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Anthem asks Missourians to think twice before going to the emergency room – KCUR

Anthem Blue Cross Blue Shield, one of Missouris largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Theyre forcing the lay public to make a medical determination, said Dr. Doug Char, a Washington University emergency physician. Theyre basically telling people you have to decide if this chest pain youre having is indigestion or a heart attack.

An emergency room is the most expensive place to see a doctor, and insurers are balking at the cost. Between 15 percent and 30 percent of emergency room visits in the St. Louis region are avoidable, according to a study by the nonprofit Midwest Health Initiative. Missouri hospitals charge an average of $372 for emergency room visits for minor issues, but some charge as much as $1,300, according to data compiled by the Missouri Hospital Association.

“Most non-emergent medical conditions can be easily treated at retail clinics, urgent care clinics or 24/7 telehealth services,” Anthem’s Missouri spokesperson, Scott Golden, wrote in an email. “The review by an Anthem medical director will take into consideration the presenting symptoms that brought the member to the emergency room as well as the diagnosis.”

In mid-May, Anthem sent letters to Missouri enrollees to alert them that from June 1, it would no longer cover emergency room services for non-emergencies. In such cases, people who have health insurance could still be stuck with the full cost of their visit, if the insurer determines that their symptoms did not reach the level of requiring emergency care.

Anthem enforces the same guidelines in Kentucky, and put the rule in place for Georgia policyholders this month. Its officials say there are several exceptions, such as if a patient is under 14, the visit occurs on a Sunday or there are no urgent-care centers within 15 miles.

The American College of Emergency Physicians raised a red flag when Anthem sent out a spreadsheet of 1,908 conditions that it may not deem worthy of coverage in an emergency room. Some of the listed symptoms could indicate a life-threatening emergency, said Dr. Jonathan Heidt, president of Missouris ACEP chapter.

To have them under that threat of not having their bills paid if theyre wrong about what their diagnosis is, its really going to harm patients in the long run, Heidt said. Our patients have a right to seek emergency care.

The doctors argue that Anthems policy, and similar rules set up by state Medicaid programs, violate the federal Affordable Care Acts prudent layperson standard. The rule asserts that a person with average knowledge of health and medicine should be able to anticipate serious impairment to his or her health in an emergency, and that laws should not assume that a person will know more than that. Anthem contends that it reviews claims using this standard already.

Though Anthem began enforcing the Missouri rule at the beginning of June, patients who visit the emergency room for non-emergencies likely will receive bills in the coming months. Heidt said that if Anthem does not reconsider its policy, ACEP may weigh legal action against the insurer.

Were still a little bit early for that,” Heidt said. “But at this time, all of our options are on the table.

According to the Missouri Department of Insurance, Financial Institutions & Professional Registration, the rule is based on previously filed language that was approved by the regulator. Other plans have similar provisions.

“If a consumer believes a claim has been improperly denied, or has questions about how a claim has been handled by their insurer, they can contact the Department’s Consumer Affairs Hotline at 800-726-7390 or they can file a complaint online,” said Grady Martin, the agency’s director of administration.

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Anthem asks Missourians to think twice before going to the emergency room – KCUR

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Anthem asks Missourians to think twice before going to the … – St. Louis Public Radio

Anthem Blue Cross Blue Shield, one of Missouris largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Theyre forcing the lay public to make a medical determination, said Dr. Doug Char, a Washington University emergency physician. Theyre basically telling people you have to decide if this chest pain youre having is indigestion or a heart attack.

An emergency room is the most expensive place to see a doctor, and insurers are balking at the cost. Between 15 percent and 30 percent of emergency room visits in the St. Louis region are avoidable, according to a study by the nonprofit Midwest Health Initiative. Missouri hospitals charge an average of $372 for emergency room visits for minor issues, but some charge as much as $1,300, according to data compiled by the Missouri Hospital Association.

“Most non-emergent medical conditions can be easily treated at retail clinics, urgent care clinics or 24/7 telehealth services,” Anthem’s Missouri spokesperson, Scott Golden, wrote in an email. “The review by an Anthem medical director will take into consideration the presenting symptoms that brought the member to the emergency room as well as the diagnosis.”

