Landmark Hospital of Cape Girardeau Announces Closure Due to Unsustainable Healthcare Market Conditions

Cape Girardeau, MO – September 10, 2025 – It is with deep regret that Landmark Hospital of Cape Girardeau announces the closure of its facility in the coming weeks. Current patients will be discharged or transferred to appropriate clinical settings based on their individual care needs, ensuring continuity and quality of care during this transition.

Since opening in February 2006, Landmark Hospital of Cape Girardeau has been a stalwart provider of specialized hospital services in Missouri. As a long-term acute care hospital (LTACH), it has offered extended care for medically complex patients beyond initial stays in short-term acute facilities. The hospital has served as a major employer and reliable healthcare resource, drawing patients from regions including southern Kansas, Oklahoma, St. Louis, and surrounding communities, with primary referrals from local hospitals such as St. Francis and Mercy Southeast.

Regrettably, closure is unavoidable due to insufficient qualifying patient volumes in the current U.S. healthcare environment. Small and rural markets like Cape Girardeau are particularly vulnerable, with specialty hospitals facing reduced referrals from local facilities amid broader industry challenges. The key factors contributing to this decision include:

1. Reinstatement of Medicare Admission Criteria Post-Public Health Emergency (PHE): Following the PHE's end in May 2023, the Centers for Medicare & Medicaid Services (CMS) reinstated stricter LTACH admission requirements that had been waived during the pandemic. This includes the prerequisite of at least three midnights in a critical care unit at a short-term acute care hospital for patients to qualify for full LTACH reimbursement, disqualifying many previously eligible cases, such as those involving severe wounds. This change, driven by efforts to control Medicare spending rather than clinical needs, has limited patient access to LTACH services. Landmark has advocated vigorously for legislative relief through industry groups and direct engagement with Congress, but proposed bills to restore broader eligibility have not passed, introducing ongoing uncertainty.
   

2. Growth of Medicare Advantage Plans: A significant shift is underway, with many seniors opting for privatized Medicare Advantage plans from insurers like UnitedHealthcare and Humana for potentially lower out-of-pocket costs. These plans apply distinct screening and preauthorization criteria, often denying LTACH admissions that would be approved under traditional Medicare, further reducing patient inflows.
   

3. Patient Outward Migration: Despite strong local physicians, many Cape Girardeau residents seek initial care in larger markets like St. Louis. Repatriating these patients for post-acute care is increasingly difficult, compounded by Medicare Advantage preauthorization requirements and regional healthcare dynamics.

4. Escalating Operational Costs: Inflation has driven up expenses for labor, supplies, and contracted services, while Medicare and insurance reimbursements have failed to keep pace. Despite rigorous cost controls, these imbalances have resulted in unsustainable daily financial losses.

Collectively, these factors prevent the hospital from maintaining the patient census and financial viability needed to uphold its renowned quality of care. The Cape Girardeau market is simply too constrained to sustain an LTACH under prevailing conditions. Patients and families can continue to access LTACH services at Landmark Hospital of Columbia, though we acknowledge the inconvenience of additional travel.

We extend profound thanks to the Cape Girardeau community, our exceptional employees, physicians, and partners for their unwavering support over nearly two decades. Landmark Hospital has been a pillar of healing and compassion, and we are committed to supporting staff through this transition. For future long-term acute care needs, we encourage consideration of our Columbia facility.

About Landmark Hospitals: Landmark Hospitals specialize in long-term acute care for medically complex patients, leveraging advanced technology and innovative management to deliver high-quality outcomes.