article by Stephanie Hobby | photo courtesy of Nichole Mehling

Since its inception in 1911, Billings Clinic has steadfastly served the region’s healthcare needs. In the past four decades, a dedicated team has worked alongside the Clinic and the community to fuel lifesaving work.

The Billings Clinic Foundation was established in 1984, and since then, the not-for-profit has provided vital support to the Clinic through philanthropic donations. Over the years, it has gifted over $125 million to its major priorities: infrastructure, facilities, and advanced medical equipment; supporting department programs, including patient aid, patient housing, and an employee crisis fund; education through medical training and scholarships; and other special projects that advance innovative healthcare in the region.

“The Foundation has been at the forefront of helping to elevate healthcare in Billings,” said Billings Clinic CEO Dr. Clint Seger. “I challenge anyone to try and find an aspect of complex care here that didn’t involve the Foundation’s efforts.”

In recent years, those efforts have paved the way to Billings Clinic’s designation as Montana’s first Comprehensive Stroke Center, the highest level of stroke center certification a hospital can receive, and being named the state’s first HeartCARE Center of Excellence by the American College of Cardiology. The Clinic is the only hospital in Montana and Wyoming with such distinctions.

In August 2023, after the largest campaign in the Clinic’s history, the Foundation broke its $30 million fundraising goal to launch the first Level One Trauma Center in Montana. The Clinic offers the region’s first extracorporeal membrane oxygenation, or ECMO, technology, which provides lifesaving state-of-the- art cardiac and respiratory support for critically ill patients, and last year, pioneered a mobile ECMO program for patients in transit to Billings. Additionally, the Foundation helped to purchase a new airplane for the MedFlight program, which extends emergency healthcare to the most remote parts of the region.

“We are Montana-basedand Montana-governed, and we have a commitment to rural healthcare and building this network across rural and frontier communities,” said former Foundation President Jim Duncan. For the past 30 years, Duncan has been integral to shaping and expanding the healthcare landscape of Montana. When Duncan started, the Foundation had $3 million in assets. Today, it has over $160 million, much of which is endowed, to start and sustain critically important programs.

Last summer, he announced that he would retire in July 2025. Within months, Nichole Mehling was named to the role, and assumed the presidency on January 1. Mehling has been part of the Clinic for four years and with the Foundation for the past three, and according to Duncan, is a natural fit for the role.

“You just really see her commitment to community. She has served on multiple boards, she’s been the chair of the Billings Chamber of Commerce, she serves on the board of one of our critical access hospitals in her hometown of Hardin,” Duncan said. “Nichole has an incredible work ethic and she is so genuine in her relationships with people. She is really engaging in terms of asking people, ‘What do you think? What do you need? How can we make it work?’ It’s been a gift that we were able to have this transition with somebody who has been on the team who has really embraced the work at hand.”

A  fifth generation Montanan, Mehling is well- versed in the challenges of rural healthcare, and is passionate about expanding access to underserved communities. For her, it’s deeply personal. As a child, Mehling’s older brother faced an orthopedic issue that required regular out-of-state care, and she saw firsthand how traveling for complex care compounded an already emotional and stressful situation for her family.

“The thing I really value about the Clinic is our commitment to community, and being a girl from Hardin who grew up on a farm and ranch and really caring about our rural neighbors, I see how much investment and support we provide to other critical access hospitals around the state, and our commitment to growing rural healthcare."

-Nichole Mehling

So, after working as a fourth-grade teacher and then in hotel management, Mehling says she felt like she had finally come home when she signed on with Billings Clinic. I really felt like that was a mission and purpose that I could get behind,” Mehling said.

Currently, the Foundation is supporting the Clinic as it focuses on three major projects: building the state’s first dedicated Surgical Intensive Care Unit (SICU), where critically ill patients receive advanced bedside care with specialized equipment; a new neonatal intensive care unit (NICU), which will open this spring; and developing a new transfer center to streamline the transfer process when a patient from a smaller hospital needs a higher level of care than the Clinic can provide.

Looking to the future, Mehling’s vision is to continue strengthening rural healthcare by constructing a philanthropy network, equipping smaller affiliated hospitals with the tools and resources needed to grow their systems and bolster access to medical coverage in Montana and Wyoming. “If you think about the financial difficulties in being able to maintain a smaller hospital and keep the doors open, it’s troubling,” Mehling said. “It’s been really neat for me to see the value that Billings Clinic brings to the table for those affiliates, things like IT support, contract negotiations, labor coverage, and fundraising.”

Mehling says it is an honor to partner with the community and hospital, emphasizing that relationships are at the heart of everything they have accomplished. “If you think about the success of the Foundation and how much this community has embraced healthcare, it’s pretty remarkable,” she said. “I feel like I am stepping in at a good time.”

Originally printed in the April 2025 issue of Simply Local Magazine

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