In mid-May, Anthem sent letters to Missouri enrollees to alert them that from June 1, it would no longer cover emergency room services for non-emergencies. In such cases, people who have health insurance could still be stuck with the full cost of their visit, if the insurer determines that their symptoms did not reach the level of requiring emergency care.

Anthem enforces the same guidelines in Kentucky, and put the rule in place for Georgia policyholders this month. Its officials say there are several exceptions, such as if a patient is under 14, the visit occurs on a Sunday or there are no urgent-care centers within 15 miles.

The American College of Emergency Physicians raised a red flag when Anthem sent out a spreadsheet of 1,908 conditions that it may not deem worthy of coverage in an emergency room. Some of the listed symptoms could indicate a life-threatening emergency, said Dr. Jonathan Heidt, president of Missouris ACEP chapter.

To have them under that threat of not having their bills paid if theyre wrong about what their diagnosis is, its really going to harm patients in the long run, Heidt said. Our patients have a right to seek emergency care.

The doctors argue that Anthems policy, and similar rules set up by state Medicaid programs, violate the federal Affordable Care Acts prudent layperson standard. The rule asserts that a person with average knowledge of health and medicine should be able to anticipate serious impairment to his or her health in an emergency, and that laws should not assume that a person will know more than that. Anthem contends that it reviews claims using this standard already.

Though Anthem began enforcing the Missouri rule at the beginning of June, patients who visit the emergency room for non-emergencies likely will receive bills in the coming months. Heidt said that if Anthem does not reconsider its policy, ACEP may weigh legal action against the insurer.

Were still a little bit early for that,” Heidt said. “But at this time, all of our options are on the table.

According to the Missouri Department of Insurance, Financial Institutions & Professional Registration, the rule is based on previously filed language that was approved by the regulator. Other plans have similar provisions.

“If a consumer believes a claim has been improperly denied, or has questions about how a claim has been handled by their insurer, they can contact the Department’s Consumer Affairs Hotline at 800-726-7390 or they can file a complaint online,” said Grady Martin, the agency’s director of administration.

Follow Durrie on Twitter: @durrieB

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Anthem asks Missourians to think twice before going to the … – St. Louis Public Radio

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Anthem asks Missourians to think twice before going to the emergency room – St. Louis American

(St. Louis Public Radio) – Anthem Blue Cross Blue Shield, one of Missouris largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Theyre forcing the lay public to make a medical determination, said Dr. Doug Char, a Washington University emergency physician. Theyre basically telling people you have to decide if this chest pain youre having is indigestion or a heart attack.

An emergency room is the most expensive place to see a doctor, and insurers are balking at the cost. Between 15 percent and 30 percent of emergency room visits in the St. Louis region are avoidable, according to a study by the nonprofit Midwest Health Initiative. Missouri hospitals charge an average of $372 for emergency room visits for minor issues, but some charge as much as $1,300, according to data compiled by the Missouri Hospital Association.

“Most non-emergent medical conditions can be easily treated at retail clinics, urgent care clinics of 24/7 telehealth services,” Anthem’s Missouri spokesperson, Scott Golden, wrote in an email. “The review by an Anthem medical director will take into consideration the presenting symptoms that brought the member to the emergency room as well as the diagnosis.”

In mid-May, Anthem sent letters to Missouri enrollees to alert them that from June 1, it would no longer cover emergency room services for non-emergencies. In such cases, people who have health insurance could still be stuck with the full cost of their visit, if the insurer determines that their symptoms did not reach the level of requiring emergency care.

Anthem enforces the same guidelines in Kentucky, and put the rule in place for Georgia policyholders this month. Its officials say there are several exceptions, such as if a patient is under 14, the visit occurs on a Sunday or there are no urgent-care centers within 15 miles.

The American College of Emergency Physicians raised a red flag when Anthem sent out a spreadsheet of 1,908 conditions that it may not deem not worthy of coverage in an emergency room. Some of the listed symptoms could indicate a life-threatening emergency, said Dr. Jonathan Heidt, president of Missouris ACEP chapter.

