Hospital closures affecting ambulance response times

Hospital emergency rooms are swamped, and that’s affecting response time for rural ambulance services, including in Anderson County.

Cases of the flu and respiratory issues spike during the colder months, which leads to more people seeking medical care, but the recent closure of Tennova Regional Physicians Hospital — formerly known as St. Mary’s — and Lakeway Regional in Morristown have added to the number of patients crowding ERs.

Jellico Hospital in Campbell County is currently in negotiations with Tennova Health, Inc., but if that sale doesn’t go through by the end of the month, it may close down too.

Nine hospitals have closed in Tennessee (population 6.7 million) since 2010, making this state the second highest in the nation, according to the North Carolina Rural Health Research Program. (But even that data is old, as it doesn’t include the two Knoxville hospital closures. No updated data was available for this story.)

Fifteen closed in Texas (population 28.3 million).

“Before we had this flu season, we still had this problem,” said Anderson County EMS Director Nathan Sweet. “It’s been going on a year and a half, nearly two years now. We’ve had several meetings with the hospitals and Region II EMS. We were trying to address this problem before the hospital closed.”

Crowded emergency rooms mean that ambulances can be stuck at the hospitals for hours as they wait for the hospitals to clear a room. In January, Tennova North (in Powell) went on diversion at least once, meaning they weren’t accepting any emergency room patients.

“If I have three out of six ambulances stuck at hospitals, that gives me three ambulances that can handle emergencies,” he said. “It’s a big issue. And it’s unfortunately going to impact people.”

Sweet said his staff tries to make the best decision for the patient when it comes to which hospital to take them to, and that factors in which ones can accept them the fastest. Turkey Creek, for example, is typically less crowded.

But, there are things in the works that might make a dent in this growing problem, according to Sweet.

Medicare just released a new program that they’re going to pilot where EMS can take patients to places other than the hospital.

“Right now, EMS can only take a patient in a 911 setting to the emergency room,” he said. “That’s the only place we’re allowed to go. But this would make it to where we can start taking patients to clinics, doctor’s offices and different places.”

A lot of people going to ERs don’t need a room, they just need to be seen by a physician, according to Sweet.

“This would save significant amounts of Medicare money,” he said.

$500 million, to be exact.

And if it works for Medicare, private insurance groups would most likely follow their lead. One side effect of that, though, could be hospitals losing even more money, since the number of ER visits would go down.

Another program Sweet would like to see implemented is “community paramedicine.” That’s something that would help identify people who use the hospital as their primary care.

“We would go meet with people at their home and educate them on how to use the medical system,” he said. “We would check on them, coordinate our efforts with physician’s offices. It’s being done in other states.”

Those two things could make a huge dent in the overcrowding problem, according to Sweet. The application period for local EMS departments to become part of the pilot program opens this summer.