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Hooked on heroin, she sat 2 days in an ER. Hospitals say you pay for this stay, too. – Charlotte Observer

A 25-year-old Gaston County woman who is addicted to heroin waited two days in a hospitals emergency department, in a psychiatric observation room with no bed.

She needed help for her drug addiction, her family says, but local treatment centers were full.

They dont have any place to put them. Theyre so packed, says the womans grandmother.

Instead, the woman was taken to an emergency room by police last month, under a judges order to involuntarily commit her. The womans family says she had threatened to kill herself and theyve been concerned about her health and behavior after learning shes been using heroin for several years.

The ER, according to the family, was the only option.

A growing opioid and heroin epidemic has escalated a problem that health care professionals have been raising concerns about for years: North Carolina has inadequate services for people with mental and behavioral health diseases.

Doctors in North Carolina confirm theres an increasing demand for help and patients are turning to emergency rooms an expensive and ineffective place for treatment.

Often, patients wait days a process called boarding. Hospitals say it takes a toll on their budgets and leaves fewer beds available for other people who need the emergency room.

Most ERs cant provide full substance abuse or psychiatric health treatment. Instead, they can assess patients and offer some medical care then work to transfer patients to specialized treatment centers.

But, when the treatment centers are full, hospitals end up keeping patients inside emergency room departments.

Recently, the North Carolina Hospital Association reported 30 to 80 percent of emergency beds are used for boarding. The result is higher costs for all patients and delays for patients who are in a mental or behavioral health crisis.

For privacy reasons, the Observer is not publishing the name of the Gaston County patient or her grandmother.

Her family says they grew concerned in the past year about changes in the womans behavior. Then, they learned she had started using heroin while she was in college in western North Carolina a few years ago. After graduating from college, she got a job but she stayed hooked on heroin, her grandmother said.

Heroin is an opioid, a class of drugs that now kills more people in North Carolina each year than car wrecks.

This familys experience of a long stay inside an ER and difficulty finding a treatment bed is a common one in North Carolina.

After calling state and local lawmakers to complain about bed shortage, the 70-year-old grandmother called the Observer in late June as her granddaughter waited inside CaroMont Hospitals emergency psychiatric unit in Gastonia.

There, two rooms, separated by gender, house three recliners each for patients. Theres no medical equipment inside and no other furniture, except for an encased television with no wires exposed. Patients may use a wireless phone and are supervised by hospital staff at a nursing station.

This is where the young woman stayed for 48 hours, her grandmother said. Hospitals are required to accept patients in mental health or drug abuse crisis and perform psychiatric evaluation.

CaroMont Hospitals average patient boarding time is four days the same as the states average for adults who are waiting for a transfer to one of North Carolinas three state-run psychiatric hospitals. For a transfer to a taxpayer-supported treatment center, the average statewide wait is 2.5 days.

We will have patients present to our (emergency department) because they have nowhere else to go, said Dr. Tom Davis, chief medical officer for CaroMont.

It is truly a public health crisis and it is really complicated … Our society in general has not funded or put an emphasis on helping to treat and manage mental health problems.

CaroMonts ER sees nearly 90,000 patients a year. When mental and behavioral patients at the ER dont have acute physical medical problems, they can wait in rooms called psychiatric suites.

Davis and other hospital officials said they couldnt talk about the specific case of any patient. When boarding, the hospital prioritizes the patients safety and medical needs, he said. And, if a patient needs follow-up care but not inpatient treatment, hospitals discharge them with a treatment plan.

Patient boarding and gaps in health care services for mental and behavioral health patients are problems nationwide.

But North Carolina, compared to other states, sees nearly twice the rate of psychiatric patients who resort to the ER each year, says Martha Whitecotton, senior vice president for behavioral health services at Carolinas HealthCare System in Charlotte. Carolinas has an emergency room that exclusively serves patients in behavioral health crisis and its often full.

On average, the boarding time at a Carolinas HealthCare emergency room or another facility in the system is about 17 hours.

But we definitely have patients who are there much longer, Whitecotton said, including children and geriatric patients because of fewer beds for those populations.

In Charlotte, both Carolinas HealthCare System and Novant Health told the Observer they board up to 40 patients daily, with some fluctuation, including those who go to the ER in crisis, with mental health and substance abuse issues.

At Novant, the average boarding time varies by location from 10 hours in Huntersville to close to 17 hours at Presbyterian Medical Center in Charlotte.

