[NRSKarenRN]

Found at healthleadersmedia.com:

Two Florida hospitals now charge extra for non-emergency ER visits

In mid-November, Orange Park Medical Center became the second Northeast Florida emergency room in recent months to ask the least sick of its patients to turn elsewhere for care or face a $100 fee. Memorial Hospital in Jacksonville started the policy in August. Both facilities are operated by Hospital Corporation of America.
Florida Times-Union, Nov. 30, 2006

[fiestynurse]

My HMO charges $100 for all ER visits, emergent or non-emergent.

[BSNtobe2009]

I think that is terrible and will cause some of the borderline poor (not poor enough to receive medicaid, but poor enough to where they can't pay their bills) to take unnecessary risks of not going when they probably should.

As someone who has to go to the ER due to migraines a couple of times a year that my medication doesn't even ease the pain, I wonder if I would be charged because it's not a life-threatening emergency...after all, it's pretty hard to die from pain.

[RunnerRN]

Interesting idea....I think it would be really great for those repeat non-emergent people, but probably not the best way to solve overcrowding. Again, how to determine emergent? If my child were up screaming at 11pm and tugging at her ear, and Tylenol/Motrin wasn't helping, I'd be off to the ER for the abx. It may not help right away, but that's about 12 hours faster that the meds would be in.
Sounds like a PR stunt that they will probably never collect on....

[skipaway]

Most, not all, who use the ER for non-emergencies do not have a primary care physician or insurance. So, how will the hospital collect their extra money. I think it's a scare tactic to make people think again before going. But I think they'll still use the ER.

[RazorbackRN]

Originally Posted by fiestynurse

My HMO charges $100 for all ER visits, emergent or non-emergent.

I think this is an additional 100.00 fee. Not including copays, other charges, etc.

[hfdguy]

I am an EMT and in LPN school (due to graduate in Jan!).. I just have one thing to say:

Shame on all of you who support this... you should be ashamed!

In Connecticut, its a law that anyone who feels the need can go to an emergency room.

What they are asking the average person in Florida to do is diagnose their illness and determine if they are 'sick enough' to go to the Emergency Room. That is absolutely against everything we have ever been taught in medicine.

I hope you all remember that the most important thing about being a nurse is to be an advocate for your patient - you are the one with the knowledge, the average person has no clue, and trusts us to do what we can to help them.

I hope two things happen: One, that everyone in Florida in healthcare write their representatives to have this outlawed, and two, that everyone charged in this manner sue the two hospitals as a class action, stating that the patient has a reasonable expectation of treatment and that they are not equiped to diagnose whether certain signs and symptoms are 'true' emergencies or not.

How many CVA patients wake up with just a headache? What are the major signs and symptoms of a MI? AAA? Would we consider 'diffuse pain, lethergy, flu like symptoms' to be minor or indicitive of a serious life threatening condition? I know ERs are overcrowded. Most hospitals in CT now have primary care clinics associated with the ER so those deemed non-emergent can still be seen. But I also know that they have sent people to the clinic with a 'non-life threatening' condition, only to find out they are minutes away from a catastrophic event.

[Shamira Aizza]

This is a perfectly reasonable and appropriate policy.

The emergency room should not be used for primary care.

EMTALA defines "pain" as an emergency, so these hospitals cannot turn away patients with complaints of a headache. MI patients with atypical symptoms will not be in greater risk because of $100; if a provider is going to improperly triage someone with an MI, a fee will not make a difference.

EMTALA always seems to be applied in a manner ONLY for the benefit of the patient while hospitals extend themselves routinely far above and beyond what is required of EMTALA to accomodate their patients.

It is time for the emergency rooms to focus on 'emergencies' and apply the allowances of EMTALA to better perform their primary purpose.

[daisey_may]

Is there anything they have that would be considered emergency and non-emergency? There is a lot of grey area that makes me nervous.

I just hope that there isn't an "accident" that will make this not be allowed any longer... I mean, remember that one article about the lady who had had a heart attack but was showing vague symptoms and it was ruled murder when the triage nurse didn't think she was in serious condition?

I'm surprised that this was passed. I agree that something should be done about the non-emergent cases the E.R. sees, but I don't think the answer is to make the visit more expensive. It's a complex problem and this seems like a gloss-over solution.

[hfdguy]

The last patient I brought to the Emergency Room by ambulance was someone complaining of 'stomach pain'... very vague, no temp, no other s/s...

Guess what... she died in the ER about 15 minutes after I got her there due to a AAA that ruptured in the ER.

People take s/s too lightly... as nurses we are supposed to be advocates for healthcare.. I reject your thought that 'the policy is valid'... I would never want to live in florida if that is the policy and would like to see all the people who support that policy be brought before a nursing board to have their licenses revoked for a complete failure to protect their patients.