Missoula parents face long drives as local pediatric ICU closes
Community Medical Center ends its critical care unit for children, citing low patient volumes and staffing shortages.
By Carlos Rousseau ·
A 100-mile emergency flight from Helena to Missoula was the only way to reach a pediatric intensive care unit for Siobhan Waldbillig in 2022. The toddler had bacterial meningitis and required a ventilator. She spent more than a week in the unit at Community Medical Center. That specific unit closed this month.
Greg Cook, the hospital's CEO, stated the closure was driven by low patient volumes and staffing challenges. The hospital averages about two children a month who need intensive care. Cook said the decision prioritized quality over financial considerations. "We made the decision to take care of the kids that we could absolutely take care of," Cook said. The hospital will stabilize critical patients before transferring them to Kalispell, the next closest pediatric ICU in Montana, roughly 150 miles north.
The closure reflects a national trend. An analysis of pediatric inpatient units found a drop of nearly 30 percent from 2008 to 2022. The number of hospitals with these wings fell from 1,749 to 1,226. This leaves three-quarters of hospitals without pediatric inpatient services. Elizabeth Mack, a pediatric critical care doctor and spokesperson for the American Academy of Pediatrics, described the situation as a spreadsheet issue. "This is a very pricey endeavor, and it's not sustainable," Mack said.
Hospitals often convert pediatric beds to newborn or adult services to cut costs. Pediatric subspecialists are scarce and earn less than adult-focused doctors. Hospitals also receive lower reimbursement for treating children. Raj Basu, division chief of critical care medicine at Lurie Children's Hospital of Chicago, noted that medical hubs now concentrate care. He expressed concern that children are arriving at these hubs in sicker conditions due to the time spent traveling. "I don't know that we have enough data yet to prove that," Basu said.
Community Medical Center is owned by Lifepoint Health, a for-profit system with revenue exceeding $10 billion annually. Cook said Lifepoint did not float the program to solve the staffing issue. In Portland, Oregon, St. Vincent Medical Center closed its four-bed pediatric ICU last November. Spokesperson Lisa Helderop said the unit was often empty. Providence, the nonprofit parent organization, reported a $15 million shortfall in Oregon as of 2024.
Federal policy changes may widen the gap. The Trump administration has added administrative hurdles to Medicaid, which covers about half of the nation's children. Public aid researchers warn that paperwork burdens can lead to lost coverage. Kenneth Michelson, lead author of the study on declining pediatric units, said this service is a national necessity. He noted that the number of hospitals performing pediatric appendectomies dropped by more than half from 2003 to 2022.
Local pediatrician Lauren Wilson at Community Medical Center said the hospital retains newborn ICU, emergency treatment, and surgeons. She stated that the facility remains her choice for sick children. "This is still the place I would take my child if they were sick and I was worried," Wilson said.