Many hospitals in the state including Novant, Carolinas and CaroMont are trying to cut down on the boarding wait times by using telemedicine services that include psychiatric consultations by phone and video.

Each time boarding happens, hospitals stand to lose thousands of dollars.

Its draining the system, said Julia Wacker, vice president for community and behavioral health with the North Carolina Hospital Foundation. Its counterproductive in every way.

Nearly 80 percent of mental health and substance abuse patients in North Carolina are covered by Medicaid or dont have insurance, which means tax dollars pay for some of their costs and hospitals absorb the rest.

Hospitals lose money by the hour when they board uninsured and Medicaid or Medicare patients because expenses past the first day of their stay cant be fully reimbursed. Some experts estimate this type of boarding costs about $100 an hour, per patient.

These extended stays in the ER burden hospital budgets, and those costs are being shifted to other patients and payers.

Some doctors and health care administrators say boarding is happening at higher rates because North Carolina doesnt have enough treatment and psychiatric beds. Others say patients are turning to the ER because preventative care for mental health disease and drug addiction is too expensive or inaccessible. Data shows about half of the states counties dont have enough psychiatric doctors.

The stakes are high, with nearly 1,100 opioid deaths annually in North Carolina a death rate higher than murder rates in the state. That figure from 2015 is a 73 percent spike compared to opioid deaths in the state 10 years ago.

Over the same time period, the wait for treatment beds and the number of patients resorting to the emergency room for mental and behavioral health care has gone up fourfold, the hospital association reports.

North Carolinas Department of Health and Human Services is trying to alleviate the boarding problem and related opioid crisis on several fronts. This year, the department introduced new criteria for the groups that manage mental and behavioral health care, and it plans to impose penalties and fees if services arent improved.

Adding beds would reduce some ER boarding but one research project performed in North Carolina suggests the state would need to effectively double the amount of beds it currently has to just ensure patients arent waiting more than 24 hours in a hospital for a transfer a potential solution that would take years to build out and millions of dollars not currently allocated.

Partners Behavioral Health Management is trying to reduce the problem of boarding at ER rooms, said Dr. Michael Forrester, a psychologist and the chief clinical officer. Partners operates in eight N.C. counties, including Gaston, Iredell and Catawba. Its one of seven regional entities that receive state and federal tax dollars to act as a managed care organization for mental and behavioral health needs.

These regional organizations have special care centers for patients who are in mental health or drug addiction crisis, as an alternative to the ER, as well as offering individualized outpatient treatment.

DHHS says many of its solutions for emergency room boarding are routed through Partners and the other regional organizations. One pilot program is running now in 13 N.C. counties, with the aim of diverting patients in behavioral health crisis away from ERs and on to specialty facilities.

A better approach to getting patients the right kind of health care outside of an ER is key, says Billy West, executive director at Daymark Recovery Services, a growing mental health and substance abuse treatment provider, with 32 clinics in North Carolina.

Whether a person is in a mental health crisis, involuntarily committed through court or is personally ready to start drug addiction treatment, West says, doctors and health care providers want to act quickly in that window of time to help a patient. Boarding delays access to long-term health solutions, West said, and may contribute to a dangerous and expensive cycle.

Some statewide statistics suggest this may be happening already.

More than one quarter of Medicaid patients who use an ER for mental and behavioral health issues return to an emergency room the same year with the same problems, North Carolina DHHS statistics show. Of those, nearly 13 percent were return ER visitors within a months time.

In the young womans case in Gastonia, her family worries shell be one of these statistics. After being discharged last month, the woman followed up on outpatient treatment as prescribed by the hospital, says her grandmother, but more waiting may be in the future.

The local outpatient treatment facility shes enrolled in has some wait times for appointments the young woman will need, her grandmother told the Observer Tuesday.

Ill do anything, says the grandmother, who adopted her granddaughter around her first birthday. I want to get her good help now.

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Hooked on heroin, she sat 2 days in an ER. Hospitals say you pay for this stay, too. – Charlotte Observer


Herman: How my drinking problem sent me to the emergency room –

I had a little (real little) medical incident the other day. All is well, and, more importantly, I did prove a medical theory of mine. This all stems from a drinking problem: Apparently, I dont drink enough.

I recently opined to friends and family that it is my semi-informed belief that before you reach the point of dehydration youll get thirsty. Kind of like youll get hungry before you starve. The body is a wonderful thing, equipped with all kinds of warning devices were free to ignore.

