found no sign of a white Ford truck.
“We have not found evidence of them at our store or at the three businesses that come along the highway right there,” Manley said. “That doesn’t mean it didn’t happen.
“My default is to absolutely believe women, and she (Lizette) was, she was rattled.”
Manley holds a Ph.D. in cognitive psychology and ran the research team at Procore Technologies before going into business for herself.
When reviewing the video, Manley logged the times Lizette arrived and left, and then watched the highway for an hour after.
“We’re absolutely not arguing the authenticity of the report in any way, shape or form,” said Manley. “In my previous life before I had the store, I actually was a memory and cognition researcher. I understand how stress impacts memory.”
The Echoes
Travis Lamb’s Facebook post went off like a flare.
He tallied 36 accounts of similar experiences in roughly the same swath of country stretching across prairie and badlands in one of the least populated parts of Montana.
The pattern in many of the comments was consistent enough to be unsettling: a white pickup, often a Ford, sometimes with out-of-state plates, tailgating women on isolated stretches of two-lane after dark.
One commenter described being followed by a white truck north of Grass Range three years ago around 10 p.m., tailgated with brights on at more than 80 mph until the truck peeled off in a different direction.
Another described a white Ford pickup near Harlowton trying to force her to stop, then waiting for her at a gas station. Another recalled a white pickup with North Dakota plates in the same area.
In Wyoming, one poster described two men in a white truck with Washington plates on Highway 120 between Cody and Meeteetse who tailgated her, tried to push her off the road, then cut in front and slammed on the brakes.
Other women described different vehicles — a dark Escalade, a small white car, a black double-cab — but the same script: tailgating, refusing to pass, brake-checking, dead zones with no cell service.
Easter Night
One name in that Facebook thread was Joni Hartford of Lewistown, who told Cowboy State Daily she had her own near-identical encounter on Easter evening just days before Lizette Lamb’s.
Hartford, who works in insurance, had dropped off some belongings to her son, a football player at Rocky Mountain College in Billings.
She stopped at a gas station on her way out of town “for a pop,” climbed back into her red 2014 Ford F-150 and headed north on Highway 87 around 7:30 or 8 p.m.
“I noticed it right after I left Billings,” Hartford said of the pickup behind her. “It was right behind me and I kept thinking, ‘God, this vehicle is super close.’”
About 15 miles out of town, past the racetracks, she pulled toward the white line and slowed to 60 mph on a long straightaway, hoping the truck would go around. It wouldn’t.
“He was so close behind me, I couldn’t see his taillights, but I could see his marker lamps on his mirrors, his tow mirrors,” Hartford said. “So I knew it was a Ford pickup, and I knew it was like a three-quarter or a 1-ton. It was a big pickup.”
She couldn’t make out the color in the dark. She called her husband.
“I said, ‘This pickup is tailgating me,’ and said, ‘It’s really kind of making me nervous, because if I had to stop for a deer, it would run me over. It would run me off the road,’” Hartford said.
“And he goes, ‘Well, just stop.’ And I said, ‘I am not stopping. I’m in the middle of freaking nowhere,’” she added.
She made it through Roundup with the truck still on her bumper.
North of town, climbing toward Grass Range, Hartford caught a lucky break with an Amish buggy sluggishly clapping up a blind hill and slowing traffic.
“I darted around the Amish buggy, right before the blind hill, and he couldn’t get around them, and I just gunned it, and I was going probably 90 mph just to put space between us,” Hartford said. “I never seen him again.”
Hartford carries a .380 pistol. She had it out and on the seat. She didn’t show it — between the dark and her tinted windows, she wasn’t sure the driver behind her would have seen it anyway.
When Lamb’s post crossed her Facebook feed, Hartford said the parallels stopped her cold.
“It’s the same exact situation,” she said. “I can’t say for certain it was the same person, but it sure seems like it was the same person.”
