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Freestanding ERs stir debate in Oklahoma

Nationwide, the number of freestanding emergency rooms has increased from about 150 in 2005 to almost 300 in 2011
by Jaclyn Cosgrove Modified: September 18, 2013 at 4:00 pm •  Published: September 17, 2013

Coeta Morrell keeps finding fewer reasons to drive into Oklahoma City.

Over the past 50 years, the Mustang resident has seen the number of businesses and services coming to her town continue to rise. Soon, Morrell can add a health care facility to that list.

Morrell was among several people who gathered last week at a St. Anthony groundbreaking ceremony for a health care campus it plans to build in Mustang.

“We're all looking forward to it, everybody I know,” she said. “And those of us who are getting older, sometimes time is of the essence, so we're very happy about that.”

The St. Anthony Healthplex Mustang will house Oklahoma's third freestanding emergency room, a term used to describe an emergency room facility that doesn't have inpatient beds.

Nationwide, the number of freestanding emergency rooms has increased from about 150 in 2005 to almost 300 in 2011, according to survey data from the American Hospital Association.

In early 2012, St. Anthony opened Oklahoma's first two freestanding emergency rooms, St. Anthony Healthplex South at 13500 S Tulsa Drive, and St. Anthony Healthplex East at 3400 S Douglas Blvd.

So far, other large health systems have yet to build freestanding emergency rooms.

An OU Medical Center spokesman said only that the hospital was evaluating the idea.

“We have seen success with freestanding ERs in other markets and are always evaluating new ways to serve our community,” said Scott Coppenbarger, OU Medical Center spokesman.

OU Medical Center is a Hospital Corporation of America hospital, a large for-profit health care management company that has freestanding emergency rooms in other states.

Meanwhile, neither Mercy nor Integris, which both have large networks throughout Oklahoma, have plans to build freestanding emergency rooms.

One of the reasons that Oklahoma only has two of these facilities, with a third on the way, might come down to the rules around who can operate an emergency room in Oklahoma.

Lee Martin, chief of medical facilities at the state Health Department, said in Oklahoma, only a hospital can be licensed through the state Health Department to operate an emergency room.

And the term “freestanding emergency department” doesn't exist within the rules regarding who can be licensed for an emergency room, he said.

Martin said companies and business administrators from other states have called him to ask about the rules around operating freestanding emergency rooms.

St. Anthony has a license from the state Health Department to operate its emergency rooms, and the state Health Department views the freestanding locations as branches of St. Anthony, he said.

Urgent care centers, meanwhile, are facilities that are operated through a specific physician's license, he said.

Kyle Nondorf, regional vice president of SSM Health Care of Oklahoma, said the concept of the freestanding emergency rooms came in 2009 after the company researched different markets where such a setup had been successful.

SSM Health Care of Oklahoma, which operates St. Anthony facilities, chose the locations of the three healthplexes after identifying markets with health care needs, Nondorf said.

“The cool thing about Mustang is, they were looking at a hospital with inpatient beds, and we approached them with — we think this is a sustainable model and is a model that's really going to be something we can develop for the future where health care is going,” he said. “They were very receptive and supportive of that concept.”

Nondorf said market research has shown between 5 percent and 8 percent of people who go to these types of facilities need inpatient care. Nationally, fewer people are using inpatient services, he said.

He said the freestanding emergency rooms can meet a community's needs and provide better access to services that are in high demand.

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by Jaclyn Cosgrove
Medical and Health Reporter
Jaclyn Cosgrove writes about health, public policy and medicine in Oklahoma, among other topics. She is an Oklahoma State University graduate. Jaclyn grew up in the southeast region of the state and enjoys writing about rural Oklahoma. She is...
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