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MECKLENBURG COUNTY, N.C. -- The administrator of the only ambulance service to serve Tega Cay, S.C. refuses to transport patients to the closest and newest emergency room because it s not attached to a hospital.

When Tega Cay s Rescue Squad closed up shop and merged with Fort Mill Rescue, town leaders elected to use Piedmont EMS.

The CEO of Piedmont Medical Center tells the I-Team that Piedmont ambulances will not transport patients to the new Carolinas Medical Center emergency room at Steele Creek, even if it s closer than other emergency rooms.

The policy means that if patients from the Tega Cay and Lake Wylie areas in York County request to go to a Carolinas Medical Center emergency room, Piedmont EMS will drive right past the new CMS Steele Creek ER to the next closest CMC emergency room in Pineville.

If you're unstable in the field and you bypass this (ER), you've probably not made the best decision with regards to the patient, says CMC administrator Chris Hummer, who oversees the new ER.

Emergency medical calls are booming along the South Carolina state line, tracking a booming population with new roads, new subdivisions and new retail shopping. Following that boom is a competition for patients and their health care dollars.

Carolinas Health Care System built a brand new freestanding emergency room, CMC Steele Creek, bridging the intersection of Highway 160, the road to Tega Cay and Fort Mill, SC and Highway 49 which reaches the shores of Lake Wylie in nearby South Carolina.

The South Carolina state line is less than two miles away.

We have had a conversation about what to do with Steele Creek facility, says Piedmont Medical Center CEO Charlie Miller. We ve elected that we re not transporting patients to Steele Creek.

The reason, Miller says All that s going to happen at Steele Creek, if you ve got a true emergency, is you re likely to get transferred again.

I think it s a bit misguided and unfortunate, says CMC s Hummer. Because I do think what we offer here has served a tremendous need.

Hummer says the CMC Steele Creek facility has doubled its patient projections in less than a year.

Hummer is the first to say that CMC Steele Creek is not a hospital. It doesn t have beds to admit a patient overnight. But Hummer cites local and national statistics which show that the vast majority of ER patients do not need to be admitted overnight.

Nationally it s less than ten percent, he says.

CMC Steele Creek is a licensed, fully staffed, emergency room with the newest CT scan in the area.

Mecklenburg County s MEDIC ambulances use it routinely.

If patients take a turn for the worse, they are moved by ambulance or even Med Center Air to a hospital.

Piedmont s Charlie Miller admits there are medical emergencies which would require an ambulance but not hospitalization for which CMC Steele Creek would be appropriate.

But he is steadfast in the decision that Piedmont EMS only transport its patients to hospitals.

We re going to take you to a hospital where you ve got a full array of options, Miller says.

But as a matter of policy and practice, the I-Team has reported that Piedmont EMS does not voluntarily offer patients an option of hospitals.

Piedmont s EMS Director sent a memo to staff in February noting that Competition in health care... can threaten the livelihood and each and every one of us.

In that context, the memo instructs Piedmont paramedics, Once a decision is made for transport to the emergency room, your response should always include I will be taking you to Piedmont Medical Center.

It should be about health care, says CMC s Hummer. It shouldn t be about jobs. It shouldn t be about the bottom line. It should be about the patient.

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