Hartford said she believes the driver is hunting for circumstance: single women, after dark, on a corridor he knows is desolate and short on cell coverage.
“They’re targeting them at gas stations,” she said. “That’s the only place they could have found me, because it’s the only place I’ve stopped.”
The Candidate
Penny Ronning, cofounder and president of the Yellowstone Human Trafficking Task Force, had a similar drive in 2022.
She remembers it as the only time in nearly a year of solo campaign travel across 41 Montana counties that she felt afraid.
Ronning, then a Democratic candidate for U.S. Congress, was driving from Billings to Havre for a campaign event.
Instead of taking the interstate, she chose the back roads — north out of Winifred on Highway 236, a route that runs about 30 miles of gravel through some of the most remote country in the state before dropping into the Missouri River Breaks, which Ronning compared to a Montana version of the Grand Canyon.
As she entered the gravel, a four-door white pickup with blacked-out windows pulled in behind her.
“That was what made it frightening,” Ronning said. “It was that I was followed.”
Ronning, who has spent years working on human trafficking policy and prevention, was careful to push back on the framing that has circulated on Facebook around the Lamb case — that the white-pickup encounters are likely abduction attempts tied to trafficking networks.
“Human trafficking is the use of force, fraud or coercion to compel a person into commercial sex acts or labor against their will,” Ronning said. “Just because someone is being followed, that doesn’t rise to the level of human trafficking.”
The most prevalent form of human trafficking in the United States, she said, is familial trafficking, one family member trafficking another.
In Montana, she said, labor trafficking is also common in construction, nail salons, illicit massage businesses, hospitality and domestic servitude in pockets of high-end real estate.
Sex trafficking almost always begins with someone the victim knows.
The Watch
Back in Grass Range, every white pickup that rolls past the four-corner blinking light is now turning heads.
Manley said her store has worked closely with the Fergus County Sheriff’s Office on past incidents, and her cameras are essentially a standing resource for investigators.
She also said the response on social media has dismayed her, commenters questioning whether these highway stalking incidents happened at all, or suggesting Grass Range itself isn’t safe.
She believes her store, and others like it in remote pockets of Montana, are informal refuges.
“We’ve all been there, whether it’s in a snowstorm or where we’re just uncomfortable driving like this where we’re just like, ‘Oh my gosh,’ you see the big lights and you’re like, there’s a beacon of safety, essentially,” Manley said.
She said that her eyes are open to potential threats along the isolated highways connecting Grass Range to the rest of the world.
“We know that it is a highway that has a reputation for, you know, trafficking, drug moving, all of those different things, and that’s why we are as diligent as we are,” said Manley. “We really care about the safety of our community, our employees, and our customers.”
Manley remains in contact with the Lambs.
“She told me, ‘I’m not going to quit looking,’” said Travis, explaining how Manley is arranging for the Lambs to review the footage themselves.
Travis figures that perhaps, “Instead of a white Ford, maybe it’s a tan Dodge.”
He added, “I’m hoping somebody’s like, ‘I know that pickup.’ That’s what I’m praying for.”
So is Lizette, who told Cowboy State Daily, she’s thankful for the response to her story. She’s also thankful she was traveling with her sidearm.
“Unfortunately, that’s the world we live in now. You know, Montana, in the middle of nowhere,” said Lizette, who encouraged anyone else with similar encounters to come forward.
“This is just a reminder that it is happening,” she said. “It is real.”
David Madison can be reached at david@cowboystatedaily.com.
Montana
Montana Lottery Powerball, Lotto America results for April 18, 2026
The Montana Lottery offers multiple draw games for those aiming to win big.
Here’s a look at April 18, 2026, results for each game:
Winning Powerball numbers from April 18 drawing
24-25-39-46-61, Powerball: 01, Power Play: 5
Check Powerball payouts and previous drawings here.
Winning Lotto America numbers from April 18 drawing
18-21-22-32-42, Star Ball: 10, ASB: 03
Check Lotto America payouts and previous drawings here.
