Children in South Florida are being taken across county lines or flown to other states for specialized medical care they can’t get close to home.
A plan to consolidate medical pediatric treatment in South Florida, though, could result in the creation of a giant children’s hospital system providing specialized care currently available only in other states. Still, the idea has caused some friction among doctors.
Leaders at Nicklaus Children’s Health System, Joe DiMaggo Children’s Hospital, and Broward Health say they want to develop a large health system similar to Children’s Healthcare of Atlanta that provides medical care to infants, children, teens, and young adults.
“I want children in the community to have the best specialty care accessible to them anywhere they are,” said Caitlin Beck Stella, CEO of Joe DiMaggio Children’s Hospital in Hollywood. “We look at the future and we’re talking about a bigger picture for children’s health, so a Children’s Hospital of Florida, concept. That is the right model. That’s the model that’s been established around the country.”
The changing dynamics
The first step toward this model is underway: Nicklaus Children’s Hospital in Miami is crossing the county line in a significant way to partner with Broward Health, the public health system in northern Broward County. As part of a recently approved affiliation agreement, Nicklaus Children’s Health System is set to become the pediatric provider of Broward Health’s Salah Foundation Children’s Hospital. Salah occupies two floors in the Broward Health Medical Center in Fort Lauderdale and also offers services through Broward Health Coral Springs.
Miami’s Nicklaus has had a small presence in Broward for 27 years. However, by the end of the year, Nicklaus doctors will treat all children at Broward Health’s flagship Fort Lauderdale hospital, follow up in nearby medical offices, and treat newborns in the neonatal intensive care unit.
Joe DiMaggio in South Broward and Salah in North Broward are part of taxpayer-funded health systems and must treat all patients regardless of their ability to pay. Nicklaus, a nonprofit in Miami, is South Florida’s only standalone children’s hospital and is funded mainly through donations.
Nicklaus Children’s Health president and CEO Matthew Love said his pediatric staff at Broward Health will work and live in Broward County, rather than travel from Miami. Its doctors will add manpower so families don’t have to drive to Miami, or endure long wait times to see a pediatric neurologist or ear, nose and throat specialist as many now do, he said. “We’re already looking at establishing a very large additional outpatient location in Northern Broward,” Love said.
“This is about how we help northern Broward have great pediatric services,” he said. “Joe DiMaggio is a good organization, but the breadth, depth, and scope of services at Nicklaus are larger. We are four times the size of Joe DiMaggio by most metrics.”
Love, like Stella, sees a future where South Florida’s children’s hospitals join to care for pediatric patients. Together, they would attract coveted pediatric specialists to the region, train new doctors, cut back on wait times for pediatric appointments, and provide complex medical care to the more than 750,000 children who live in the tri-county area.
“I do have a vision of a pediatric healthcare delivery system that rivals others across the country,” Love said. “We in Florida deserve it. Our kids deserve it. We don’t want people leaving Broward or Palm Beach or Miami-Dade and having to go to the northeast to get their pediatric health care.
“Our goal is to grow across South Florida, to create Children’s Hospital of Florida, whatever you want to call it … so that no kid has to leave Florida,” he said.
The example local hospital leaders point out is Children’s Healthcare of Atlanta, a consortium of three children’s hospitals. CHOA is considered the largest healthcare provider for children in Georgia, offering more than 60 pediatric specialties and providing children access to 2,300 physicians.
Some Joe DiMaggio doctors feel slighted
While local CEOs may have that vision, some Joe DiMaggio staff view the situation differently.
Memorial Healthcare, the parent of Joe DiMaggio, is currently collaborating with Broward Health under a single interim CEO, Shane Strum; some staff at Memorial who are chafing under Strum’s leadership are wondering why he would partner with a competing children’s hospital. “There’s a core, vocal group who are unhappy with the situation,” said a Joe DiMaggio doctor who asked not to be named.
