Free-standing ERs — they’re a Cedar Rapids-Marion thing (2024)

By the end of this year, the Cedar Rapids-Marion metro area will have five hospital-run emergency rooms — two in the hospitals in downtown Cedar Rapids and three free-standing ERs in Marion and Hiawatha.

That’s notable on several counts. The free-standing ERs improve access to 24/7 emergency medical providers for the thousands of people who live in Linn County and surrounding counties.

It’s also notable because the Cedar Rapids-Marion metro area is the only place in Iowa with multiple, free-standing emergency rooms.

Only one other city in Iowa, Bettendorf, has a free-standing emergency room, the Genesis Health Plex, according to Chris Mitchell, president and CEO of the Iowa Hospital Association.

While other states are seeing an increase in free-standing ERs, that’s not the case in most of Iowa, Mitchell said, adding he is unaware of any plans to open such ERs elsewhere in the state.

Free-standing ERs are viewed as a way to increase service, Mitchell said, “trying to meet patients (closer) to where they are at — to make access to care easier.“

New ERs

UnityPoint Health-St. Luke’s Hospital, 1026 A Ave. NE, is opening its Marion ER on Tuesday. The 10,000-square-foot ER was built inside an existing building at 3301 Armar Dr., just off Marion Boulevard near the border of Cedar Rapids and Marion.

The Marion ER has 12 treatment rooms; advanced imaging for diagnostics and testing, including CT, X-ray and ultrasound; and an on-site laboratory.

Mercy Medical Center, 701 10th St. SE, has had a free-standing ER in Hiawatha since 2020, just off Interstate 380 on Boyson Road. It was the first free-standing ER in Iowa outside a hospital setting.

Mercy also is aiming to open its second free-standing ER on Dec. 3 in Marion. That ER, now under construction, will be at 999 35th St., next to the MercyCare Marion clinic, across 10th Avenue from the Marion Hy-Vee.

Additionally, Mercy last week announced a $1 million donation from a Cedar Rapids couple, who chose to remain anonymous, that will go toward renovating the hospital’s downtown ER waiting area.

Officials at both hospitals said they completed studies before deciding to expand their emergency services beyond the downtown hospitals.

St. Luke’s study

St. Luke’s identified Marion “as an ideal location due to its fast-growing population and community expansion projections,” said Dr. Sarah Hoper, the medical director for the new Marion ER.

“This new location is crucial to the Marion community as well as northeast Cedar Rapids and surrounding eastern Linn County communities to receive fast emergency care when time is critical,” she said.

Access to emergency medicine physicians “close to home for residents will save lives and enhance patient recovery,” she said in an email.

Having the new ER, she said, also will help “alleviate congestion and enhance the patient experience” at the downtown hospital’s emergency room, “one of the busiest emergency departments in the state.”

“The Marion ER is another option for care when family medicine clinics and urgent cares are closed," Hoper said.

The St. Luke’s Marion ER anticipates first-year costs and capital expenditures of under $1.5 million, she said, adding that UnityPoint Health has 50primary care, specialty, urgent care and express care clinics in Eastern Iowa.

Mercy’s plan

Dr. Matthew Aucutt, medical director of emergency services at Mercy, said Mercy's decision to open a free-standing ER in Marion was based on increased patient loads and community growth.

“Marion is going to grow extremely fast,” he said. ("The new ER) is located on one of the area’s busiest streets.”

The new ER also will bring faster, better emergency care to residents of Central City, Anamosa, Mount Vernon and Lisbon by eliminating the need to travel to downtown Cedar Rapids, he said.

Aucutt said competition was not much of a consideration in the decision to build the new Marion ER.

“There's plenty (of patients) to go around for everybody,” he said, noting that baby boomers are aging and experiencing more health problems.

Also, he said, quick appointments at doctor offices and clinics are hard to get now, and the new ERs will help alleviate that situation.

The numbers

Emergency rooms are busy places.

Aucutt said when he started at Mercy in 2006, ER patient visits totaled less than 40,000 for the fiscal year.

In fiscal 2024, which ended June 30, the Mercy’s downtown ER had 44,218 patient visits and the Hiawatha ER had 22,522 visits, for a total of 67,340, an increase of more than 1,000 from the previous fiscal year.

St. Luke’s ER recorded 51,264 patient visits in 2023, with the top three health problems being abdominal pain, chest pain and shortness of breath, and 53,266 visits in 2022.

ER physicians

Given that state and local hospital officials have been calling attention to an anticipated shortage of doctors, how do the Cedar Rapids hospitals anticipate staffing their new ERs?

St. Luke’s downtown emergency room is staffed by board-certified emergency medicine providers from East Central Iowa Acute Care, which has 29 ER doctors and 17 physician assistants and nurse practitioners, Hoper said.

Seven new emergency medicine doctors were hired in the past year in anticipation of the St. Luke’s Marion ER opening, she added.

The doctors will work in both the downtown and Marion ERs, Hoper said.

East Central Iowa Acute Care, she added, “has not had difficulty recruiting physicians because of variety of factors, some of which include emergency medicine residency programs inEastern and central Iowa.”

Many of the residents in these programs, she said, are Iowa natives or from the Midwest, making them amenable to staying in Iowa.

Mercy's Aucutt also said his hospital has had success lately hiring new doctors.

All three of Mercy’s ERs will be staffed by board-certified physicians, along with trained “physician extenders.”

Aucutt said Mercy needed about seven new doctors and has already hired six, four of them from outside Iowa.

Ambulances, helicopters

Both St. Luke’s and Mercy plan to have ambulances at their free-standing ERs in case a patient must be transported to a downtown hospital.

The ambulance ride to the hospital will be free if the patient chooses to go to the hospital that’s running the free-standing ER. If the patient chooses another hospital, there will be a charge.

Mercy's Marion ER will have a landing pad for patients arriving or leaving by helicopter. The Hiawatha ER does not have a helipad.

St. Luke's will not have a designated helipad at its Marion ER but, if needed, a LifeGuard Air Ambulance helicopter could land in the ER’s parking lot.

Both hospitals have medical helicopter landing pads at their downtown locations.