Seriously ??? I'll bet you can count, on 1 hand, the number of developers that built a full service hospital in conjunction with housing units. Give them a break, and let the market do it's thing. We're all lucky to be here and have the facility as good as it is. Are you volunteering there to try and improve service? None of us is entitled to local medical care, so I for one am thankful to have it as it is.

TV Hospital Medicare Claims
 

For what it is worth..

I read last year that The Villages Hospital had the highest percentage of medicare claims in the nation.. Around 86 % .

I was working in the ER the other day and we had 7 (yes 7) EMS teams waiting in the ER halls with their patient. The rule is that they have to remain until their patient is seen by an ER doc and assigned an ER room.

It is not a matter of under-staffing it is a case of overpopulation. Every single one of our ER rooms was full plus the 7 EMS in the hall with another 20 (?) or so in the waiting room.

We can not release a patient to an admit floor until a room becomes available. So the wait is long. I was down there to act as stop gap nurse as if the patient had been admitted 'upstairs'.

This time of year there are simply too many patients and not enough rooms. In the summer it is just the opposite. The down side of a hospital in a 50% snowbird (plus guests in the winter) community.

True.

It does not take 7-8 hours to get you out of the hospital once you are discharged. I do it every day at TVRH. Perhaps you had 'some' doctor who told you you could go home but I gurantee it was not your admitting doctor. Once the admit doctor says you can go and signs the papers I usually have you out the door in about 1.5 hours, many times less.

What quite often happens is that some consultant doctor (cardio, neuro etc.) says that you are clear to go but the attending physician of record (who sees you every day at least once) must clear you and sign the order. If a consulting doc ever tells you that you can go make sure that he/she has the authority to do so from the attending doc.

I write these things because although TVRH has some issues that need to be worked through I don't like misinformation. In fact our charge nurses are on our butt to make sure we discharge ASAP. We have to clear room for ER patients ready to come up.

Thanks, Russ, for all the info. It's good to receive details from the inside and not just speculation from us on the outside of the business.

Thank you
 

Thank you for bringing some professionalism to this thread! I am from the suburbs of Boston where I had my choice of probably five of the best hospitals in the U.S., but you could not walk into the ER and get seen immediately. I was a patient at the Boston Beth Israel and it was a "factory" compared to the treatment we have received here!

My other half was an emergency "life or death" patient at TV hospital and his treatment and care was above reproach.

To add to this..People are not taken in turn when coming to an ER. Remember..it is an EMERGENCY Department. Each ER has a triage system numbered 1-5. One meaning you're actually dieing right then and there. They trump everybody and anybody coming in. Level 2 is someone who's in very serious danger..life threatening danger. An emergent stroke or MI. Your cut finger is not a 2 and in many cases not even a 3. While it's imporant to you and an emergency to you..to the hospital the Heart Attack in room-1 and the gunshot in room 3 and car accident in room 7 all take predecent. Unless you are TRULY dieing, plan on waiting. A 7 hour ER wait is unfortuantely not a very long wait. In many cases in larger cities the waits can run anywhere from 24-36 hours. Yep, that's right.

Now if you think that calling the big red bus is your ticket to a bed even faster, don't bank on it. Nothing irritates the ER staff much more than you taking the bus to the back door when you're going to be triaged as a 3 or lower. And Mr. Russ is quite correct in saying that the EMS teams have to stay with their deliveries on their gurneys until there is an acceptable bed for them to be handed off to. Of course if you have called the big red bus for a trivial matter, and you get coded somewhere between a 3 and 5, the charge nurse will very likely have you removed from your gurney, and given a seat in the waiting room, and release the EMS team.

Someone suggested that the flu epidemic is one of the reasons for the crowding and that seems very logical and of course so many people are here now who are NOT year 'round residents who get sick and don't know what else to do but go to the ER and I suppose a lot of people do NOT see their doctor when a problem is emerging and wait until it becomes an emergency.

