The Villages Hospital ER

[mommieswamie]

I just figured out why The Vllages Hospital ER is so busy. The only way to be admitted to the hospital is to go through the ER.

Friday I called my doctor as a condition for which I had been in the hospital twice since Christmas had returned with a vengeance. He said he was going to admit me but that I needed to go to the ER. The last time I went through the ER for hospital admittance, the triage nurse told me that my doctor could call ahead with orders and that would save some time. He did call and was told the hospital was not taking orders over the phone from doctors. I asked if I could just stay home until there was a bed available as it was clear that I needed to be in the hospital, but it was not an emergency. No again - I was told that I needed to go to the ER. It was the only way to be admitted to the hospital.

Desperate for help, knowing that I needed to be on IV antibiotics immediately, yet just being unwilling and unable to face the lengthy wait at The Villages hospital ER, I went online to check the ER wait times that are posted for a nearby hospital system. I then drove to that hospital where I waited a short period of time and was admitted through their ER. Granted, I do not have my regular primary care doctor, but my admitting doctor knows my primary care doctor well and he called him. The infectious disease doctor that I needed has privileges here, so here I am.

My infectious disease doctor confirmed that there had not been a direct admit to The Villages hospital in a long time.

[graciegirl]

I just figured out why The Vllages Hospital ER is so busy. The only way to be admitted to the hospital is to go through the ER.

Friday I called my doctor as a condition for which I had been in the hospital twice since Christmas had returned with a vengeance. He said he was going to admit me but that I needed to go to the ER. The last time I went through the ER for hospital admittance, the triage nurse told me that my doctor could call ahead with orders and that would save some time. He did call and was told the hospital was not taking orders over the phone from doctors. I asked if I could just stay home until there was a bed available as it was clear that I needed to be in the hospital, but it was not an emergency. No again - I was told that I needed to go to the ER. It was the only way to be admitted to the hospital.

Desperate for help, knowing that I needed to be on IV antibiotics immediately, yet just being unwilling and unable to face the lengthy wait at The Villages hospital ER, I went online to check the ER wait times that are posted for a nearby hospital system. I then drove to that hospital where I waited a short period of time and was admitted through their ER. Granted, I do not have my regular primary care doctor, but my admitting doctor knows my primary care doctor well and he called him. The infectious disease doctor that I needed has privileges here, so here I am.

My infectious disease doctor confirmed that there had not been a direct admit to The Villages hospital in a long time.

I don't think I understand this. If I would go to my regular doctor and he would order tests and ascertain I needed to have my gall bladder removed and sent me to a surgeon, I could not be admitted at.....admissions?

What if my next baby is by c section?

I hope you are feeling much better now Mommieswamie.

[jblum315]

I don't understand it either. An expectant mother in labor has to go through ER? Someone scheduled for surgery next morning has to be admitted through ER? Seems wrong.

[BobnBev]

I understand that if you arrive by ambulance, you go right to the head of the line, is this correct?

[gomoho]

Don't think they have obstetrics at TV hospital Gracie so you probably don't want to go there for delivery of your next baby.

[jnieman]

Don't think they have obstetrics at TV hospital Gracie so you probably don't want to go there for delivery of your next baby.

:popcorn:

[Mikeod]

I understand that if you arrive by ambulance, you go right to the head of the line, is this correct?
Nope. You are evaluated and a priority for treatment is established. Life/limb threatening conditions are seen before others.

[Warren Kiefer]

I just figured out why The Vllages Hospital ER is so busy. The only way to be admitted to the hospital is to go through the ER.

Friday I called my doctor as a condition for which I had been in the hospital twice since Christmas had returned with a vengeance. He said he was going to admit me but that I needed to go to the ER. The last time I went through the ER for hospital admittance, the triage nurse told me that my doctor could call ahead with orders and that would save some time. He did call and was told the hospital was not taking orders over the phone from doctors. I asked if I could just stay home until there was a bed available as it was clear that I needed to be in the hospital, but it was not an emergency. No again - I was told that I needed to go to the ER. It was the only way to be admitted to the hospital.

Desperate for help, knowing that I needed to be on IV antibiotics immediately, yet just being unwilling and unable to face the lengthy wait at The Villages hospital ER, I went online to check the ER wait times that are posted for a nearby hospital system. I then drove to that hospital where I waited a short period of time and was admitted through their ER. Granted, I do not have my regular primary care doctor, but my admitting doctor knows my primary care doctor well and he called him. The infectious disease doctor that I needed has privileges here, so here I am.