To have them under that threat of not having their bills paid if theyre wrong about what their diagnosis is, its really going to harm patients in the long run, Heidt said. Our patients have a right to seek emergency care.

The doctors argue that Anthems policy, and similar rules set up by state Medicaid programs, violate the federal Affordable Care Acts prudent layperson standard. The rule asserts that a person with average knowledge of health and medicine should be able to anticipate serious impairment to his or her health in an emergency, and that laws should not assume that a person will know more than that. Anthem contends that it reviews claims using this standard already.

Though Anthem began enforcing the Missouri rule at the beginning of June, patients who visit the emergency room for non-emergencies likely will receive bills in the coming months. Heidt said that if Anthem does not reconsider its policy, ACEP may weigh legal action against the insurer.

Were still a little bit early for that,” Heidt said. “But at this time, all of our options are on the table.

According to the Missouri Department of Insurance, Financial Institutions & Professional Registration, the rule is based on previously filed language that was approved by the regulator. Other plans have similar provisions.

“If a consumer believes a claim has been improperly denied, or has questions about how a claim has been handled by their insurer, they can contact the Department’s Consumer Affairs Hotline at 800-726-7390 or they can file a complaint online,” said Grady Martin, the agency’s director of administration.

Republished with permission of St. Louis Public Radio: http://news.stlpublicradio.org/post/anthem-asks-missourians-think-twice-going-emergency-room

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Anthem asks Missourians to think twice before going to the emergency room – St. Louis American

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Entry to Leesburg hospital ER moving as part of $27 million expansion – Orlando Sentinel

LEESBURG The entrance to Leesburg Regional Medical Centers emergency room, which will grow in size as part of a $27 million expansion, will close Thursday as part of the construction, hospital officials said.

Starting then, patients will be required to access to the ER through the hospitals main entrance, officials said. Signage and extra security will be in place to help guide patients and family members. Additional parking spaces have been added to the east and west lots to accommodate patients and visitors.

The expansion will increase the hospitals east side by almost 48,000 square feet of space, adding 24 beds to the ER and including a fast-track unit to handle pediatric patients, three or four trauma-sized rooms for critical-care treatment, a spacious waiting room and an atrium-like lobby.

Its the first increase in the ERs capacity since it was built more than 50 years ago, according to Don Henderson, president and CEO of Central Florida Health, LRMCs nonprofit parent company. The expansion is due to be completed in spring of 2018.

jfallstrom@orlandosentinel.com or 352-742-5916

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Entry to Leesburg hospital ER moving as part of $27 million expansion – Orlando Sentinel

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Patient, BBB seek change with Emergency Room "hidden charges" – FOX 46 Charlotte

CHARLOTTE, NC (FOX 46 WJZY) – Hidden charges at emergency rooms are causing transparency questions to be raised.

“Any other form of purchasing, people know what they’re paying,” patient Steve Komito said. “Somehow if you’re in the emergency room, you don’t have to know and I’m saying that’s wrong.”

Komito took his son to the Carolinas Healthcare Systems Emergency Room in Waxhaw this past Spring. X-rays were done but when Komito received his bill, he noticed a “room charge” for $1,244.44. Komito said, had he known about that charge up front, he would have taken his son elsewhere — adding, the X-rays were not even conducted in that general service room and they could have waited elsewhere.

“I guess my mission at this point is transparency,” Komito said.

Komito said, during his visit, someone with the E.R. told him they will not give pricing ahead of a visit because if the patient determines it’s too expensive and leaves — the E.R. will be held liable if something were to happen with their health.

The Better Business Bureau said it receives roughly 1,000 complaints a year for situations like this in the Greater Charlotte region.

“It’s not like going into a fast-food restaurant and seeing prices up on the board,” BBB’s Tom Bartholomy said.

FOX 46 Charlotte reached out to Carolinas Healthcare Systems earlier this Spring with a list of billing questions that have still not been answered. We sent them an email again on Friday and are waiting for a response. Here’s a portion of the email…

1.Will Carolinas Healthcare System give pricing information prior to service at the Emergency Room, upon request?

2.Does CHS stand behind this standard room charge and policy? When did this charge go into effect?

