Children’s hospital beds vanish as closures push families across the nation farther from care

Closures deepen rural care gaps

Hospitals have shut pediatric intensive care units in Montana, Oregon and Missouri over the past year. Overnight hospital wings for children have also closed in Illinois and California. Rural communities are especially exposed as cutbacks affect community hospitals of different sizes and ownership types.

Elizabeth Mack, a pediatric critical care doctor and American Academy of Pediatrics spokesperson, said families cannot be expected to manage when the nearest children’s hospital is a flight or an eight-hour drive away. Many seriously ill children already travel long distances for treatment.

A Montana family’s experience

In 2022, Darby Waldbillig’s nearly 2-year-old daughter, Siobhan, became difficult to wake. The family’s closest pediatric critical care option was in Missoula, about 100 miles from their home in Helena, requiring an emergency flight.

Siobhan had bacterial meningitis, a life-threatening infection that causes swelling around the brain and spinal cord. After local emergency workers began antibiotics, she was transferred to Community Medical Center and spent more than a week in its pediatric intensive care unit. That unit closed this month.

Cook said the hospital chose to care for children whose needs it could meet. Hospital spokesperson Megan Condra later said the closure stemmed from low patient volumes and long-standing staffing challenges, not concerns about the quality of current care. Cook estimated about 25 patients a year would be affected; the next in-state pediatric intensive care unit is in Kalispell, about 150 miles north of Missoula.

Why hospitals cite low volumes

St. Vincent Medical Center also pointed to low patient numbers rather than finances when explaining its unit’s closure. Spokesperson Lisa Helderop said its four-bed unit was often empty.

Pediatricians cite low numbers of children treated at some community hospitals, a declining U.S. birth rate and improved diagnosis and treatment. Vaccines have reduced some once-common hospitalizations, while more children now survive complex illnesses. Basu said children needing critical care may arrive with more complicated conditions, though he said there is not yet enough data to confirm that trend.

Medicaid changes add pressure

Researchers and organizations warn that federal Medicaid spending cuts could widen care gaps. The Trump administration has added administrative hurdles and narrowed eligibility, while about half of the nation’s children receive coverage through Medicaid or the related Children’s Health Insurance Program. Researchers have said children can lose coverage when caregivers struggle with paperwork.

Lower Medicaid enrollment among adults and children would also reduce hospital revenue. Mack described pediatric critical care as costly and said it was not sustainable without a clear solution. Kenneth Michelson, a researcher at Lurie Children’s Hospital, said options include more federal support for low-access areas and higher Medicaid reimbursement rates.

Michelson said pediatric care capacity should not be treated like an ordinary consumer good, calling it a national necessity because children’s lives are at stake. The article ends mid-sentence after warning that regional centers could be overwhelmed, so it provides no further detail.