My infectious disease doctor confirmed that there had not been a direct admit to The Villages hospital in a long time.

I just spent a long wait in the hallway of the emergency room along with a lot of other ill persons. The only way I would agree with my wife to go the emergency room in the first place was if transported by ambulance. I really needed this type of transport because of being so ill and very dehydrated, I would never do the ambulance thing is not necessary. Sadly I spent over 8 hours in the hallway, the place was packed. I hate to guess how long the wait would have been if I had walked into the emergency room. It is well known that it is best to go to the Villages Hospital is by ambulance if needing attention. I truly believe the staff did the best they could for me considering the overwhelming circumstances. THE PROBLEM, AND THERE DEFINATELY IS A PROBLEM, IS THAT THE SINGLE HOSPITAL FACILITY SIMPLY CANNOT HANDLE THE 100,000 PLUS POPULATION. Ocala with a population less than the Villages has no less than three major hospitals.

[villager]

Interesting. About a month ago, my mother-in-law was scheduled for a surgical procedure. The doc wanted her admitted the day before. She stayed at home until the hospital called to say there was a bed available. When we arrived at the hospital, we went directly to the admissions window (not through the ER) and they signed her in right away. I have no idea why she didn't have to go through the ER as the OP says. I have also heard from medical professionals that if you go to the ER on your own, you will wait much longer than if you arrive by ambulance. Who knows what to believe these days.

[ilovetv]

I'd be pretty sure your primary doctor here is not satisfied with the administrative procedures like this at TVRH. Imagine being a doctor or nurse working in such a setting!

As Michael Dukakis said so famously, "The fish rots from the head down".

We've all seen more than enough to say:

This hospital needs the entire top and middle level administration ousted and replaced with people who have run hospitals effectively in other large cities over 100,000. Tweeking this thing is going nowhere, and the developer's clout and managerial insight are needed.

There. I said it.

To Gary Morse, Mark Morse, and Jennifer Parr:

Are you listening? You need to speak with front-line doctors (as in ER), NOT administrative ones that "manage" by having one meeting after another, playing political games.

[billethkid]

as I have said many times before I would not go to TV for anything.....for many reasons, not the least of which is the issues presented in this thread.

Leesburg hospital admission policy is they give you 3-5 prior to your scheduled procedure to come in and pre-register. Then the day of the procedure or when ever you are to be admitted, one just stops by the desk and checks in.

My personal experience at Leesburg? Pre registration took about 30 minutes. Check in day, I was on my way to my procedure in less than 30 minutes.

My priority for hospitals:

Leesburg
Monroe Regional Medical Center
Waterman

None are as convenient as TV hospital, however one will spend significantly less time getting the treatment at the ones further away.

And I know there will be others who have personal experiences at these places as well.
Our experience with needing treatment over the last 9 years at Leesburg (4 different times between my wife and I)....they get straight A on their report card from us. Patient and family focused and expedient.

btk

[scarecrow1]

I would go to the e.r. After 8:00 p.m. Nothing goes on in the villages after eight !!!!!!!

[Fuzz323]

About a month ago I cut my thumb open with a razor knife opening boxes. I tried to stop the bleeding for more than a couple of hours and then had my wife drive me to the Villages hospital for the first time since we moved here. Info was promptly taken and shortly after I was seen by a (triage?) nurse. All this time I was applying good pressure to the wound. After that little interview (continue with the pressure!) we sat in the waiting room for another 2 1/2 hrs. By this time the bleeding had slowed to a manageable rate so we said goodby - I have nerve damage in that thumb now & a nice scar plus a great memory of that hospital!! If you can go somewhere else!!

[red tail]

About a month ago I cut my thumb open with a razor knife opening boxes. I tried to stop the bleeding for more than a couple of hours and then had my wife drive me to the Villages hospital for the first time since we moved here. Info was promptly taken and shortly after I was seen by a (triage?) nurse. All this time I was applying good pressure to the wound. After that little interview (continue with the pressure!) we sat in the waiting room for another 2 1/2 hrs. By this time the bleeding had slowed to a manageable rate so we said goodby - I have nerve damage in that thumb now & a nice scar plus a great memory of that hospital!! If you can go somewhere else!!

the hospital has an urgent care across the street for small emergencys. no waiting! that's what triage is all about. those arriving by ambulance are treated first

[Mack184]

the hospital has an urgent care across the street for small emergencys. no waiting! that's what triage is all about. those arriving by ambulance are treated first
NO..THEY ARE NOT! This nonsensical idea needs to be buried forever.