So it was fortuitous that I recently had the opportunity to test whether one indeed will get thirsty prior to getting dehydrated. Obviously, one has to reach the point of dehydration (which I maintain is beyond thirst) to run this test. So, in the name of research, I reached the point of dehydration. Youre welcome. And the short answer is yes, I did get thirsty before I was pushed on a gurney dehydrated into the ambulance.

RELATED: 10 tips for staying cool while running in the summer

This excitement went down when I couldnt get up last Saturday during a morning bike ride that started at 8 a.m. in Northwest Hills and ended in early afternoon in North Austin Medical Centers efficient (and well air-conditioned) emergency room.

Just over 28 miles into what would have been a 28.2 mile ride a routine distance for me and, lest you judge my mph, this ride included a leisurely breakfast stop at Sweetish Hill (and lest you judge my breakfast, it was eggish, not sweetish) fellow American-Statesman staffer and cyclist Ralph K.M. Haurwitz and I turned into Anderson High School to take a look at the new robotics building. After rolling by that, we dismounted to watch an inning of the adult baseball league game underway at the high school.

I felt a bit fatigued, hot and thirsty after a westbound, mildly uphill stretch of Steck Avenue, but nothing serious. Things got more serious when I tried to stand up and felt my field of vision narrowing like a curtain closing as nausea brewed within. I told Haurwitz to give me a few moments and Id be fine. I wasnt. I actually got less fine pretty quickly as seated on the bleachers advanced to prone on the ground. I still thought Id be OK, though I was pretty sure Haurwitz would not offer mouth-to-mouth resuscitation if needed.

So there was that.

Haurwitz quickly realized this was not going to end with me getting back on the bike and pedaling the few blocks back to my house. And I quickly realized I was on the verge of a Saturday nap. Dont get me wrong. Im pro-Saturday naps, but the scheduled, voluntary kind watching televised baseball in a comfy chair, not the unscheduled, involuntary kind watching live baseball prone on the ground.

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One thing led to another, though I dont remember all of them. Haurwitz later told me the real action began when he yelled Emergency! and called 911. Folks on hand for the baseball game gathered to help as I sat in a chair, apparently un- or semiconscious for a few seconds. (And here is where its OK for you to say, Oh, kind of like when you write columns?)

I recall some conversation, not including me, about the approaching ambulance. And I recall the two friendly and helpful EMS guys (I wish I got their names; thanks, guys) moving quickly to assess my situation by asking three questions, including one intended to shock my heart back to pumping if it had stopped:

Who is the president of the United States? he asked.

I answered correctly, somehow opting not to offer editorial comment. (Imagine the battery of psychological exams that would have ensued if, a mere three years ago, youd have answered that question with Donald J. Trump.) He also asked me what city we were in and, attempting to trip me up, added a math question: How many dimes in a dollar? Not bragging here, but I aced the exam.

They hooked me up to some fluids as I shared with them the coincidence of this happening a few days after my official pronouncement of my theory about thirst and dehydration. By the way, they agreed that youll get thirsty en route to dehydration.

I felt much better by the time we got to the hospital, where, shortly after being wheeled into a chilly ER treatment room, I quickly realized my next challenge might be frostbite. I got to meet lots of helpful ER folks, all of whom were affable and relaxed. Must be nice to go to work in your pajamas. They ran some tests and pronounced a diagnosis of dehydration and syncope. Id never heard of syncope until I saw it in the discharge paperwork.

You have been diagnosed with syncope (pronounced SINK-uh-pee). This is the medical term for a rapid loss of consciousness or a fainting episode. There are many causes of syncope. Some of these are life-threatening and others are not serious, it said, adding, Patients without life-threatening conditions may be sent home.

I was pleased to qualify for that. And I didnt need the hospital definition of dehydration. I know what that is. And I was correct. Its that thing beyond thirsty.

Now, having proven my point that youll get thirsty before you get dehydrated, Im working on my acceptance speech for the Nobel Prize for Medicine.

Friends, its hot out there. Youve probably not heard this from anyone, but, having road-tested this theory, let me recommend the introduction of orally administered liquids when youre thirsty. And sometimes water isnt enough. Electrolytes, yes. Alcohol, no (ever).

And, despite how you feel about it, endeavor to give the right answer, sans editorial comment, when a health care professional asks you whos the president of the United States. This is about your state of consciousness, not your state of confusion about how this particular president got to be this particular president.

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Herman: How my drinking problem sent me to the emergency room –


Fueled by growth, $70M Waterman expansion plan includes larger ER – Orlando Sentinel

TAVARES Florida Hospital Waterman in July will launch a mammoth expansion of its nearly 15-year-old Tavares campus, fueled by a substantial uptick in demand for services in its Emergency Department and Lakes steady population growth.

