Joy Coulston was handling massive multi million dollar accounts for lumber companies working in Cour d’ Alene, Idaho and in Laramie.

Then a nephew she cared for was involved in a bad wreck.

“And after seeing what happened with him, and the amazing treatment that he had, I wanted to switch professions,” she said.

She decided she couldn’t switch fields and become a nurse, but she could switch to health care and help in the field she knew well: finance.

“It was a good transition and I don’t regret it for a second,” she said.

So, 17 years ago the Dubois native became a comptroller at Iverson Memorial Hospital. From there she went to Riverton and, 10 years ago became comptroller at Powell Valley Healthcare, and five years later she ascended to the chief financial officer position.

On July 10 she’ll move over to the top leadership position after being approved by the majority of Powell Valley Hospital District as CEO on June 7. She said she applied for the position in the first round of searching for a new CEO, held off during the second round and then put her name back in the hat for Round 3.

“I really believe in this place. And I've been here for 10 years now,” she said. “And so I just wanted it to continue forward progress that we've been making for the last four or five years — it has been amazing to see and be part of and I just wanted it to continue.”

Now she’ll get her chance at the helm, and she’ll be able to draw on her experience within and outside of the health care field, while relying on those around her who she said make Powell’s hospital such an important institution.

“I'm just really appreciative of our staff, of everything,” Coulston said. “I hope people understand how amazing our providers are. We've got some incredible providers for the little town of Powell. I mean, it’s amazing. Our staff, our nurses are incredible. It's just a unique place. It’s by far the best place I’ve worked.”

Her goals are to continue on the work accomplished by outgoing CEO Terry Odom and use her financial skills to try and improve the affordability of health care, such as she recently did with the new Car Payment program that helps self pay or high deductible patients pay for procedures using no interest installment plans.

She said she also wants to work with the other hospitals in the region so they can together provide the kind of care that can keep patients from having to go to Billings as often.

“Everybody is trying to do the same thing. If you can kind of spread that around and figure out who does what best and make sure you provide what you can for the community at an affordable cost,” Coulston said. “That'll be the challenge for the future. How to keep the cost of care down and still have staff.”

She said as far as financials go, it’s important that hospital staff are working with patients so that they know ahead of time at least an estimate of what the final bills will look like.

Coulston also said she wants to continue the push toward publicizing better all of the services the hospital has to offer.

“We have some amazing services and I think people don't always know about them,” she said. “Our OB department is amazing. I mean, our OB providers, we have a nurse midwife program. Even our patient financial services. We have a menu to help people understand what the costs are and know how best to deal with that. We just want more people to understand that we do those things … we want to continue to provide what the community needs. Our oncology program and hematology program. Dr. (Carletta) Collins is amazing — because of her we put in the infusion center. So now people on chemo don't have to drive to Billings or somewhere else. They can do it right here. And when you're not feeling well, you don't want to drive somewhere.”

Coulston said no one hospital, especially in a smaller area, can be everything to everybody. Her and her leadership team’s goal, she said, will be to continue working to provide the best services they can for the Powell community, and help those who need to go elsewhere.