IF..and ONLY IF you have TRUE emergency..will you be taken ahead of everybody else. If you are rated a 1 or 2 by Triage, will you get to be taken ahead of ofthers. 1=You are dieing and they are bringing you back. 2=Emergent stroke, MI, gunshot, serious trauma. If you don't fall into those 2 catagories you will wait like everyone else. NOTHING and I mean NOTHING annoys the ER staff more than people who've taken the big red bus to the hospital because they think it's a ticket to the front row when they are not suffering from a TRUE emergency.

If you feel you need to call EMS, by all means do so. But don't be annoyed if you don't get taken right away once you have been triaged. If you're not a 1 or 2..There are others who need the doctors and the nurses more than you do.

Those nurses & doctors work 12-hour shifts often without lunch, coffee or pee breaks. They work HARD. They are not off playing cards & drinking beer while you're waiting. They bust their butts. They'll get to you as soon as they possibly can.

[StarbuckSammy]

If you talk to your doctor and he wants you to be admitted in the hospital immediately for something that should be looked at he will get you admitted through the ER...not Admissions.
Would like to know which local hospitals show online the wait time for the ER.

[Villages Kahuna]

I'd be pretty sure your primary doctor here is not satisfied with the administrative procedures like this at TVRH. Imagine being a doctor or nurse working in such a setting!

As Michael Dukakis said so famously, "The fish rots from the head down".

We've all seen more than enough to say:

This hospital needs the entire top and middle level administration ousted and replaced with people who have run hospitals effectively in other large cities over 100,000. Tweeking this thing is going nowhere, and the developer's clout and managerial insight are needed.

There. I said it.

To Gary Morse, Mark Morse, and Jennifer Parr:

Are you listening? You need to speak with front-line doctors (as in ER), NOT administrative ones that "manage" by having one meeting after another, playing political games.You make it sound like the Morse's have been sitting on their hands, letting market forces dictate the quality of healthcare in The Villages.

There's a reason, I think, why the developer chose to create The Villages Health System and is in the process of recruiting and hiring 64 new, board certified primary care physicians. The eight offices he's building are over-the-top first class, by the looks of the new Colony Cottage office. Much if the developer's action and investment to improve healthcare in our community follows recommendations made by a top notch medical consulting firm that the developer hired and paid for. The success in attracting the Moffitt Cancer Center and the affiliation with the University of South Florida medical school was no accident.

My guess is that healthcare in TV and the hospital are on their way towards dramatic improvement. It may take some time, a few years probably. After all, we keep adding to the population to the tune of about 5,000 people per year. Then there's the problem caused by the influx of people during "the season". It might be awhile before all these problems of quality and capacity are resolved. It won't be easy.

[mommieswamie]

About my experience. I am only relating what happened to me. I begged my doctor to be allowed to stay home until there was a bed available so as to be admitted as a direct admit. I was told the only way to be admitted to the hospital was through the emergency room, even thought I pointed out that it was not an emergency. I was informed that there were no beds available and the hospital was not taking orders over the phone from doctors. In desperation I went online and checked local hospitals to see which ones had ER wait times listed. I choose a very reputable hospital that was close by that did have the ER wait times listed. When I arrived the online wait times were pretty accurate. The specialist that was called in from The Villages area confirmed that there has not been a direct admit to The Villages hospital in a while.

Every doctor and nurse that I have ever seen associated with TV hospital ER works as hard as they can. I asked a nurse the last time I was there what the problem was. She said there simply were not enough beds for the ever increasing number of people that needed services of the hospital.

I don't think I will say anything more about this.

[gocubsgo]

I was told TV ER has no triage and that's why people go in there and sit for hours on end. I think that's absolutely ridiculous and unacceptable in this day and age. ALL hospital ER's should have a triage!!

I have given instructions to my family that if I am ever in need of an ER, DO NOT take me to TV ER...I don't care if I am 10 feet from the door. I would go to Munroe first.

[Mack184]

I was told TV ER has no triage and that's why people go in there and sit for hours on end. I think that's absolutely ridiculous and unacceptable in this day and age. ALL hospital ER's should have a triage!!

I have given instructions to my family that if I am ever in need of an ER, DO NOT take me to TV ER...I don't care if I am 10 feet from the door. I would go to Munroe first.
Whomever told you that hasn't the faintest idea of what they are talking about. TV has MULTIPLE Triage Nurses doing their job each and every day. EVERY hospital has a triage program. If you don't want to take my word for this, ask TOTV poster Russ Boston who works there. You'll get the same answer.