The $70 million undertaking will include the renovation and expansion of the Emergency Department and include the addition of a four-story patient tower dedicated to womens services, pediatrics and future growth, totaling 111,000 square feet in additional patient-care space.

The project represents the single largest investment in a Lake County health-care facility since Watermans Tavares hospital was completed in 2003, David Ottati president and CEO of Adventist Health System Central Florida Division North Region, said in a prepared statement.

Florida Hospital Waterman Foundation has pledged to raise $5 million in donations for the project.

Built to accommodate 50,000 patients annually, the emergency facility last year treated more than 65,000 patients and prompted the need for the expansion, said Abel Biri, the hospitals chief executive officer.

Its the primary reason for the project, he said. Weve had substantial growth in our Emergency Department over the past several years and weve outgrown our capacity.

The countys population has climbed by 50 percent since 2000 and is expected to increase another 12 percent by 2021, according to the U.S. Census Bureau, which will increase the number of people seeking treatment at the hospital. Lakes population is 323,985, according to the latest estimates.

We want to produce an environment that is conducive to the quality of care that we like to provide to our patients, Biri said. There are physical limitations to our current ER.

The project will more than double the Emergency Departments size, taking it from 35 to 58 beds, and will include improvements in privacy and patient flow, as well as innovative treatment options for special patient populations like children, seniors and heart attack patients.

Were not only doubling its size, were building it with a purpose to enhance patient care environments, Biri said.

The expanded emergency room will occupy the first floor of the tower and the second floor will house the 24-bed women and childrens unit. The new center will include womens services including labor and delivery, postpartum care and inpatient pediatrics.

The 269-bed hospitals current Center for Women and Children will be converted to a medical-surgical unit.

The towers third and fourth floor will be shelled for future growth, with the structure able to support an additional two floors.

When fully built out, it will be a six story building, Biri said.

Groundbreaking is scheduled for July 6, with construction starting sometime in August, said Biri, with the expansion and new tower completed by the first quarter of 2019. The existing Emergency Department then will be renovated with a completion in summer 2019.

The project is being designed by Gresham, Smith and Partners of Jacksonville with Robins & Morton of Orlando serving as general contractors.

Waterman is the third major healthcare facility in the County to undertake a major expansion this year.

The 170-bed South Lake Hospital started a $50 million project earlier this year, including upgrades to its Clermont campus and construction of two freestanding emergency departments. The 308-bed Leesburg Regional Medical Center is expanding its Dixie Avenue campus, with a $27 million project that will enlarge the emergency room and add 24 permanent and 24 temporary beds.

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Fueled by growth, $70M Waterman expansion plan includes larger ER – Orlando Sentinel


Report: Opioid use continues to swamp Virginia emergency rooms – Daily Press

In one year, Riverside Regional Medical Center saw an increase of more than 47 percent in emergency room visits related to opioid use.

The Newport News hospital had 26 cases in 2016, compared with 16 in 2015. There were 23 in 2014, hospital spokeswoman Wendy Hetman said in an email.

A national report shows the local hospital is not alone opioid treatment in emergency rooms have surged 99 percent since 2005. There were 1.3 million opioid-related emergency room visits or hospital stays in 2014, the latest year for which complete figures were available.. With the country in the midst of an opioid epidemic, experts expect the numbers to continue to rise, according to the Agency for Healthcare Research and Quality, which released the report.

“Our data tell us what is going on. They tell us what the facts are. But they don’t give us the underlying reasons for what we’re seeing here,” report co-author Anne Elixhauser, a senior research scientist with the agency, told The Washington Post.

The 2014 numbers, the latest available for every state and the District of Columbia, reflect a 64 percent increase for inpatient care and the jump for emergency room treatment compared with figures from 2005, the Post reported.

The sharpest increase in hospitalization and emergency room treatment for opioids was among people ages 25 to 44. The data also show that women are now as likely as men to be admitted to a hospital for inpatient treatment for opioid-related problems.

At least 1,420 people died in Virginia last year from drug overdoses, the fourth year that drugs have outpaced motor vehicle accidents and gun-related incidents as the leading cause of unnatural death, the Virginia Department of Health reports. On Tuesday, the state agency hosted more than 300 health officials, community agencies and law enforcement officers at an opioid summit in Hampton to discuss a drug crisis decades after the “War on Drugs” was declared.

