SHERIDAN — The air ambulance company that operated a helicopter out of Sheridan Memorial Hospital discontinued service in November, stating that maintenance of the local service was financially unsustainable.

Medical Air Rescue Company CEO Steve Dale, whose South Dakota-based company began running an air ambulance from SMH in early 2019, said the high cost of maintaining the service combined with infrequent demand forced MARC to make the business decision.

“We would have loved to serve the community and we wished it would have worked, but honestly we’re a for-profit company,” Dale said. “And if we don’t make a profit, we can’t survive.”

MARC was responsible for all costs attached to running the service, SMH just served as a base of operations.

The factors that hurt the financial viability of MARC’s local service are not unique to Sheridan, Dale said. Wyoming and many surrounding states have small populations that do not generate enough demand to support helicopters as air ambulances. Because of that reality, Dale said the company has laid off all of its helicopter pilots and returned its helicopters to the company from which they were leased.

“In the Midwest, with smaller towns and the distances between towns, fixed-wing aircraft work better,” Dale said.

SMH Chief Operating Officer Nyle Morgan said the loss of MARC’s service is disappointing, but noted the hospital has functioned without an air ambulance for long stretches before.

“When you look at the past 10 years or 12 years, the hospital has only had an air ambulance for two of them,” Morgan said.

Air Methods operated a helicopter out of SMH before MARC and ended its service in 2018, also due to cost concerns.

Without MARC’s service, Morgan said SMH will return to relying on air ambulances from Billings Clinic. He estimated those flights would take 30 minutes, weather depending, to reach SMH. While every minute is crucial in an emergency situation, Morgan said patients have to be stabilized before being loaded into an air ambulance and doctors would spend most of the time it would take a helicopter to reach Sheridan stabilizing the patient.

Whether another company comes in to replace MARC is unclear at this point, Morgan said. But considering the short tenures of SMH’s previous air ambulance operators, he said, for the sake of consistency, the hospital will be wary about hosting another service.

“We certainly aren’t going to just turn our backs on it and say, ‘no,’” Morgan said. “But I think it would have to be someone who had a little more financial stability, someone out of a bigger operation.”

He added, though, that the area’s low population density is always going to pose a financial challenge to air ambulance operators and it’s unclear whether any company can overcome that obstacle.