WLOS -- ASHEVILLE, N.C. -- When you go to an emergency room you hope for immediate care. However, that's not always what you find.
News 13 investigation found Mission Memorial Hospital's emergency room, the area's largest, is often overcrowded and had higher than average wait times compared to hospitals across the country and in North Carolina.
RELATED LINK| Click here to file a complaint with the Joint Commission
The most recent published data reports come from Medicare and its affiliated website called Hospital Compare; the data is from 2014-2015. Mission Hospital is designated as the only high-volume hospital in western North Carolina.
Administrators report their ER sees more than 100,000 patients a year.
News 13 started looking into wait times after we spoke to 14 people about long waits. News 13 took concerns directly to Mission Hospital and Mission's President and COO Jill Hoggard Green.
We first asked what challenges the ER faces on a daily basis. "We have some significant challenges," said Hoggard-Green. "We are very focused on making sure that each patient is getting high-quality safe care each and every day. If you walk through our doors with a life-threatening illness, you're going to get some of the most superb rapid care that you'll find anywhere in the country."
RELATED LINK | Hospital wait time search engine
In July, four people contacted News 13 by email and Facebook complaining about long waits.
Mission records show Merissa Tipton went into the ER July 14th at 7:51 p.m. "I have congestive heart failure," said Tipton. She said her diagnosis came after childbirth.
The mother of four said she told staff she had chest pain, breathing problems, and numbness. "They had not seen me by 1 o'clock that morning so I went ahead and walked out," said Tipton.
Hospital records show Tipton's check-out was actually 1:48 a.m., which was after nearly 6-hour wait, five hours and 57 minutes to be exact, and she never saw a doctor.
Records show staff did an EKG and a comprehensive set of preliminary tests and analysis on Tipton within 30 minutes of her arrival.
William Hathaway, Mission's Chief Medical Officer, said in an email to News 13 that "Ms. Tipton indicated a low-risk profile and she was managed accordingly."
Tipton said ER staff never told her she was low-risk. She said she has a pacemaker defibrillator to control her condition.
She said she went home, took a fluid pill and her symptoms decreased.
"But my symptoms flared up about three to four days later," said Tipton. She said she called an ambulance. "And they admitted me right then to the hospital."
Brittany Rittenberry said she took her two-year-old daughter Hope to Mission's ER because she had pain and bleeding. "We initially decided to go because she had blood clots in her urine," said Rittenberry ,who showed News 13 a photo of the blood that that was in her daughter's urine. "I decided to get her up, get her dressed, to take her to Mission."
Hospital records show Rittenberry checked in July 13 at 9:38 p.m. Rittenberry said after a staff member took Hope's vitals, she and her daughter then sat for hours. "I was starting to get angry," said Rittenberry. "I think actually at one point in time, she was so upset because she was hurtin' so bad, that I was in tears with her."
Hospital records show a doctor saw her daughter at 4:48 a.m. the next morning. It was a 7 hour and 10 minute wait.
ER records obtained by News 13 show 299 patients arrived the day Rittenberry went in. Mission reports anything above 280 patients causes overcrowding.
We asked Hoggard-Green, Mission's COO, to watch and review the patient's stories.
Merissa Tipton reported the following as Hoggard-Green listened.
Tipton: "There was over 180 people waiting that night."
Kim: "How did you count that up?"
Tipton: "Because they told me. Because I was complaining about the wait time."
"I apologize," said Hoggard-Green. "We strive to make sure we are meeting every patient's needs each and every time, and I'm distressed she experienced what she experienced."
She said this to anyone who's had a delay inside Mission's ER, "I apologize. Every day we focus on improving the quality of care and the safety of the care in this hospital. What I do know is if she(Merissa) was having a life- threatening condition, she would be getting that life-sustaining care very rapidly."
The wait times for Mission Hospital's Emergency Room are listed on Hospital Compare. When News 13 checked in July data from 2014 to 2015 showed the hospital lagging in five of six categories behind ER's nationwide.
Thirty-three minutes was the average national emergency room wait to see a healthcare professional, 37 minutes in North Carolina. At Mission, patients waited for an average of 52 minutes according to the Hospital Compare website.
Data showed a patient with a broken bone nationally waited for 54 minutes to get pain medication, 56 minutes in North Carolina.
At Mission Hospital the report showed patients waited for an average of 100 minutes.
Hoggard-Green is familiar with the charts.
"We are a regional referral center," said Hoggard-Green. "We've talked about the challenges we're having in terms of the increase in behavioral health. I know we need to improve wait times and reduce wait times for anyone getting routine care in our ED(emergency department."
She added that wait times have not compromised care. "So I can tell you definitively at Mission Hospital we have some of the lowest mortality rates in the country, and we measure ourselves with over 2000 hospitals and that includes all patients."
The hospital says mental health patients are a big part of the crowding problem. "We have incredible numbers of folks that can wait days in an observation room or in an ed bed before they get access to in-patient care," said Hoggard-Green. "Because there're no beds available in the western part of North Carolina or throughout the state."
What ends up happening is something called boarding. It's called that because a patient is literally boarded. They're admitted into the ER but are kept lying on a bed or gurney waiting for a room because the hospital doesn't have one available.
Kim: "So are psych patients being boarded in the ed?"
Hoggard-Green: "The ed and these psych observation units."
Kim: "For long periods of time?"
Jill: "For long periods of time, They can be in our ER and our observation areas, for up to three to four days, while they're waiting for needed care."
Dr. Peter Viccellio, Vice-Chair of Emergency Medicine at New York's Stony Brook University Hospital is a leading expert in ER overcrowding and wait times. "There's no question it's dangerous," said Viccellio. "People deteriorate. The reason the ER is there is for emergencies and an emergency means you need to be treated now."
Data provided by Mission to News 13 during the four-month investigation shows wait times have significantly improved this summer to a median of 20 minutes in July.
Hospital administrators said adding a triage nurse to initially assess patients has helped the ER improve times. Brittany Rittenberry and Merissa Tipton, however, came in July but sat for hours.
Tipton said after repeatedly asking staff when she would be seen they said this to her. "You just have to wait your turn."
News 13 knows of no patient whose health deteriorated because of a wait.
Mission has a major emergency-room expansion planned in three years, but it won't help ease crowding issues right now. The hospital's president has spearheaded getting primary care services in rural areas to reduce patient visits to the ER for non-urgent care. The hospital has also added beds to help admitted mental health patients. Park Ridge and Pardee in Henderson County are medium volume hospitals; both have wait times above state and national averages.
To contact Kimberly King with an investigation idea, email her at firstname.lastname@example.org
Emergency Room overcrowding has become a focus in recent years. Here are some links to other national publications about the situation:
New York Times: The Patients in the Hallways
Modern Healthcare: ER overcrowding tied to higher death rate: study
New York Times: Hospitals Get Orders To Reduce Crowding In Emergency Rooms
New York Times: When Hospital Overcrowding Becomes Personal
SF Gate: Overcrowded ER points to larger problems