Winning Big Sky Bonus numbers from April 18 drawing
10-16-29-31, Bonus: 13
Check Big Sky Bonus payouts and previous drawings here.
Winning Montana Cash numbers from April 18 drawing
06-08-09-20-22
Check Montana Cash payouts and previous drawings here.
Feeling lucky? Explore the latest lottery news & results
When are the Montana Lottery drawings held?
- Powerball: 8:59 p.m. MT on Monday, Wednesday, and Saturday.
- Mega Millions: 9 p.m. MT on Tuesday and Friday.
- Lucky For Life: 8:38 p.m. MT daily.
- Lotto America: 9 p.m. MT on Monday, Wednesday and Saturday.
- Big Sky Bonus: 7:30 p.m. MT daily.
- Powerball Double Play: 8:59 p.m. MT on Monday, Wednesday, and Saturday.
- Montana Cash: 8 p.m. MT on Wednesday and Saturday.
- Millionaire for Life: 9:15 p.m. MT daily.
Missed a draw? Peek at the past week’s winning numbers.
This results page was generated automatically using information from TinBu and a template written and reviewed by a Great Falls Tribune editor. You can send feedback using this form.
Montana
Between Bozeman And Billings Is Montana’s One-Of-A-Kind Historic Mill Filled With Cheese – Islands
Montana may be well known as a top destination for nature enthusiasts and adventure seekers thanks to its outdoor activities like hiking and paddling, but there are some unique foodie gems to be found here, too. One of the best ways to experience Montana’s local food scene is with a visit to Greycliff Mill, between Bozeman and Billings. Here, you can discover a one-of-a-kind cheese attraction along with a number of other things to see on site during your visit to Big Sky Country.
Greycliff Mill is housed in a restored 1760s barn, which features a water-powered gristmill and pretty scenery like ponds framed by rock formations. You may see bison wandering the site — there are five that live here. You may also catch a glimpse of a 10-foot-tall bear, but no need to panic as it’s only a statue, carved by a chainsaw. The pretty cafe, a mix of modern and rustic decor, serves from a menu that includes coffee, milkshakes, and pastries, plus paninis like “The Cattleman” and breakfast sandwiches like the “Sheepherders Sandwich.” Book in advance for a special farm-to-table dinner in the evening — these are only offered on select dates throughout the year, and may sell out. But one thing you shouldn’t miss here is the cheese cave.
Discover Greycliff Mill’s cheese cave
Greycliff Mill has an underground cheese cave, which is a must-see on any visit. It’s possible to see experts making artisan cheeses while you learn about the cheesemaking process and sample a few products. The cheese is aged in the cave at a temperature of 50 degrees with 85% humidity to create the perfect environment for a tasty product. It’s possible to buy some cheese at their market — which also sells seasonal produce, bread, and lots of other Montana-made products.
Besides the food-based spots, Greycliff Mill is also home to a small wool-weaving studio, and there are accommodations if you want to spend the night in restored log cabins or reclaimed farm silos. Greycliff Creek Ranch offers horseback rides and a chuckwagon dinner for more authentic Montana experiences. Whether you’re visiting especially to see the cheese cave, or road tripping and need a break, Greycliff Mill is a quirky and special spot. One Google reviewer summed up the experience well, praising the “amazing rustic atmosphere,” and saying, “I stopped for a coffee and ended up staying just to enjoy the view. Great coffee, peaceful place, and such a unique spot. Definitely worth the stop if you’re driving through Montana.”
Greycliff Mill is between Bozeman and Billings, the largest city in Montana and surrounded by natural beauty. It’s almost equidistant between the two cities — 1 hour to Bozeman and 1 hour to Billings. The closest major airport is Billings-Logan International Airport, although Bozeman Yellowstone International Airport, Montana’s mountain gem of an airport, is also a convenient option.
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