Missoula Hospital Closes Pediatric ICU, Joining National Trend

Families in Missoula, Montana, now face a longer journey for their children’s most serious medical emergencies. Community Medical Center closed its four-bed pediatric intensive care unit this month. The hospital will continue to treat stable children, but those requiring ventilators or continuous seizure monitoring will be stabilized and then transferred to a regional hub. The next-closest pediatric intensive care unit is in Kalispell, located about 150 miles to the north. This local change mirrors a nationwide pattern where hospitals are shutting down units dedicated to critically ill children.

Greg Cook, the hospital’s chief executive officer, stated the decision was based on low patient volumes rather than a lack of funding. He noted that the hospital has struggled to recruit local pediatric critical care doctors since the last specialist retired eight years ago. Specialists have flown in on rotations to cover the unit. Cook estimated the closure will affect roughly 25 patients per year. He said, 'We made the decision to take care of the kids that we could absolutely take care of. It’s about quality more than it is about the dollars.'

A recent analysis found that pediatric inpatient units, which provide overnight care, decreased by nearly 30 percent between 2008 and 2022. The number of hospitals offering these services dropped from 1,749 to 1,226. This leaves three-quarters of U.S. hospitals without pediatric inpatient services. Similar closures occurred in the past year in Oregon, Missouri, Illinois, and California. Hospitals often convert these beds to serve newborns or adults, citing cost pressures and the specialized nature of pediatric care.

Elizabeth Mack, a pediatric critical care doctor and spokesperson for the American Academy of Pediatrics, described the trend as a financial calculation. 'This is a very pricey endeavor, and it’s not sustainable,' Mack said. 'There’s not a great answer here.' Hospitals often charge less for pediatric care than adult care. Additionally, pediatric subspecialists generally earn less than their adult-focused counterparts, making recruitment difficult in rural areas.

The closure impacts families like Darby Waldbillig’s. In 2022, her daughter Siobhan, who was nearly two years old, suffered from bacterial meningitis. The family lived in Helena and had to fly 100 miles to Missoula for critical care. Siobhan spent more than a week in the unit that no longer exists. Waldbillig said, 'I firmly believe it’s because of those doctors that she lived.'

Community Medical Center is owned by Lifepoint Health, a for-profit company with over $10 billion in annual revenue. CEO Greg Cook said leaders consulted with Lifepoint before downgrading the unit. A hospital spokesperson, Megan Condra, clarified in an email that the decision was not driven by concerns about current care quality. She cited staffing challenges and low patient counts as the primary factors.

The hospital will maintain other pediatric services, including an intensive care unit for newborns, emergency treatment, and surgeons. Lauren Wilson, a local pediatrician, said she would still take her child there if they were sick. She noted that local doctors can consult with distant specialists to stabilize and transfer patients when necessary.