PRESS RELEASE - Texas Freestanding ERs’ Essential to Overwhelmed Healthcare System During Surge

AUSTIN, TX (August 30, 2021)-  Amid the worst wave of COVID-19 to date, Texas Freestanding ERs are proving an essential front-line resource for an overwhelmed healthcare system by holding and caring for patients for whom no hospital beds are available. Hospitals across the state are grappling with a lack of ICU bed availability, and Freestanding ERs are consequently taking in patients who would otherwise end up lining hospital hallways, waiting rooms and, in some cases, parking lots.

“For us, this is the worst surge since COVID has started,” said Dr. Robert Velarde of Altus Baytown. “It’s hectic. It’s tiring. It’s stressful. Due to a lack of hospital beds.”

Freestanding ERs, like hospital ERs, are designed to triage, stabilize and when necessary, prepare patients for transfer to the Intensive Care Unit or surgery to receive additional care not provided in the emergency room.

“We’re having to take care of not only emergency patients but also ICU-level patients,” said Jeffrey Beers, a board-certified emergency room physician at a freestanding ER in Longview.

In recent weeks, however, staffing shortages have prevented some hospitals from being able to accept transfer patients from Freestanding ERs, despite transfer agreements between the facilities. In many cases, Freestanding ERs are holding patients for days while attempting to find a hospital that can care for them.

"We are the first line of defense, patients come to our emergency center when they require oxygen, or an ICU bed, we get them stabilized, and then we immediately start working on a transfer and typically that would take an hour or so," said Dr.  Jeremy Gabrysch, Director of The Emergency Clinic in La Vernia Texas. "Now we're seeing that it takes days sometimes, where we're caring for these patients while our doctors and nurses are on the phone trying to get beds for these patients. In some cases, we're calling hospitals as far away as Laredo or Corpus Christi even, if the beds in San Antonio are not available, just trying to find an ICU bed for a patient we are caring for in our emergency room." 

Holding patients in an ER who require intensive care or surgery for an extended period is highly unusual and risks poorer outcomes for patients. The State of Texas requires Freestanding ERs to report if they had to hold a patient longer than 23 hours. Many facilities have had staff members call more than 80 hospitals and often had to turn to google to look for a hospital bed for a patient. One facility even hired a staff member whose sole function was to track down any hospitals accepting transfers in order to find beds for patients.

Because of the high number of COVID-19-related hospitalizations, Texans suffering from common health emergencies, like strokes, heart attacks and injuries, are affected by the hospital bed shortage as well.

“If they happen to get anything else like a urinary tract infection that gets complicated or a kidney stone that needs a procedure, they can’t get a bed. They can’t get treatment,” Dr. Velarde of Altus Baytown said.

There are more than 200 freestanding ERs in Texas offering 1500 extra beds across the state. Without the life-saving care provided by these facilities throughout the state, the Texas healthcare system would lack an increasingly essential front-line resource during these extraordinarily demanding times. Thanks to the creation of the freestanding ER industry by the Texas Legislature in 2009, Texans in need have high quality emergency medical care with shorter wait times throughout the state. Freestanding ERs are serving their communities and alleviating the strain on Texas’ hospital system as patients with medical emergencies – whether COVID-related or not – turn to them in their time of need. Freestanding ER staff, like their peers in hospitals, are working back-to-back shifts and are serving patients at risk to their own health and lives.

“The men and women who have been risking themselves to serve their patients in Texas Freestanding ERs are healthcare heroes,” said Kevin Herrington, President of TAFEC. “During this surge, they not only have to care for patients but embark on lengthy searches to find them the next stage of care, whether ICU or surgery. They are making superhuman efforts to keep up with the demand for care and they’re meeting the challenge. We owe them a tremendous debt of gratitude.”

Even though there is a lack of hospital beds, Dr. Daniel Roe, Medical Director with VIK Complete Care said, “We are still finding alternative solutions to treat patients in the emergency room.”

TAFEC Response to Recent TAHP Complaint

AUSTIN, TX (February 11, 2021)

PRESS RELEASE - TAFEC: Setting the Record Straight - TAHP’s HHSC Complaint Attempts to Mislead State Agency, Curb Texans’ Emergency Care

AUSTIN, TX (February 24, 2021)-  In a letter sent today to Texas Health and Human Services Executive Commissioner Cecile Young, the Texas Association of Freestanding Emergency Centers (TAFEC) identified the misstatements and deceptions within a complaint filed by the Texas Association of Health Plans (TAHP) with HHSC on January 29, 2021. The letter addresses TAHP’s ongoing pattern of misinformation and false accusations. The insurance industry’s deceptive practices and routine under-payment of patient claims has led to recent record fines.

“TAHP’s false allegations and misstatements are a deliberate distraction from the fact that big insurers continue to benefit themselves by throwing patients and healthcare providers under the bus.  Even during the pandemic, big insurers continue to avoid their contractual obligations to cover patients' medical claims and they deliberately deny and delay fair reimbursement to medical providers.  It’s a shameful way to increase the bottom line, especially in light of insurers' record-breaking profits," said Dr. Eric Mclaughlin, Member of TAFEC Board of Directors.

TAHP’s complaint alleged numerous instances of non-compliance with House Bill 2041, which deals with price disclosures and applies only to Freestanding Emergency Medical Care Facilities (FECs). TAFEC has advocated for price transparency legislation and supports efforts to hold non-compliant FECs accountable. The TAHP complaint, however, showcased a number of licensed hospitals’ supposed infractions and mischaracterized them as FECs, attempting to purposely mislead a state agency. TAHP also provided no evidence of when screenshots of the cited examples were taken, further calling into question the validity of the allegations. Health insurance companies in Texas have a history of producing and distributing misleading marketing materials to their customers on emergency care.

“Let’s clear something up, TAHP is comprised of insurance experts not healthcare professionals,” said Kevin Herrington, President of TAFEC. “FECs are staffed by emergency trained physicians and nurses who make the life-or-death decisions on care every day.” 

Record hospital closures and hospital over-crowding during the COVID-19 pandemic have reinforced the critical need for access to high-quality medical care in Texas. The value FECs provide to Texans has never been more evident. One-fifth of Texas’ 254 counties have fewer than two doctors, and pre-pandemic Texas ranked dead last in ease of accessing medical care.

“The freestanding ER community has long advocated for being able to provide both emergency and non-emergency care to patients, particularly in rural areas where medical resources are scarce,” said Herrington. “The insurance industry inexplicably opposes every attempt we make to provide more Texans better access to care at a lower cost.”

FECs, which are fully licensed and regulated by the state, help alleviate strains on hospital capacity, and their short wait times reduce the risk of exposure to COVID-19. Throughout the pandemic, thousands of dedicated emergency medical personnel at FECs have risked their own health to care for Texas patients affected by the pandemic, provided close to 1 million COVID-19 tests, provided critical care such as life-support when Texas hospitals couldn’t take in anymore patients, and supported countless numbers of infected patients – all while still caring for other emergency patients. Some FEC personnel have fallen ill and lost their lives as a result of their commitment to serving their patients. 

Freestanding ERs were recognized in 2020 by the federal government as a valuable resource during the COVID-19 pandemic. In April, the Centers for Medicare and Medicaid (CMS) provided a temporary waiver that allows Freestanding ERs to receive reimbursement for treating Medicare patients during the public health emergency, providing elderly, disabled and under-served Texans with valuable healthcare options. In December, the U.S. Congress passed a year-end spending package, which included bipartisan language to protect patients from getting “surprise” medical bills. The landmark legislation, supported by Texas-based FECs,  added Freestanding ERs into federal statute for the first time.