Lifepoint Health Ends Pediatric ICU in Missoula as National Unit Closures Accelerate

Darby Waldbillig remembers the 100-mile emergency flight from Helena to Missoula in 2022, a journey made necessary when her toddler daughter needed treatment for bacterial meningitis. That flight ended at Community Medical Center, a facility that this month closed its pediatric intensive care unit. The closure marks the latest in a series of reductions that have forced families across the United States to travel farther for life-saving treatment for their children.

A recent analysis found that pediatric inpatient units decreased by nearly 30 percent between 2008 and 2022. The number of hospitals offering these overnight services fell from 1,749 to 1,226. This shift means three-quarters of hospitals no longer provide pediatric inpatient services. Closures occurred in Montana, Oregon, and Missouri over the past year, while overnight wings in Illinois and California also shut down. Hospitals are converting these beds into services for newborns or adults to manage costs.

Greg Cook, the CEO of Community Medical Center, stated the decision was driven by low patient volumes and staffing challenges. The hospital has been unable to recruit pediatric critical care doctors to live locally since the last one retired eight years ago. Specialists previously flew in on rotations. Cook estimated the unit handled approximately two children requiring intensive care per month. He projected the closure will impact roughly 25 patients annually. The next closest pediatric intensive care unit in Montana is in Kalispell, about 150 miles north.

Megan Condra, a hospital spokesperson, clarified in an email that the decision was not driven by concerns about the quality of current care. She cited the long-standing difficulty in finding staff. Elizabeth Mack, a pediatric critical care doctor and spokesperson for the American Academy of Pediatrics, described the issue as a "spreadsheet issue." She noted that pediatric subspecialists often earn less than those treating adults, and hospitals are paid less for child care. Buying specialized equipment for children also adds to expenses.

The financial pressure is compounded by changes in federal Medicaid spending. The Trump administration added administrative hurdles to accessing low-cost health coverage and narrowed eligibility requirements. Approximately half of the nation's children are covered by Medicaid or the Children's Health Insurance Program. Public aid researchers warn that when caretakers face paperwork complications, children can lose coverage. Fewer enrollments translate to a direct financial hit for hospitals relying on those payments.

Raj Basu, division chief of critical care medicine at the Ann and Robert H. Lurie Children's Hospital of Chicago, said medical hubs are exploring solutions like regional training centers and protocols. Kenneth Michelson, lead author of the study on declining units, suggested securing more federal funding and raising Medicaid reimbursement rates. He noted that the number of hospitals performing pediatric appendectomies decreased by more than half between 2003 and 2022. Michelson warned that small community emergency departments may again have to call multiple hospitals to find a bed for a critical patient.