For decades, Joe DiMaggio Children’s Hospital has been the premier destination for pediatric care in Broward County, treating children for a wide range of conditions, from gunshot wounds and organ transplants to broken bones or severe infections. Located next to Memorial Regional in Hollywood, Joe DiMaggio has built its reputation and pediatric specialties over three decades. In the last two years, Joe DiMaggio expanded from four floors to eight, adding new technology and pediatric ICU rooms. It also recently added a pediatric cardiology group.
Strum, CEO of Broward Health since 2021, became the interim CEO of Memorial Healthcare System in September 2024. In his short tenure, Strum has restructured departments at Memorial, fired staff and demoted department leaders. A half-dozen Joe DiMaggio employees told the South Florida Sun Sentinel they are angry that the only two options for physicians to work at a children’s hospital in Broward now fall under the same CEO. They asked not to be named and said they fear for the future of Joe DiMaggio Children’s Hospital.
“It is only a matter of time before Nicklaus assumes control of Joe DiMaggio,” someone who identified themself as a Memorial doctor wrote in an email to the South Florida Sun Sentinel. “It was always part of the plan to partner with our only real competitor in the pediatric acute care space in South Florida … The Children’s Hospital of Florida will eliminate competition in the tri-county and directly impact physician compensation, because there is nowhere else to go without leaving the market.”
Dr. Frank Scholl, a pediatric cardiologist at Joe DiMaggio, said those voices represent a minority. Most doctors at Joe DiMaggio want to collaborate with their colleagues at other children’s hospitals, including those at Nicklaus, when they begin working at Broward Health. “We want to better serve the patient population we all care for,” he said.
Scholl envisions Holtz Children’s Hospital in Miami also participating in the Children’s Hospital of Florida. “By pooling our resources together, we can better attract and retain talent from a national and internal pool that is limited,” he said. “That’s a huge factor in this. There are people at all three hospitals who truly want to collaborate.”
If they were to form a united network and one local children’s hospital were to lure a top pediatric neurologist, a highly sought-after specialty, all those who are part of the Children’s Hospital of Florida could tap into that expertise for consultations or referrals.
Missed opportunity?
While the bigger vision for a future Children’s Hospital of Florida includes Joe DiMaggio, for now, the Hollywood hospital is not part of the Broward Health/Nicklaus partnership. However, both Love at Nicklaus and Strum at Broward Health say they independently had approached Memorial Healthcare System’s former CEO Scott Wester to collaborate or partner with Joe DiMaggio. Wester served as CEO from 2022 to 2024, serving only two years on a three-year contract. He resigned under pressure from the board in September 2024.
“Nothing came out of that discussion, and that was not my decision,” Love said. “I would have loved to be able to collaborate (with Joe DiMaggio). Shane had approached them first and they had an opportunity to do something big and great with Broward Health and it was turned down.”
Wester did not return calls or text messages seeking comment.
“It sounds like people are mad because we’re trying to get good health care to all the children in Broward County,” said Memorial Board member Doug Harrison. “When it comes to this idea of a Children’s Hospital of Florida … my take is I just want to provide great health care for children. It’s not a mysterious thing. There’s no stock in it. There’s no money in it. I’m not a doctor. I don’t make any money off of it. It’s about the children of Broward County.”
Stella said doctors at Joe DiMaggio who resent that Nicklaus has teamed up with Broward Health are misguided and don’t understand the “headwinds” facing children’s hospitals: More children on Medicaid rather than on higher-paying private health insurance, sicker children with chronic conditions or preventable diseases, a greater need for specialty care for children with more complex illnesses, fewer medical graduates pursuing pediatrics, and more financial pressure.
Federal cuts to Medicaid, if passed on to states, could pose a problem, too, by jeopardizing the coverage that pays for much of the pediatric hospital care in Florida. At Nicklaus, for example, about 70% of patients use Medicaid.
The best path forward for children, Stella said, is for Nicklaus, Joe DiMaggio and Broward Health to work together, “and maybe even include other children’s hospitals in Miami or Palm Beach.”
“If you pool your resources and you regionalize programs and you create centers of excellence and you come together under a larger network or integrated delivery system, you’re basically directing children to the place where they will get the highest level, most specialized, most appropriate care,” she said. “That’s the model that’s happening around the country.”