The crowd listened to a series of speakers who talked about coordinating continuous care for drug addicts.

Fred Brason II of the North Carolina-based Project Lazarus, which worked with officials there to create an opioid overdose prevention program, talked about successes the state had with its opioid problems. And he encouraged local officials not to try to copy North Carolina’s program.

“You have to create a program that will work for your communities,” Brason said. “You know your communities and what they need. You have to own it to make it a success.”

Several local agency leaders expressed a need for an agency to coordinate care for people and not just leave them to their own devices to find counseling on their own after facing a crisis. Brason told the crowd if a person is ready and wants treatment, the community has to have services in place to help him or her succeed.

In 2014, fatal overdoses overtook motor vehicle crashes as the most common cause of accidental death in Virginia. Last year, Gov. Terry McAuliffe and state health officials declared the opioid epidemic a public-health emergency in the state.

By this time last year, more than 300 people in Hampton Roads had overdosed on drugs, local police and health officials reported. Sixty-five of those overdoses many of them pertaining to heroin and prescription painkillers were fatal.

When the health department planned the opioid summit, organizers worried they wouldn’t have enough people who wanted to participate, said Dr. Heidi Kulburg, director of the Virginia Beach health department and the Hampton Roads Opioid Working Group.

They were encouraged to see so many people interested in helping, she said.

The Washington Post contributed to this story. Canty can be reached by phone at 757-247-4832.

Report: Opioid use continues to swamp Virginia emergency rooms – Daily Press


New policy impacts emergency room visits for customers of BCBS i … – WRCB-TV


The Affordable Care Act may survive next year, but North Georgia patients who depend on it are now learning there’s a catch. Starting in July, the health insurance provider Blue Cross Blue Shield of Georgia will stop covering emergency room visits it deems unnecessary.

The insurance provider sent letters explaining the new policy to patients. It said if patients with individuals policies go to the ER and it’s not an emergency they will be stuck footing the bill.

Everyone’s definition of an emergency is totally different, said Travis Marler.

Blue Cross Blue Shield of Georgia customers have a lot to say about a new policy meant to lower the number of ER visits. They’ll try and get you. The hospitals will get you, for a tiny aspirin, they will get you for it, said Kristie Digges.

The company is steering patients who do not need emergency care to their personal physicians or urgent care clinics. They don’t want people to use the emergency room as their primary health care.

“They are supposed to accept any kind of patient. Whether it is minor, whether it is major, or a child being born, they are supposed to expect.

There are some exceptions to the new policy. It won’t apply to kids under 13 years old, members who don’t have an urgent care clinic within 15 miles of their address, or visits on Sundays and major holidays. If a baby is sick, it is an emergency to a young mother. But if my son’s hurt at his rodeo and stuff it might not be an emergency to me, said Marler.

A spokesperson with the company said patients should use their best judgment. But some people are worried patients who belong in the ER may not go. I think it is crazy. If you get a cut this big and they are saying it is not an emergency and they expect you to pay, I think it is stupid, said Digges.

The company said it was forced to take action because of the rising cost of health care. North Georgia residents said the restrictions are one more challenge in affording health care. It is not fair how insurance is today. It is hard for most people to afford it with they make.

Channel 3 checked with Blue Cross Blue Shield of Tennessee. A spokesperson here in Chattanooga said no one with Blue Cross Blue Shield of Tennessee coverage will be impacted by this change.

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New policy impacts emergency room visits for customers of BCBS i … – WRCB-TV


Emergency Room | Bay Medical Sacred Heart, Panama City FL


The Emergency Department at Bay Medical Center provides medical care for approximately 72,000 patients each year, evaluating and treating patients and their families, of all ages, 24 hours a day, seven days a week.

The Emergency Department at Bay Medical Center is comprised of a triage area, a main emergency department, which features three extra-large trauma rooms as well as 28 private treatment rooms, including specialized areas for pediatrics, ENT, obstetrics, orthopedics, and psychiatry. Additionally, we have an eight-bed Rapid Response unit that provides more rapid assessment and treatment for patients with illnesses and injuries that are not serious or life-threatening and a six-bed clinical decision unit.

The Emergency Department nurses are dedicated to providing outstanding quality care to our patients through collaboration with our physicians and other team members. When it comes to making improvements in the Emergency Department, we have a voice. We serve on teams that plan and implement change. Some of our current Performance Improvement activities include, but are not limited to the following:

We are very excited that Bay Medical is currently applying for state designation as a Level II trauma center, which will take us to the next level and is further recognition that Bay Medical is a top-notch hospital where our patients receive Five Star emergency care and treatment.