[blueash]

I have never been in the hospital or their ER, however, it is good medicine to have patients with acute illnesses who require admission to go to the ER. There is no reason for a pre-op patient to be seen, but if you are ill enough that your condition has deteriorated to the point you need to be in the hospital then it is not unlikely that it may have deteriorated further between the time you were seen by your doctor (or in the OP case, not even seen just sent in based on a phone call) and the time you arrived for admission. Additionally the floor nurses do not have the equipment or the same training as the staff in the ER to manage acute situations. There may well be no doctor on the floor until the following morning to assess you. So you are telling me you are in deteriorating medical condition and wish to be sent to a hospital bed where you will not see a doctor until tomorrow. If I am the hospital I want you seen on arrival to ascertain whether you are floor, ICU, or transfer to tertiary care sick. If the ER is operating efficiently (a whole different topic) you will be assessed, necessary lab and Xray tests done and reviewed, IV's and meds started and then up to the floor for ongoing care now that you are stabilized.

[Warren Kiefer]

Interesting. About a month ago, my mother-in-law was scheduled for a surgical procedure. The doc wanted her admitted the day before. She stayed at home until the hospital called to say there was a bed available. When we arrived at the hospital, we went directly to the admissions window (not through the ER) and they signed her in right away. I have no idea why she didn't have to go through the ER as the OP says. I have also heard from medical professionals that if you go to the ER on your own, you will wait much longer than if you arrive by ambulance. Who knows what to believe these days.

We are dealing with apples and oranges here .....
The orginal post was in regards to actually having an emergency, not simply being admitted. Being admitted for a procedure usually encounters little if any problems. On the other hand, if you become ill, fall or such , you might have more than a 8 hour wait in the emergency room waiting to be treated I have concluded with my recent experience that long waits are not the fault of the staff but are the fault of the facility not being large enough to deal with such a large population.

[justjim]

Its obvious that TV is growing faster than their hospital. The TV Hospital is overwhelmed. Especially the ER. No quick fix and no easy answers---we are all going to need some patience. I know it's easy for me to say because I haven't had the "pleasure" of using the Hospital or it's ER. 60 more hospital rooms is a start but much more is needed.

[Jhooman]

Last July I went to The Village ER, examined quickly, two days later needed emergency surgery. I was treated with compassion, kindness and the surgeon saved my life. Spent 10 days in the hospital. Returned three months later for a reversal of original surgery, once again, the treatment was excellent. I had a few issues, but the husband took care of them.

My original problem was not diagnosed correctly by two doctors here in The Villages. I currently have a doctor in Orlando. But I'm actively looking for a doctor here. I'm hoping to find a competent doctor.

[graciegirl]

I think that the trouble is this;

The huge surge of population during the months of January, February and March,of many, maybe most who have no doctor here that they consult and who has their records and who seek medical treatment at the hospital rather than see a doctor before it becomes an emergency.

The ever increasing population.

The fact is that triage is in place to take immediate life threatening cases first, such as stroke, heart attack, breathing emergencies, shock, hemorage, etc.

Although many arrive that have terrible pain, and SERIOUS infection, fever, dehydration and other things that are by far not minor, they are not life threatening.

We have gone to an emergency room in Cincinnati with grandson who had an asthma attack and he was immediatly treated. Clumsy me tripped and fell over a curbing thingy and landed like a tree on my noggin and split a kinda big place above my eye and I waited for six hours with the blood dripping down. (I was NOT drinking!) Same large and wonderful hospital in Cincy.

It is far worse here because in this aging population we have MANY serious injuries and auto/cart accidents and strokes and heart attacks, diabetic comas, etc.

[Cantwaittoarrive]

In my experience, I don't see how TV ER is any busier than the ER back home

[Mack184]

We are dealing with apples and oranges here .....
The orginal post was in regards to actually having an emergency, not simply being admitted.....I have concluded with my recent experience that long waits are not the fault of the staff but are the fault of the facility not being large enough to deal with such a large population.
BINGO..As they say at the church hall! As I mentioned in earlier posts & threads the real problem related to long waits in the TVRH-ER..and for that matter in most hospital ERs is a shortage of beds in OTHER parts of the hosptial. Once a patient is admitted for whatever reason they will be assigned to a proper medical floor. Often there are no beds currently available and the admitted patient has to stay in their ER bed until they can be moved. Since the ER is now "holding" this admitted patient, they have one less ER bed to bring in someone who is waiting. If you're holding 5-8 patients, that slows down the progress of any ER. Also, because the most needy patients have to be seen first, space must be kept available for someone arriving with an emergent MI, stroke and the like. Again, this is not merely a TVRH problem, it's a problem all across the US. It's not at all unusual in large cities such as Baltimore to have 36 hour ER waits. However, it's a major problem at TVRH and it's not likely to get better.

