Mineral Community Hospital in Superior is a critical access hospital with a mission to improve the health care and quality of life of its community.

The hospital provides inpatient and outpatient services, 24-hour emergency care, physical therapy and long-term care, along with other health services not often found in a rural setting. One of those services is brand new and already being well received by both patients and administrators.

“We just hired a full-time dietician which is amazing as she will provide diabetes education and nutrition services to our community. Something we haven't had EVER in the 25 years I’ve worked here,” beams CEO Laurel Haskins Chambers. ”We always have had a contract to provide the oversight and Nicole has actually done that for a few years for us but now she is here full-time and will see outpatients for diabetes, chronic medical conditions, and inpatients that need special diets.”

That new hire is Nicole Cirilli, who moved to Missoula in 2018 and worked at Community Medical Center, as well as in private practice, for several years. 

“But I’ve always worked for Mineral Community Hospital as a contractor,” she explained. “So, while it was a small gig with them, I had other jobs in clinical dietetics. I just had a good bond with Laurel and Stacy (Conrow-Ververis CFO of MCH). I moved out of the area but we stayed in touch and I just moved back and they signed me on as a full-time employee. It was great opportunity for everyone,” she said.

As director of nutrition services, Cirilli’s role is wide-ranging. 

“I have a lot of food service responsibilities such as making the hospital menu, overseeing the kitchen, providing nutrition training to staff, and managing the food safety policy and procedures. This trickles down to home delivery meals to the community. As the clinical dietitian, I conduct as-needed consults on our long-term care patients, assess every skilled nursing patient, coordinate care with our physical therapists, occupational therapists, doctors, nurses.”

Cirilli will also serve the broader community through the MCH Clinic. 

“I am also a certified diabetes educator so I’m doing out-patient and in-patient diabetes education at the clinic. This will be very helpful for our hospital patients who I can continue working with on diabetes self-management even after they discharge.”

She anticipates providing extensive diabetes support through outpatient counseling and potentially group settings. 

“Then I also see patients for kidney disease, general nutrition counseling-healthy eating. I have experience and training with disordered eating through my private practice that I have had for 6-years.” 

Cirilli completed her graduate work at Montana State University in Bozeman, with clinical rotations in Missoula, experience that led to her position at Community Medical Center. She also sees patients at the Jack Lincoln Clinic in St. Regis, which is operated by MCH and serves residents who find it easier to receive care locally.

“We’re still ironing out the referral process, but they could call Jack Lincoln or the MCH Clinic in Superior and depending on their insurance, they might need a referral from their provider.”

A discussion about the federal government’s updated food pyramid prompted thoughtful reflection from Cirilli. 

“Generally, I support many areas of the new food pyramid and feel it's consistent with a lot of great nutrition advice like eating way less processed foods, added sugar, more water, more fiber, more color. I thought it was interesting to return to the food pyramid, an image that was replaced by the 'my plate' visuals over a decade ago. 'My plate' was a really great visual aid for people to look at their plate and say, ‘OK, do I have vegetables, do I have protein, do I have fiber. Do I have water?’ I will miss having those resources available on the USDA's website. I question the new guidelines increased recommendations for red meat and full-fat dairy, especially since the American Heart Association put out a statement of concern. I also wonder why plant-based proteins like beans, lentils, intact whole grains, seeds, and nuts were moved down on the pyramid, meaning they are recommended less. I wonder about that because those foods are so effective in lowering cholesterol, blood pressure, keeping us full and satiated, and stabilizing blood sugar especially in the diabetes population. Those are my initial thoughts.”

Cirilli also addressed popular diet trends, noting that intermittent fasting lacks strong evidence-based support for widespread effectiveness. She emphasizes individualized care, explaining that nutrition strategies must be tailored to each person. She supports balanced, brightly-colored, and ideally home-cooked meals — breakfast, lunch and dinner — with healthy snacks in between, along with daily physical activity to maintain metabolism through consistent fueling.

Her philosophy toward nutrition counseling is grounded in a weight-neutral approach that focuses on behavior rather than numbers on a scale. She believes in small, sustainable steps that fit each individual. 

“I feel that makes people feel more confident and less fixated on the scale and then that leads to a lot more sustainable lifestyle change.”