It is wise to get yourself a doctor here even if you are a part time resident. I hate to point out to any of you that we are ALL a little older and have more medical problems than we used to have.

I think that finding a doctor here is very difficult because so many people judge physicians primarily on bedside manner and I don't care how curt and abrupt a doctor is, I just want him or her to be knowledgable. So someone liking a doctors personality really isn't all that helpful. AND so many of us are fairly new here ourselves and it is scary to start a new doctor patient relationship. You are placing your life in their hands.

I don't mean to be negative and yet I do sound negative. Our daughter has had some very serious and unusual health situations over time and I became so grateful for the knowledgable physicians that guided us through them and became aware of others who were born with her cardiac difficulties not faring so well in small communities across the country. We continue to go back to Cincinnati for her cardiac check ups because her plumbing is so unusual.

I guess over time I have become a doctor snob. I have not had a bad situation here with our doctor in the four years parttime and one year full time we have been here. But thank heavens we haven't really been sick either.

Dentists are a different story. There are some very unethical dentists in Florida.

It is interesting that our insider Russ says that the problem with the ER is not understaffing but overpopulation. But this has been a problem for the past several years and from my perspective The Villages Hospital has not solved the problem. What in the world happens when the next 20,000 or so residents move in? This is not the developer problem..it is the hospital. I don't know about you, but the thought of more possible patients the next few years makes me worry.

The problem may be more the limitations of the physical plant, i.e., the number of rooms, rather than staff. There are plans to expand the hospital rather than build another facility near Brownwood. In my experience, it requires less time to expand an existing facility than to build a new one as far as getting through the local permitting process and the state and federal approvals. But it still takes years to accomplish this. The hospital has been expanded once before and will expand again. Hopefully this will help the wait times in the ER. It would appear the administration is taking some steps, but one may question whether they are projecting appropriately for the increased population.

I think we have a total of 24 ER rooms at this point. I know the other day each nurse had 4-5 rooms assigned. It's mostly a snowbird problem the way I see it. The population swells during the winter months and the physical plant (while due for expansion over the next two years) can not (and maybe should not?) be made with the highest number in mind. There were many times last summer when we called off nurses and other staff due to lack of patients! We are increasing the number of beds by almost 1/3 in the next two years and perhaps that will free up ER holds (holds = ER beds awaiting an admit room in another unit such as cardio, medical, surgery etc.)

So what you are saying is that you need 15-20 ED beds from May-November and a minimum of 45 beds from December-April.

hospital
 

When we first moved to the villages 8 months ag o, my daughter had an accident and needed stitches in her hand. The villages emergency room were wonderful.yes we were there a few hours but that was expected. She was seen immediately. Everyone was so wonderful. The past month my husband had to be taken to thr er twice by ambulance, again wonderful care. If anyone is very sick, call 911, they wwill send an ambulance and will take you right into the emergency room. Or go to urgent care and they will call an abulance.

My mind is not at ease
 

I, too, have been a bit worried about the possibility of getting quality emergency care. Thankfully, neither myself or my husband have needed it thus far. I have no experience with TV hospital or urgent care centers, so my thoughts and opinions are solely based on what I have read and heard. I have told my husband that if I need to be hospitalized please get me to Ocala. What I wonder is if I go to TV hospital by ambulance, and want to be transported to Ocala hospital, will an ambulance transport me if my condition warrants?? I do worry about needing immediate, quality medical care. And I had no idea the medical care was so poor before I moved here. Not something I even thought about checking out. I figured since there were 90,000+ people the medical care had to be pretty good. Apparently not.....

Happinow- I don't think they will taxi you from place. Try leesburg, but then again it is a few years older I know how you feel about older buildings

In my experience ERs throughout the nation are nearly all experiencing the same kinds of pressures that we experience in TV. I served as a director of a 235 bed critical care hospital in a small town (100,000 ) in Md for 17 years. We were constantly rebuilding, renovating, expanding that operation during that entire time and still were unable to satisfy the more than 70,000 people who arrived asking for care . Even with the enormous proliferation of urgent care centers throughout the country, the pressure on ERs has continued to grow. My family has had three evperiences with the TV ER in the last two years and our care (quality and wait) was no different than we had experi ernced at Johns Hopkins Hosp in Baltimore or several other MD facilities.

