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Area's First Free-Standing ER Opens

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By MARY SHEDDEN | The Tampa Tribune

Published: March 7, 2008

Tampa Bay's newest emergency room opened this week, miles from any hospital campus.

The $9 million Morton Plant Mease Bardmoor Emergency Center in Largo is the first free-standing hospital emergency room in the seven-county Tampa Bay region, and just the fourth in Florida. The 15-bed facility will serve some of the estimated 84,000 central Pinellas County residents who visit hospital emergency rooms each year.

"There's a real need for urgent care," says John Couris, vice president of Morton Plant Mease Health Care, a system that includes four traditional full-service hospitals. "There wasn't a real need for more [traditional hospital] beds."

Like other emergency rooms, the facility is equipped with walk-in and ambulance entrances, trauma, triage, exam and observation rooms. And though it's about half the size of the Morton Plant Hospital's emergency room in Clearwater, about eight miles away, the Largo facility does include a full hospital-level radiology department and laboratory. It also is open and fully staffed 24 hours a day, seven days a week.

Located at the intersection of Bryan Dairy and Starkey Roads, the 15,000 square foot emergency center was added to the campus of the Bardmoor Outpatient and Surgery Center, a 10-year-old center sometimes mistaken as a full-service hospital by people walking up and needing immediate medical attention.

"That helped underscore what we knew, that there was a need," says Couris, who added that patients needing longer care can be transferred to the main hospital in Clearwater.

Between 1995 and 2005, the number of hospital emergency rooms in the United States decreased to 3,795 from 4,176, according to the National Center for Health Staistics' 2005 Hospital Ambulatory Medical Care Summary. By comparison, the number of emergency room visits during that decade increased 31 percent to 115 million visits in 2005.

In central Pinellas County alone, three hospitals have closed in the past 12 years, says hospital spokeswoman Beth Hardy.

Morton Plant Mease never planned to build a new hospital on the site: An emergency center was the plan from the start, Couris says. This approach points to fundamental shifts in health care delivery. In particular, demand for inpatient hospital stays has diminished as patients have grown increasingly comfortable with outpatient care.

In fact, free-standing emergency centers have existed in the United States since the 1960s, according to the state's Agency for Health Care Administration. They've cropped up in several states, including Texas, California, Virginia South Carolina and Delaware. These centers differ from hospitals that shut down operations but leave emergency departments behind, as has been proposed at South Bay Hospital in Sun City Center.

In Florida, the HCA requires the facility to be licensed as an emergency department, and it must be available to the public as a place that provides emergency medical care without a required appointment. Florida's first stand-alone emergency center opened in Ocala in 2002; the second opened a year later in Fort Walton Beach in the Panhandle.

But the centers are not without controversy. Last year, the Florida Legislature passed a moratorium on additional centers, challenging the quality of care. But the bill was vetoed by Gov. Charlie Crist. A third center, in Miami Beach, opened in January and several others are planned across the state.

A 2004 state study on the issue showed that concerns surround whether the potential overdevelopment of stand-alone departments would threaten the viability of hospitals serving many uninsured and underinsured patients. Hospitals that build these departments usually want to establish their presence in a growing market, the HCA report says.

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