TVRH has a problem that's not of it's own making and it will hurt them more & more as time goes on. The average hosptial gets about 30-40% of it's revenue from Medicare. TVRH on the other hand gets fully 88% of their income stream from Medicare. No hospital in the US gets more per-capita Medicare dollars than TVRH. Medicare reimbursements are paying less and less to doctors and hospitals. Under the Affordable Care Act, Medicare reimbursements will be even less. Currently most Medicare reimbursements to doctors and hospitals do not even cover the base costs incurred in giving the Medicare patient their needed care.

Because of it's location and who it serves, they have very little opportunity to receive significant income from private insurance, or engage in for-profit items such as cosmetic surgery and other elective treatments for cash as other hospitals do to raise their bottom line.

As Medicare reimbursements continue to be cut that means that TVRH will be even more strapped to have the needed revenue to build larger facilities, pay more staff and so on. So as the load will increase, their profit margin will continue to decrease. Which of course means fewer beds available, less staff to handle the increased load and so on.

While costs continue to rise on everything that they do, the Affordable Care Act will cut their Medicare reimbursements year after year.

Based on what I know of TVRH and from posters like Russ Boston who work there, TVRH is doing the best they can with what they've got. Their problem is that they're in a box that they didn't build and there's not much of a way out of it for them.

[StarbuckSammy]

I would think that most folks would say that sitting in an ER for 6-8 hours waiting to be seen by anyone is unacceptable. Some say Morse should step in and do something while others say that is not his responsibility. It is of course not his responsibility but he does provide the vision for this community. After all, the accolades do go to him for building this wonderful community and having the insight to build all the commercial areas plus The Villages Hospital. And don't forget that he saw the need for the Moffit Cancer and now the new Villages Health System(?) with 6-8 spaces to treat people in a Marcus Welby style. The Morse family can help with this ER situation. They can look into the problem of the hospital ER area and suggest to the Board to do something...like add more space. They added more beds didn't they?
I am surprised that the ER is this way. Every one knows the demographics and what the population is today and what it will be 5 years from now. It certainly sounds like some one is not paying attention.
Perhaps the first step for the hospital is to put on their web site the waiting time for the ER. I have seen many hospitals do this and I think it is a great idea...that way you have at least an expectation.
The Morse family have done everything right for this community. They have risked their capital and have rightfully prospered. All of us who have homes here have benefited from them. Hopefully they will see the problem that exists at The Villages ER and give the Directors a nudge.

[Mikeod]

I think Russ mentioned that TVRH decided to forego a new facility near Brownwood and instead expand the capacity of the current building. More beds will improve wait times in the ER as there will be more space to move patients onto a floor once they are evaluated and admitted.

It is not valid to compare this 100K community with a 100K community elsewhere. The demographics are so skewed here that the hospital will be much, much busier. The presence of Urgent Care facilities in the area is a good option for those who need care soon, but not life/limb threatening.

[billethkid]

has it been 4+ years since the expansion of TV hospital?
Let's assume it is (more or less)...that means the population has increased more than 25% since then (The population has doubled since we built our home in 2004). Whatever the exact number, it is growing evry month by around 200 families per month.

Add to the current "load" on the hosptals the impending addition of Obamacare and the millions more eligible for care on existing systems....like TV hospital....and the reality will become increasing more obvious that today's medical care facilites, systems and care givers will go from inadequate to something worse.

And as has been said in the past there will become a new norm of care that will be less acceptable than we have today. It is upon us.

Those of us who can afford it will pay more to keep the level of care in the future the same as we have today. And we will also go to facilities that meet our expectations.....like some of us do now.

There is no doubt or mystery about the inaduacy/lack of capacity of TV hospital today....they are behind the growth curve.....without the soon to be increase of the uninsured impact + the balance of the new population to come as build out approaches.

As long as medical care objectives are based on profit and loss instead of patient care, being behind the growth curve assures all beds full and all other operations functioning (or better said trying to function) above capacity....hence you will wait.....longer for attention now and in the future.

btk