Poor medical care!
 

If you have not yet needed to avail yourself of the medical care here in TV how do you come to make the statement "I had no idea the medical was so poor before I moved here".

The medical care available to you here is good to excellent. You have a hospital right here in TV. You have a hospital in Leesburg. You have Florida Watermans. You have two hospitals in Ocala. You then move into the very high end hospitals, namely - Orlando General, Tampa General, Moffatt, Gainesville and Mayo in Jacksonville. The farthest one is a three hour ride from here and how bad is that?

This thread has vilified TV hospital, but there are hundreds of residents who have had excellent treatment from our local hospital.

To clarify a point..both The Villages Hospital & Leesburg General are operated by the same company...Central Florida Health Alliance. So in essence if you like the care you get at TV you shouldn't have a problem with Leesburg, but if you don't like the care at TVH then you most likely won't like the care at Leesburg.

There also seems to be a rather big discrepancy between doctors affiliated with Munroe and those at TVH/Leesburg. If you read each hospital's website, they list the background & schooling of many of their physicians. TVH/Leesburg seems to have a rather large amount of 3rd world doctors educated at medical schools that are not well known, while the majority of doctors at Munroe Regional have been schooled at well-known American medical schools.

one trip to er at the village received good care. Two heart attacks care for in leesburg still here so that was OK. The medical care in the area is very good. As for where the drs come from Americans go overseas the people overseas come here that is the way it is.

Well now that opens a whole different issue. Are the docs from those schools less than the best??? Have a son who recently graduated magna cum laude from the University of North Carolina. He is 28 with life experience working in the ER of a hosptial in South Carolina and several years working experience in a psychiatric facility, EMT certified and has done Meals on Wheels for several years and actually saved someone's life 'cause he recognized one his stops was not right and the man was having heart problems. But unless he scores absolutely OUTSTANDING on the MCAT (test for admission to medical school) he won't get a spot in a US school 'cause he is a white male and their are only a few spots for those kids.

So I hear you concerns about those "other" medical schools, but not so sure if they are correct. At least the Caribbean schools require you to do your residency in Miami. May be the new "normal".

Hmmmmm! what do you mean by discrepancy? Don't all Docs have to pass the same boards and licensing requirements to practice. I believe all Hospitals have credentialing requirements which undergo scrutiny be thier accredation body. Discrepancy?

Home Heath services
 

Not sure if this will help, but I recently had a hip replaced and went to THe Club for rehab. I couldn't get out fast enough. It was a horrible place. When I came home, I hooked up with a home health care service called "Florida Firstcare." It was wonderful. The Visiting Nurse, home health aid and Physical therapist were all amazing and caring. I highly recommend them.

Had similar experience. Will never go back there

I agree that most ER's are ridiculously busy, however only about 30% of those patients seeking care are truly in need of emergent care. The other 70% do not have timely convenient access to high quality primary care providers to suit their needs.

I have had 3 experiences with The Villages Emergency Room. The first time was for my daughter who cut herself with a knife. total time was 3 hours. I thought that was pretty awesome. Second and third times my husband was brought in by ambulance and the care was commendable. While I am not crazy about the family practice doctors, the urgent care doctors are wonderful. We have to keep searching until we find the doctor for us. Unfortunately they seem to come and go like the wind! Just found new gastro doctor and surgeon and they have a pretty good practice.
In NY we knew our doctors and if someone needed a recommendation we knew who to go to. Here we are all new at this.

I am not the only person who has serious concerns about doctors educated in places outside of the USA, especially those educated in the 3rd world. I will admit to being a "brand snob". I like to have doctors who've graduated from Ivy League-style schools. But if there's a choice between a doctor who was born, raised and educated in the USA over someone from another country I will pick the USA educated doc every single time. USA all the way!

