Why We Said No: Our Decision on the Memorial Hospital of Converse County Loan Request

The Natrona Collective Health Trust was founded on a commitment to strengthening health and well-being across Natrona County — and that commitment requires us to make difficult decisions with care, transparency, and fidelity to the agreements that govern our work. On Feb. 20, 2026, we formally declined a $29.2 million loan request from Memorial Hospital of Converse County (MHCC). Our community deserves a clear explanation of why.

The Request

MHCC sought financing from the Trust to support their proposed acquisition of Summit Medical Center in Natrona County. We reviewed their application materials in full and consulted with legal counsel before reaching our decision.

A Binding Contractual Obligation
We operate under governing agreements that carry real legal weight. One of those agreements — which defines our relationship with Banner WMC — expressly prohibits us from providing monetary support to a healthcare provider that competes in the same geographic market as Banner WMC, unless a narrowly defined exception applies.

Our review determined that approving this loan would result in direct overlap in core clinical services within Natrona County, constituting support to a competing provider under the terms of the agreement. We also carefully evaluated whether any exceptions applied — including non-competing services related to behavioral health or care primarily directed to medically underserved or indigent populations. The request did not meet the criteria for any permissible exception.

As fiduciaries, we are bound by the agreements that govern our work. We do not have discretion to approve a transaction that would place the Trust in direct violation of its contractual obligations.

— Eric Nelson, Chairman, Natrona Collective Health Trust Board of Directors

The Broader Healthcare System at Stake

Beyond our legal obligations, we evaluated what this transaction could mean for healthcare in Natrona County at a system level. Rural healthcare markets operate with limited patient volume, constrained workforce capacity, and financial structures that depend on stability across the entire system. Duplicating core hospital services in such a market can fragment patient volume, strain staffing, and put essential services at risk — particularly those serving uninsured and underinsured residents.

Banner WMC is Wyoming’s only Level II trauma center and the region’s primary referral hospital, providing 24-hour access to general surgery, orthopedics, neurosurgery, anesthesiology, emergency medicine, and critical care. These are not just institutional assets — they are community assets that draw patients and providers from across the state and anchor our local healthcare economy.

When patient volume, reimbursement, or workforce stability is eroded in ways that weaken these core services, the consequences are not just institutional — they are medical and economic for Natrona County as a whole.

— Eric Nelson, Chairman, Natrona Collective Health Trust Board of Directors

We also weighed the financial scale of the request. A loan of $29.2 million would significantly limit our capacity to continue community investments that address barriers to care, support prevention efforts, and direct resources to vulnerable populations across Natrona County.

Our Commitment Going Forward

This decision was not made lightly. We recognize the genuine challenges facing healthcare providers in our region, and we remain open to future proposals that are consistent with our governing agreements and that clearly advance care for underserved populations or address unmet community health needs.

Our decision is about honoring the agreements that guide our work and about protecting a resilient healthcare system that serves all residents equitably. We have a responsibility to ensure that the healthcare system in Natrona County remains strong, stable, and sustainable for the long term.

— Eric Nelson, Chairman, Natrona Collective Health Trust Board of Directors

We conveyed our decision directly to the Board of Directors of Memorial Hospital of Converse County and the Board of County Commissioners of Natrona County on Feb. 20, 2026.