Freestanding Emergency Rooms are hot health care trends.
William H. Johnson was cheering his beloved Wildwood Wildcats when white-hot pain shot up his left arm, his chest tightened, and he crumbled onto the Carter Field bleachers. Helpers quickly rushed to his aid. Two friends performed CPR. An ambulance was promptly summoned.
All for naught.
W.H. Johnson, Methodist, Mason, Civitan, Roadmaster, county commission candidate, died on the way to the nearest emergency room – Leesburg General Hospital, 12 miles away. That’s 12 miles to Wildwood, and 12 miles back. At least 40 minutes, probably more. Sumter County didn’t have a hospital when tragedy struck the 66-year-old husband and father of two sons on November 21, 1980.
Would W.H. have lived if an emergency room was three minutes away instead of 25 or 30? Who can say?
This we do know: your odds of surviving a heart attack, stroke, or accident in Sumter County increased dramatically in February when two freestanding emergency rooms (FSERs) opened in Wildwood, just outside The Villages.
Not familiar with the FSER concept? Simply stated, an FSER is an emergency department that isn’t attached to a hospital. And FSERs are the hottest trend in health care. Two years ago, there were zero standalone emergency rooms in Lake and Sumter counties. Today, there are four. All are open 24/7. All are required to accept patients regardless of ability to pay.
Statewide, there are at least 67 FSERs. There were 26 in 2016. And at least 22 more freestanding emergency departments are coming to central Florida. Why? Because FSERs are an attractive alternative to hospital ERs known for long waits. And, for many patients, they are closer than the nearest hospital ER. Bottom line: freestanding ERs are more convenient. They are the express lane/fast-food drive-thru/15-minute oil change/Wawa of health care.
In 2016, Ocala Health opened the first local standalone ER, in Summerfield, just north of The Villages. It’s been busy ever since. Word quickly spread throughout the nearby retirement community: no need to wait for hours at our hospital, you can be in and out of the Summerfield ER in a fraction of the time.
Ocala Health added an FSER on Maricamp Road in Ocala in 2019.
In February, Ocala Health opened Trailwinds Village Complex, a 11,630-square foot facility with 11 ER beds staffed by 30 full-time health professionals, including “highly trained and certified emergency physicians and nurses,” in Wildwood, just outside The Villages.
“We saw an opportunity to bring emergency care closer to Sumter County residents,” says Ocala Health CEO Chad Christianson. “Over the last few years, we have seen more patients from Sumter County and Lake County choosing Ocala Health for their healthcare services. We believe this freestanding emergency room will provide our patients a more convenient, higher level experience for emergent care.”
“Each of our FSERs offer 24/7 access to all the resources needed for acute care of a serious illness or injury. All locations offer adult and pediatric emergency care; diagnostic imaging on-site; and comprehensive laboratory services. At both Maricamp and Trailwinds Village ER there is a designated resuscitation room,” says Ocala Health Director, Public Relations and Communications Lauren Debick.
UF Health, which acquired The Villages Regional Hospital and Leesburg Regional Medical Center in 2019, also saw opportunity. UF Health opened a freestanding ER in February, also in Wildwood (on State Road 44). The Villages® Hospital Brownwood E.R. is outfitted with “the latest diagnostic imaging technology,” including CT and X-ray, 16 beds (and room for eight more), state-of-the-art trauma bays, and a negative air pressure room for patients who need to be isolated. The 25,000-square-foot facility is open 24/7 and features “a full complement of staff, including physicians, nurses and patient care technicians.” It also offers laboratory and respiratory therapy services.
According to a UF Health spokesperson: “UF Health Central Florida recognized the need to provide convenient access to high-quality health care in the Brownwood area of The Villages®, the city of Wildwood, and the surrounding communities to meet the growing demand for emergency services.”
Convenient is the operative word. Dictionary.com definition: “suitable or agreeable to the needs or purpose; well-suited with respect to facility or ease in use; favorable, easy, or comfortable for use.” When was the last time anyone described a hospital ER visit as agreeable, favorable, comfortable, or easy?
Freestanding emergency rooms are marketed as user-friendly, bright, cheery, ultra-efficient alternatives to hospital ERs. They supposedly take the wait out of waiting rooms. They are the better mouse trap.
Thousands of Lake and Sumter residents obviously think so. More than 120,000 patients have visited Ocala Health’s three FSERs. UF Health’s standalone ER outside Brownwood has already treated more than 3,500 patients.