3.Weve heard talks about Level 3 and Level 4 E.R. room visit cases. What are the specific levels and what determines one of these levels?

4.What goes into the room charge? Is there a time limit a person has to be in there for a charge? A specific procedure? Does a doctor have to physically examine them? What warrants this charge?

5.Does CHS maintain that it will not release pricing prior to an E.R. patient being seen because it can be held negligent if the patients decides the cost is too high, and leaves without treatment?

FOX 46 Charlotte has now reached out to State Senator Tommy Tucker (Komito’s district) to see if he would be interested in any sort of legislation surrounding hospital charges being disclosed up front. Here’s a portion of that email…

Would Sen. Tucker support legislation demanding immediate transparency of ER pricing? As these bills are broken down into “Levels” — why can’t a patient know ahead of time the approximate costs of his service?

*This obviously does not include any additional testing that may be ordered or needed. But again, these prices – all pricing – is slotted ahead of time.

The Better Business Bureau told FOX 46 Charlotte there needs to be more transparency between E.R.’s and patients.

“If there’s going to be a basic charge for you for being in that emergency room no matter what you’re there for, then, yeah, why not?” Bartholomy added.

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Patient, BBB seek change with Emergency Room "hidden charges" – FOX 46 Charlotte

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Belleville Board To Hear Clara Maass Emergency Room Proposal – Patch.com


Patch.com
Belleville Board To Hear Clara Maass Emergency Room Proposal
Patch.com
BELLEVILLE, NJ The Belleville Board of Adjustment plans to hear a proposal to construct an addition and make alterations to the emergency room of Clara Maass Medical Center at 1 Clara Maass Drive on Thursday, July 6, according to the municipal …

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Belleville Board To Hear Clara Maass Emergency Room Proposal – Patch.com

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WVMetroNews – Thomas move takes aim at emergency room waits … – West Virginia MetroNews

CHARLESTON, W.Va. Thomas Hospital System is trying to improve the cost and efficiency of emergency room visits by more clearly presenting lower-cost alternatives to patients determined not to be facing life-threatening illnesses.

Starting in the next few weeks, Thomas plans to start informing emergency room visitors deemed to not be facing a life-threatening illness that their visits will be subject to co-pays up front.

Emergency room personnel in the Thomas system will advise those patients that they could receive less expensive and potentially timelier care at an associated clinic or with an available family doctor.

Similar measures are alsotaking place elsewhere in attempts to keep costs and wait times lower in emergency rooms.

We are going to start doing screenings of patients when they present to the emergency room, said Dan Lauffer,president andCEO of Thomas Health System which owns Thomas Memorial Hospital and Saint Francis Hospital.

Were going to inform them about their condition whether its an emergent condition or something that could be seen in a care center or doctors office.

Lauffer added, Were doing it as a means of communicating to our patients the culture of delivery. We feel that many patients who representto the emergency room are using it as their primary source of healthcare.It would also improve their knowledge of their financial health as it relates to delivery of healthcare.

The Thomas system calculates that 30 percent of its emergency room visitors are deemed by doctors or nurses to not be in an emergency medical situation. That situation is costly to both patients and the hospital and also results in longer waits.

The biggest change for Thomas Health System will be charging co-payments to patients who choose to remain under emergency room care even after being told their conditions are not life-threatening. The collection of co-payment prior to services would begin in August.

Co-payments begin at $8 for Medicaid payments but can be higher depending on the patients insurance and the care being delivered.

Patients who have true health emergencies would be treated regardless of their ability to pay, hospital system representative said.

Patients would have another choice to make too. They could opt for care at a clinic associated with Thomas (or elsewhere) and be treated in order of arrival or remain under emergency room care but be treated in order of severity. A reference to a family doctor is also an option.

If you say I want to be seen by the emergency room we wont refuse you, but well ask you to pay the co pay and to be seen in the order of severity, Lauffer said.

If the patients visit is after the hours of clinics or associated family doctors, Lauffer said the hospital system would work with the patient for the earliest possible appointment time.

If theres any question about whether or not this may be life-threatening we most certainly will continue to see them in the emergency room, Lauffer said. We want to communicate with these patientsabout how these decisions impact their health and their financial well-being.