Stella acknowledges some of her medical staff aren’t happy about Nicklaus partnering with Broward Health, or the concept of a Children’s Hospital of Florida.
“It’s disruptive. We get it,” she said. “We get that it’s a strange way of thinking for folks here that are used to a very traditional healthcare model. The market’s changed, though, and we have to be thoughtful about what it’s going to look like 20 years from now, not 20 years behind us.”
In California, Children’s Hospital of Orange County and Rady Children’s Hospital San Diego announced in January that a merger had been completed between their parent companies, creating a new combined healthcare system called Rady Children’s Health. Each kept its separate medical staff, governing boards and onsite leadership.
Hospital executives said the merger aims to create “one of the nation’s most advanced pediatric healthcare systems.” The organizations say they’ll be able to improve patient outcomes, expand their research capabilities, and be better positioned to attract and keep top talent.
“The regionalization of children’s hospitals is an incredible model,” said Dana Ferrell Birchfield, executive director of the Florida Association of Children’s Hospitals. “I would love to see what they have been able to do in Georgia happen in Florida. You don’t have to have every service at every children’s hospital because they can collaborate and form one provider network.”
Hospitals nationwide that serve the general population, from regional medical centers to smaller local facilities, are closing down pediatric units. The motivation is financial; hospitals make more money from adult patients.
Parents with extremely sick children who need specialized services such as transplants and childhood cancer or rare disease treatments typically turn to children’s hospitals because this care is not provided at general hospitals. They tend to use Medicaid coverage to access highly specialized services, and Medicaid reimbursement is often far below the actual cost of care.
Florida has 14 children’s hospitals, five in the tri-county area of South Florida: Nicklaus Children’s Hospital, Salah Foundation Children’s Hospital, Joe DiMaggio Children’s Hospital, Holtz Children’s Hospital at Miami Jackson Memorial Medical Center, and Palm Beach Children’s Hospital at St. Mary’s Medical Center.
Some families have reported traveling outside the state after difficulty finding specialists or getting timely access to needed care for their children, especially for complex or rare conditions. While no one tracks how many leave Florida, Strum at Broward Health said about 16% of pediatric patients leave Broward County for specialized care.
Strum said the affiliation with Nicklaus will eventually triple the size of the pediatric staff at Broward Health’s Salah Children’s Hospital. But that’s just the start, he said, referencing his vision of a Children’s Hospital of Florida: “Imagine the combined forces, the cross-pollination, the credentialing physicians could do so they can go back and forth. It would actually change the pediatric landscape,” Strum said, adding that this vision may take time and baby steps to accomplish.
Strum said medical staff at Joe DiMaggio have no reason to be fearful: “We want to grow. We want to get larger. We want to recruit more physicians. I mean, South Florida should be a hub for innovation and technology in the healthcare space. The for-profits aren’t going to do the academic work … they aren’t going to train future pediatricians because you don’t make money in that. But we can do it.”
Nicklaus has the largest physician teaching program in the Southeast United States, and of its residents and fellows, about 70% stay in Florida, said CEO Love. “Through the Nicklaus affiliation, Salah will be a robust pediatric hospital with both inpatient and outpatient, as well as community activity,” he said.
Time will tell, says a skeptical Joe DiMaggio doctor: “A lot can happen with Nicklaus and Broward Health … it may or may not work out. It could be a failed partnership or it could be a great one.”
If the partnership does work, the doctor said, then Memorial could find a way for Joe DiMaggio to also partner with them. “That’s going to take buy-in, though. For a long time, our doctors have looked at Nicklaus as competition. It will be hard to look at them as collaborators.”
Says Love: “This is not about Nicklaus Children. It’s not about Joe DiMaggio. It’s not about the physicians. It’s not about Broward Health. It is really around the kids in our community. And if we always come back to that and leave our egos at the door, then we’ll get what we need done and the families of South Florida will benefit.”
Originally Published: May 8, 2025 at 5:31 AM EDT