Visiting Hours General 8:30 a.m. 8:30 p.m. daily Cardiovascular Intensive Care Units (CVICU)

9:00 a.m 11:00 a.m. 2:00 p.m. 6:00 p.m. 8:00 p.m.10:00 p.m. All Other Intensive Care Units

9:00 a.m 5:00 p.m. 8:00 p.m.10:00 p.m.

View Map of Main Facility.

615 North Bonita Avenue, Panama City, FL 32401 | (850) 769-1511 Bay Medical Center All Rights Reserved. Site designed by CYber SYtes, Inc.

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Emergency Room | Bay Medical Sacred Heart, Panama City FL


Estero residents speak against proposed NCH emergency room – The News-Press

Thaddeus Mast, USA TODAY NETWORK – FLORIDA Published 12:17 a.m. ET April 27, 2017 | Updated 22 hours ago

Plans for a 40,000 square foot facility with ER and outpatient services were submitted to the Village of Estero in direct competition with Lee Health. Thaddeus Mast/Naples Daily News

Estero residents filled Wednesday’s Design Review Board in opposition of a proposed ER facility by NCH Healthcare System.(Photo: Thaddeus Mast)

The NCH Healthcare System plans to expand into Estero met strong opposition from local residents during its first public presentation Wednesday.

Scores of residents filled the Village Council Chambers, cheering in support of a dozen speakers voicing disapproval of a freestanding emergency room facility near Coconut Point mall.

Many comments pointed to the heated past between NCH and Lee Health.

I am insulted NCH is trying to undermine the efforts of Lee Health when theyre in the process of building a $140 million facility, resident Phil Douglas said. Its insulting. NCH has done nothing to deserve the support of this community.

Conflict has surrounded the two medical groups for years, stemming from NCHs success in halting a hospital proposed by Lee Health.

Instead, Lee Health is building a 163,000-square-foot medical complex south of Coconut Point mall, set to open in fall 2018. A focus on outpatient services and a 24-hour emergency room will try to fill the role of a full hospital.

More:Report: Lehigh Regional Medical Center safety improves

NCHs proposed facility is less than a mile from the Lee Health campus under construction.

The smaller 40,000-square-foot building brought forward by NCH will offer several health care programs, said Phil Dutcher, chief operating officer.

The facility will include a freestanding, full-service, 24/7 emergency room, a full-service outpatient imaging center, outpatient surgery and endoscopy services, and NCH Physician Group offices staffed with approximately six primary care and specialty physicians, he said.

The facility is similar to NCH Healthcare Northeast at Immokalee Road and Collier Boulevard in North Naples.

The Estero Design Review Board heard the presentation and public comments. The board is tasked with ensuring new development projects fit with village landscaping and architecture styling.

Board members offered suggestions and concerns to NCH officials to change and adjust the proposed building plans. They can deny plans based on architectural reasons until developers make appropriate changes.

The board cannot deny development plans based on how a business or organization could affect the community.

Resident Don Eslick said an NCH facility could fully halt any future expansions of the Lee Health complex.

More:Lee Health approves $140M Estero outpatient campus

Its everything but a hospital being designed to hospital standards, which are very much more costly, in order to be able to bring in a hospital in a second phase, he said. If (the NCH facility) goes ahead, it will undermine the ability of that ER to be able to function effectively.

Too many medical facilities in one area will cause trouble when applying for a full hospital, Douglas said.

If this is approved, we will have more and more difficulty getting the hospital we desperately need in south Lee, he said.

Dutcher did not provide comment after Estero residents spoke.

Nowhere else in Lee County are two ER facilities so close to each other, said Betsy Clayton, Lee County spokeswoman. This could lead to confusion during emergency ambulance trips.

Normally, emergency responders go to the nearest hospital if the patient is unconscious, she said. We havent discussed what would happen in this case.

Conscious patients can tell responders where they would like to be taken for treatment.

The Wednesday meeting was the first part of a longer review process, said Mary Gibbs, director of community development.

This is the very first step, she said. The submitted application will now undergo staff review, which will take a while. We wont have another hearing anytime soon. We have to review this for compliance with the land development code and zoning resolutions.

VIDEO:Lee Health at Coconut Point in Estero

The Lee Health hospital system has started work on a $140 million medical campus on 30 acres in Estero. It is expected to open in 2018. Frank Gluck/The News-Press

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Estero residents speak against proposed NCH emergency room – The News-Press