Thomas Health has invested more than $1 million into four Care Clinic locations in Kanawha and Putnam counties.

Thomas has tried all along to inform emergency room patients about alternative care and the potential for lower costs, Lauffer said, but this is a concerted effort.

In the past we have not been diligent about this, he said, but we feel it s necessary to educate our community about the decisions about where they see care has an impact not only on their pocketbook but also their health.

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WVMetroNews – Thomas move takes aim at emergency room waits … – West Virginia MetroNews

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Hospital Ends Agreement to Have Off-Duty Police in Emergency Room – KARK

LITTLE ROCK, Ark. – A footprint in town, means you have history to share.

CHI St. Vincent’s history dates back more than a century to 1888.

“We’re here to protect and take care of people,” says an emergency room staffer.

The Emergency Room employee, who asked we hide their identify, knows things change over time.

“Something’s got to be done to keep it safe. It could be anybody that something happens too,” the employee says.

The staffer says about two months ago, the hospital ended its agreement to keep an off-duty police officer in the Emergency Room.

“If something starts going down–we have to get to the appropriate phones, call 911 and wait for back up to get there,” the worker says.

St. Vincent officials say they have a full-time security team and the off-duty police officers were only working ‘a few hours overnight each night’.

The staffer says overnights are primetime for problems.

“A patient has charged an area of the desk where they could’ve gotten to the staff and they were said to be quite threatening and very abusive and even threatening to hurt staff,” the employee says.

St. Vincent Hospital officials provided a prepared statement:

“Our Environment of Care and Workplace Safety committees are made up of coworkers from multiple divisions, including Nursing and Security. Those committees are involved in re-evaluating our security protocols in order to maintain the highest level of safety possible and ensure we are allocating resources where needed most.

As part of an ongoing evaluation, we determined it would be more beneficial at this time to focus resources on how to improve security throughout the hospital. The off-duty police officers who were previously contracted by us were only located in the Emergency Department and only for a few hours overnight each night. So, we are in the process of implementing additional security measures for all of our departments on all of our campuses.

We continue to have an excellent relationship with law enforcement in every community we serve. Those partnerships, in addition to an active, full-time security team, help us ensure the safety of patients and coworkers.”

“Just keeping an eye out for what’s going on, who’s going where,” the staffer says.

While CHI St. Vincent has a full-time security team, the Emergency Room employee says the guards are not armed.

A Little Rock Police spokesperson says off-duty officers provide armed security in the Emergency Room at Baptist Health and Children’s Hospital. UAMS has its own separate police force.

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Newman Regional Health emergency room expansion begins – Emporia Gazette

One turn of a shovel and it was official.

Ground was broken at Newman Regional Health Wednesday, signifying the beginning of its $14.4 million emergency room expansion project.

I want to thank you all for coming out today for the groundbreaking, Bob Wright, Newman Regional Health chief operating officer said. I was looking at the statistics today and, since 2013, our emergency room volume is up 22 percent, which helps explain why this project is so important to our community. We are doubling the number of rooms in our ER and tripling the square footage. We are co-locating express care and our critical decision unit on the same floor of the ER for better access to patients to our diagnostic equipment and their caregivers.

The expansion will increase the size of the emergency room tremendously. The current ER consists of 5,000 square feet with the expansion providing an additional 10,000 square feet. Wright said the expansion will benefit hospital staff and patients.

Just the space is a huge benefit, Wright said. The current rooms are so small we cant get the staff we need in a room. Sometimes you need three staff members in a room and they are too small for three people.

The emergency room will have a centralized nursing station and 19 total rooms the current ER has 10 small rooms. The 19 rooms include three trauma rooms, four fast track rooms and 12 regular examination rooms. The rooms are arranged around the central nursing station, which provides a clear line of sight to all patient rooms, which increases patient and staff safety.

Harold Blits, vice president of facilities at Newman Regional Health, said the emergency room expansion will benefit the community.

Its not so much how its going to benefit the staff. The big benefit is to the community, Blits said. If you have ever been a patient in the ER you know how tight it is, how loud it is, the lack of privacy.