As a former healthcare professional, this is sad to hear. I suspect that many don't understand the criteria for what is considered a "medical emergency." ER personnel are sufficiently trained to identify such, however, in many instances, their assessments are generally in conflict with those who are waiting to received services. You can be assured that a "true" medical emergency will be treated promptly and without delay. On the other hand, you can pretty much bet that not being treated promptly when you arrive at the ER is a clear indication that your "emergency" declaration is clearly not the case.

I would agree with Gracie Girl - perhaps you should have called 911. Just be prepared to pay the difference.... The same is true when you go to the ER. Most insurances will not pay for non-emergency situations which is determined based on the final diagnosis. You have to be willing to pick up the tab based on the final outcome.

Try to understand this. ER personnel see lots of patients who believe they have a "true" medical emergency. What may appear to be a medical emergency to a lay person could easily be considered "routine" medical care to ER personnel. My suggestion to anyone considering use of the ER instead of an Urgent Care Clinic or doctor's office visit is this. If you are required to sit in excess of an hour in an emergency room awaiting treatment, consider leaving and seeking urgent care. Chances are you're going to be stuck with an ER expense that you will regret.

My wife is an ER-NP. Agree 100%!! I'd also like to add that nothing annoys the ER staff much more than somebody taking the "Big Red Bus" to the hospital in an effort to get to the front of the line when they are not experiencing a true life-threatening emergency. In many cases if you do this, besides incurring the charges mentioned above, the charge nurse will simply just triage you at the level you actually rate, and offer you a seat in the waiting room and release the ambulance crew.

I think the whole point of calling 911 is that they can be there in a matter of minutes and can provide critical emergency care right there without the drive to the hospital or the wait in the ER

Even if you ride to the hospital in the ambulance you will still be triaged on your arrival. If you are not either a "1" or "2" you will not get to bypass the wait in the ER. You will wait just like everybody else. All you will have done is rung up a nice big bill to pay for the ride.

I don't think there is a charge for EMS transportation here in TV. There was no charge for EMS transportation in West Chester, Ohio where we moved from.

Somebody correct me if I am wrong.

What I just learned yesterday is that the team that transports you MUST stay with you until you are released to the hands of a doctor. That is why it is important that we schedule our heart attacks and strokes for other than the months of January, February and March when people who do not have MDs here may be overusing the EMS. You may think that the EMS is at the fire station down the street but probably they are putting in "wall time" at the emergency room and can't come and transport you.

GG:The charge will come from your insurance company most likely NOT your local EMS. What was said earlier is that if you are transported and it is NOT found to be a true emergency in the eyes of the hospital and/or insurance company, you're going to get a bill because the insurance isn't going to cover the cost.

You are right about the EMS crews having to stay with their deliveries until they are released. But..the incoming patient will be triaged and the decision will be made as to what level they are on the triage scale. If they are a 3 or lower, it is often likely that the charge nurse will invite that person to have a seat in waiting room until they can be treated, at which time the charge nurse will release the EMS crew. If that does not happen, then the EMS must stay with their delivery until a bed can be found. Now if the incoming patient is a "1" or "2" which indicates a TRUE emergent condition..MI,or stroke in progress, gun shot, serious accident and so on, EMS must stay with their delivery until there is a bed for them, which will be quick.

Many small rural fire companies who have ambulance services often run annual "subscription drives" where you get the opportunity to donate to the fire company. If you should pass on that opportunity and need the ambulance you will get an extra bill because you are not a member.

I'm pretty sure there's an astronomical charge for EMS in the Villages. I had a friend that took EMS a few weeks ago and the charge was out of this world... It was a true emergency too.

It is not part of the services our taxes pay for?

If you need the fire department to put out a fire, is there a charge for that?

It wasn't where we came from.

