AUSTIN (KXAN) – When Kathy Gassman’s dog, Sophie, has to go outside to run her business, she has to go.
Even if it’s in the middle of that brutal snowstorm in early 2023.
“There was a snowstorm on January 31st,” Gassman recalled.
As she opened the back door for Sophie to get out, Gassmann slipped on some snow on the porch.
“Boom, I’m down,” she said. “I still opened the door for the dog and went in to see what was happening to my body.”
Gassman’s right wrist and left leg are injured.
“So, I went to this free emergency room that I thought was an urgent care,” she said.
It was called Brush Creek Family Hospital, and it was just minutes from her home in Round Rock.
After a quick examination and two x-rays, she saw that the doctor and the radiologist who read the x-rays predicted that nothing was broken. And so, with tape on her fingers and bandages on her wrists, Gassman continued on her way.
Days later the bills arrived. One was from the doctor, the other from the facility.
“I’m like, ‘That’s disgusting,'” she said. “It was over $10,000.”
What Gassman didn’t realize was that the facility she went to was not an urgent care or a freestanding emergency room, but a hospital, on a smaller scale.
“I had no idea,” she said. Although she did sign a form that day stating that she was at a facility that is part of the Liberty ERs and Hospitals group.
“When you sign things, you know, do you read all the fine print? No, I didn’t either. I probably didn’t,” she said.
Urgent care with ERs and hospitals
“It’s really confusing,” said Dr. Diana Fite, an emergency physician and former president of the Texas Medical Association. Between urgent cares, freestanding ERs and smaller, neighborhood hospitals, “it’s a tough decision for the general public,” she said.
Fete said urgent cares are not state-licensed, services are not limited, they are not open all day and they are not required to have doctors and nurses on staff. Instead, they may have nurse practitioners or physician assistants.
Urgent care costs less than free-standing emergency rooms and smaller hospitals. Those are similar to traditional ER or hospital visits in that they provide a higher level of care with 24/7 operations and are limited by state mandates.
“They have to have nurses there, they have to have doctors, ultrasounds, cat scans, all kinds of medications. There are all kinds of requirements that are more than just an urgent care type of place,” she said.
Dr. Nathaniel Greenwood is the chief medical officer at Brush Creek Family Hospital, where Gassman attended.
“As an industry, we’ve done our best to educate people,” he said.
Gassman gave Greenwood permission to speak with KXAN Investigates about her case. Greenwood said his small hospital with an AR still has the value of a full-size hospital because it’s staffed 24/7 with doctors and nurses and has two operating rooms and long-term patient beds.
Despite what the bills reveal, Greenwood explained that they expect to earn a fraction of what they normally charge.
“Basically, we send an inflated bill and realize the insurance company won’t pay anything,” he said.
Apparently Gassman’s insurance agreed to pay less than 10% of the $10,436.38 between the two accounts, for a total of $950.52. That’s the amount Gassman had to pay out of pocket because she didn’t get the insurance deductible.
KXAN Investigator Mike Rush put Gassman in touch with Dr. Greenwood of Brushy Creek Family Hospital because Gassman still thought the dose was too high.
They agreed to pay $181.55.
Gassman’s advice to others is to do what she didn’t do.
“Read the signs, maybe ask questions before you start stuffing things,” she said.
How to decide where to go
According to the Texas Association of Freestand Emergency Centers, urgent care is best for treating things like minor infections, flu symptoms, sprains and minor cuts.
Freestanding emergency centers are equipped for cases such as heart attack or stroke, open fractures, head injuries or severe bleeding. Small hospitals with emergency rooms have the same capacity, Greenwood said.
And if the facility has the word “emergency” in its name, expect to pay premium prices.