The expansion will also include a waiting room, three exam rooms and a procedure room for express care. As patients enter they will self-determine if they need to be seen in express care or the emergency room. If they begin treatment in express care but the severity level is too high, they will be transferred to the emergency room.

A room for pre- and post-patients using the cath lab is included as well as room for an infusion station for those patients who come to the hospital for IV medications. Two safety rooms, observation rooms, a sexual assault nurse exam room and office space are also included. Staff will have access to a break room, staff bathrooms and locker rooms.

With Wednesdays groundbreaking, Bilts and Wright anticipate the expanded emergency room to open in December of 2019.

We anticipate being open 18 months from today, Bilts said.

I believe the next 18 months will go very quickly and we will be here soon cutting a ribbon, Wright said.

How patients benefit

^ Decrease in wait time

Wait times are expected to decrease with the additional space.

The space allows the ability to turn the patients quicker, Wright said. Waiting times will go down because we can get them in a room quicker. We can lose 20 minutes to an hour while people are in the waiting room and we havent even got them in a room yet.

^ Increased safety

Safety is always a top priority for patients and staff. The new emergency room is designed with safety in mind.

This space is designed for safety, Bilts said. Good line of sight to all patient rooms and a central nursing station.

^ Privacy

Each room in the new emergency room has a private bathroom to increase patient privacy.

Now we have two little bathrooms in the middle of a hallway and you are wandering out there exposed, Bilts said. Every room will have a restroom and there is just so much more privacy.

^ Space for family

The larger room sizes not only accommodate medical equipment and staff but also allow space for family to remain in the room with the patient. Each room will have a sleeper sofa for family members to rest while waiting.

Currently there is no room for family in our ER right now, Bilts said. If the doctor and nurse have to come in, the family member has to stand in the corner and basically hope they dont take up a spot more than 18 inches by 18 inches. Now the rooms will be plenty big enough for family to be there with the patient.

***************** Second Info Box *******************

By the numbers

^ $14.4 million is budgeted for the emergency room expansion

^ 19 total rooms in the emergency room three trauma rooms, four fast track rooms, 12 regular exam rooms

^ 15,000 square feet in the new emergency room

^ 7-percent increase in the number of patients using the emergency room in 2017 over 2016

^ 22 years since the last emergency room renovation was completed in 1995

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Newman Regional Health emergency room expansion begins – Emporia Gazette

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LewisGale Montgomery unveils a new emergency room | WSET – WSET

by Breann Boswell & Annie Andersen

Dozens attended the ribbon cutting for LewisGale Montgomery’s new Emergency Room. (Photo: Annie Andersen)

BLACKSBURG, Va. (WSET) — Dozens gathered for the unveiling of LewisGale Montgomery’s new and expanded emergency room on Wednesday.

The remodeled ER has added four more rooms for different types of patients. Extra rooms will help on lowering the wait times.

Emergency Room Medical Director Edmond Sciullo says that more rooms will help to save lives.

“The key to most conditions is early diagnosis,” explained Sciullo. “The diagnosis then drives your treatment, so the earlier we can focus on your diagnosis, and make the correct diagnosis, the quicker we can treat you.”

For Blacksburg Mayor Ron Rordam this ribbon cutting had a personal connection for him. “10 or 15 years ago, I try not to remember the date … you get that call at 11:30, 12 o’clock at night; ‘Mr. Rordam, Mr. Rordam, your son is on his way to the ER. He’s had an accident,'” Rordam recalled.

The $6 million project also helped with upgrades to the surgery center including a Laparoscopic surgery device with a 3-D camera.

“When you see other communities out struggling to maintain their hospitals and hospitals are leaving and what that means to the economic development, but then to be in a place where the hospital is growing is so important,” Rordam said.

The New River Valley is one of the areas in Virginia experiencing major growth, according to the Virginia Employment Commission.

At a time when some hospitals in Southwest Virginia are cutting back services, LewisGale Montgomery is expanding.

The renovated ER is open and serves patients 24 hours a day.

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LewisGale Montgomery unveils a new emergency room | WSET – WSET

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