May I suggest you call 911 any time your Mom needs help. I did what you did with my Mom, and we experienced the same wait. Awful. The nurse said call 911, and they will take her right it. As for the staff, they were wonderful to her once we got in.
Good luck, M. Boyle

GG Person: I have just sent you a long & boring PM about this.
Enjoy. Or Not.

It is a fact that, compared to other hospitals in the same category, the emergency room services at The Villages Hospital are dismal. It is understaffed and disorganized. Some say it is uncaring too. Tales about patients in real distress having to wait to be seen some six or seven hours abound. So do sad tales of patients already in the emergency wards being asked the same lengthy key information by three different staff members; not just name and update since first interviewed.. In fact, when we moved here three years ago, we were told to never go directly to the TVs emergency room, but to call an ambulance instead for transportation to those facilities. Then, the chances of being seen faster are higher.

That said, one would think that the developer, Mr. Morse, would take an active role in improving the situation. After all, health care facilities are selling points in attracting home buyers.

More surprising is that the Daily Sun has not investigated this very legitimate story. I know that negative reporting about TVs is taboo. But whatever happened to journalistic proactivity, to even improving coverage in order to sell more papers?

The situation at the Vs Hospital emergency room merits analysis.

I for one, rather go to Ocala, as the Leesburg hospital has the same corporate parent as TVs facility. Penny pinching?

The Ambulance service is contracted by Sumter County so you will get a bill when you call. it goes to your insurance company which in most cases pay a $100 to $150 fee for this service. The Volunteer Fire Dept. and Ambulance Company's from up north collected tax dollars from your yearly taxes to finance both Fire & EMS services. IN TV the FD is paid thru taxes but the Ambulance is a private run outfit contracted by the county so they can bill you. Asfor the ER if your not critical you will wait. That's why they have a Triage Nurse to access your needs.

I had written a long PM to Gracie about this, but I will mention a couple of points that I had written to her. One of the REAL problems that cause long waits in virtually all ERs is the lack of available beds in OTHER areas of the hospital. When someone goes into the ER and the person is admitted they will be moved from the ER onto a medical floor. HOWEVER..IF there are no beds currently available on the appropriate medical floor, that patient MUST stay in the ER until a bed is available for them. When a patient is being "HELD" in an ER bed, that means that the ER has one less bed to be able to accept another patient.

Some larger hospitals have units that are designed to be an ER-Hold section where patients are sent and cared for until a bed on the proper floor is becomes available, thus relieveing pressure on the ER. TVRH is a relatively small ER and once they begin to hold patients, the entire process slows down. I have been told that the bed shortage on the medical floors at TVRH is chronic.

As far as people being in REAL distress, the Triage Nurse will assign a number from 1-5 on the condition of the patient. (1 most important-they're dieing and 5 is a hangnail) A kidney stone for example is NOT a major emergency. (Usually a 3) You might hurt like hell but you're not dieing. You may feel like it, but you're not going to die. Emergent MIs, strokes, gun shots, serious accidents and the like trump everything else. ABC is what matters most...
A=Airway
B=Breathing
C=Circulation
Any of those conditions come FIRST. And..YOU have no idea what's developing behind the doors. YOU do not know how many serious patients they are tending to before you. If you are truly dieing..you will get back there fast. In an old episode of MASH a shocked visitor asks.."How loud do they have to scream before they get taken?" Col. Potter answers.."It's the ones who CAN'T scream who get to go first.

As far as you being asked your name, rank & serial number over & over & over again..that my friend is a FEDERAL regulation. It is designed so that nurses & doctors do not accidently give you the wrong treatment or blood or medicine. And..in virtually ALL hospitals..failure to ask those questions is a "Zero Tolerance" rule. They are not being incompetent or nosey..If they fail to do that, they can be fired on the spot. I hate being asked the same questions over and over..but your doctor or nurse MUST do that and you will make their job MUCH easier to do if you don't gripe to them about it. They don't have any choice in the matter. So please be kind to your care giver and play along.