Lifepoint Health closes pediatric critical care unit in Missoula

A pediatric intensive care unit at Community Medical Center in Missoula, Montana, closed this month, removing a local option for the state's most critically ill children.

The hospital, owned by for-profit Lifepoint Health, is not operating alone in this shift. A recent analysis of pediatric inpatient units found that the number of hospitals offering overnight care for children dropped from 1,749 in 2008 to 1,226 in 2022. That represents a decline of nearly 30 percent. As a result, three-quarters of the hospitals in the study no longer provide any pediatric inpatient services.

Hospitals cite low patient volumes as the primary driver for these closures. Greg Cook, the CEO of Community Medical Center, stated that the unit saw an average of two children per month requiring intensive care when the decision was made. He estimated the closure will impact approximately 25 patients annually. The next closest pediatric intensive care unit in Montana is in Kalispell, located about 150 miles north.

Elizabeth Mack, a pediatric critical care doctor and spokesperson for the American Academy of Pediatrics, described the decision-making process as a financial calculation. She noted that treating children often costs hospitals more due to specialized equipment and lower reimbursement rates compared to adult care. "This is a very pricey endeavor, and it's not sustainable," Mack said.

The financial pressure is compounded by staffing shortages. Cook said the hospital has been unable to recruit a local pediatric critical care doctor since the last one retired eight years ago. Specialists now fly in on rotations to treat patients. The hospital will continue to accept most sick children but will stabilize the most critical cases before transferring them to other facilities.

In a statement, hospital spokesperson Megan Condra said the decision was driven by low patient volumes and long-standing staffing challenges. She clarified that the move was not driven by concerns about the quality of care currently being provided.

Similar closures have occurred in Oregon, Missouri, Illinois, and California. St. Vincent Medical Center in Portland, Oregon, closed its four-bed pediatric intensive care unit last November. Lisa Helderop, a spokesperson for the hospital, said the unit was often empty. St. Vincent is part of Providence, a nonprofit health system that reported a $15 million shortfall in Oregon as of 2024.

Federal funding changes are adding to the financial strain. The Trump administration has added administrative hurdles to Medicaid, a program that covers about half of the nation's children through Medicaid or the Children's Health Insurance Program. Public aid researchers warn that increased paperwork can lead to coverage lapses, reducing hospital revenue.

Kenneth Michelson, lead author of the study on declining pediatric units and director of emergency medicine research at Lurie Children's Hospital, said the disappearance of critical services ripples into routine care. He noted that the number of hospitals performing pediatric appendectomies decreased by more than half from 2003 to 2022.

Lauren Wilson, a pediatrician at Community Medical Center, said the hospital will maintain an intensive care unit for newborns and continue to provide emergency treatment and surgeries. She stated that the hospital remains the place she would take her child if they were sick.

Raj Basu, division chief of critical care medicine at Ann and Robert H. Lurie Children's Hospital of Chicago, said regional hubs are exploring solutions such as regional training protocols and specialized centers. He noted that doctors worry patients will deteriorate during the long transfer times to these hubs.