Orlando Health is also doing steady business at its FSERs – Orlando Health South Lake’s Hospital Emergency Room and Medical Pavilion – Blue Cedar in Leesburg, and Orlando Health South Lake Hospital Joe H. & Loretta Scott Emergency Room and Medical Pavilion in Clermont. Both have 12 beds, are staffed with board certified emergency physicians, and have full in-house labs, and imaging services such as CT, X-ray, ultrasound and MRI. Blue Cedar offers telemedicine for any medical specialty, a helipad for transport, and two resuscitation rooms for active heart attack patients.
AdventHealth also wants a piece of the Clermont-area market. It will open a freestanding ER adjacent to the intersection of State Road 50 and Citrus Tower Boulevard in 2021. “This growth demonstrates our commitment to provide convenient, exceptional whole person care close to home,” says Abel Biri, president and CEO of AdventHealth Waterman.
Convenient. There’s that word again.
Are FSERs really more convenient? An August 2019 study by Stratasan concluded that “… FSERs are more efficient with getting patients in and out more quickly.” That certainly seems to be the case locally. “ER wait times at Trailwinds Village ER average around five minutes or less,” says Debick. According to a spokesperson for The Villages® Hospital Brownwood E.R., the average time for check-ins is less than 3 minutes, and the average time for a patient to see a provider is just 13 minutes.
Local hospital ERs aren’t nearly as fast. Here’s how long you can expect to wait for the initial exam according to hospitalstats.org: 35 minutes at AdventHealth Waterman in Tavares; 50 minutes at Leesburg Regional Medical Center, 52 minutes at South Lake Hospital, 55 minutes at The Villages Regional Hospital.
Editor’s note: UF Health did not own Leesburg Regional Medical Center and The Villages Regional Hospital when the data was tabulated.
End of debate? No. Because the times listed above only indicate how long you’ll wait to get checked in. How long will you actually spend in a freestanding ER? Ocala Health’s Debick says, “Overall length of stay times depend greatly on a patient’s level of acuity; low-acuity patients’ length of stay in the Trailwinds Village ER is about 45 minutes.”
Low-acuity is medical speak for non-life threatening conditions like bronchitis, respiratory infections, sprains, and urinary tract infections.
What about high-acuity patients with more challenging medical conditions? A UF Health spokesperson answers, “The total visit time varies depending on the patient’s condition. For example, there are certain tests that need to be completed for suspected heart attack patients that take a minimum of three hours as part of best-practice protocols.” Debick says, “The other scenarios are impacted by many factors day-to-day; it could be difficult to give numbers that accurately depicted an average case.”
Yes, you may spend three or four hours in a freestanding ER.
Enough about wait times. Receiving the best possible care in a timely manner is the only thing that matters in an emergency. According to Northeast Ohio Medical University researcher Dr. Erin Simon, in the event of a true emergency, patients should generally choose the closest emergency department, whether it’s freestanding or not.
When asked, “Under what circumstances would a patient at the Brownwood ER be sent to a hospital?” a UF Health spokesperson answered, “Patients who require further diagnostic workups or specialty care can expect to be transferred to the hospital. This includes emergent interventions and other specialist care, i.e. neuro, ortho, et cetera.”
Research emergency facilities now, before you need them. Here are some things to consider:
You can view surveys of patients’ experiences, ER wait times, even details like the percentage of outpatients with chest pain or possible heart attack who got drugs to break up blood clots with 30 minutes of arrival at: medicare.gov/hospitalcompare.
Will you be treated by a nurse, nurse practitioner, doctor, or a doctor board certified in Emergency Medicine (EM)?
Will your insurance be accepted?
A patient will be hospitalized following a visit to an FSER if the patient requires additional treatment other than being discharged with a prescription, i.e. IV antibiotic therapy, medical specialty need, surgery, etc. The time it takes to transport you by ambulance depends on which hospital the FSER is affiliated with.
Editor’s note: This article isn’t intended to promote any facility. Each person should evaluate what’s available to make an informed decision.
Average time patients spent in the ER before being admitted:
Leesburg Regional Medical Center: 3 hours, 12 mins
Florida Hospital Waterman: 3 hours, 16 mins
South Lake Hospital: 3 hours, 17 mins
The Villages Regional Hospital: 3 hours, 35 mins
Average time admitted patients waited to be taken to a room:
South Lake Hospital: 5 hours, 9 mins
Leesburg Regional Medical Center: 5 hours, 32 mins
The Villages Regional Hospital: 5 hours, 35 mins
Florida Hospital Waterman: 6 hours, 7 mins
Average time spent in the ER before being sent home:
Florida Hospital Waterman: 2 hours, 44 mins
Leesburg Regional Medical Center: 2 hours, 56 mins
South Lake Hospital: 3 hours, 14 mins
The Villages Regional Hospital: 3 hours, 29 mins