What does it mean when a hospital goes “on diversion?”
A hospital goes on diversion when there are not enough beds or staff available in the emergency room or the hospital itself to adequately care for patients. When a hospital goes on diversion, it notifies area Emergency Medical Services (EMS) units so that they can consider transporting patients to other hospitals that are not on diversion.

How does a diversion affect my medical care?
If you are in an unstable condition, the EMS will take you to the nearest appropriate hospital, regardless of diversion status. If your condition is stable and you choose to go to a hospital on diversion, the staff will do their best to provide you with high quality medical care as quickly as possible. However, if your illness or injury is not serious, you may have to wait longer than usual to be seen by a doctor. Also, if you need to be admitted and there is a shortage of beds in the hospital, you may be held in the emergency room or another area of the hospital until the type of bed you need is available. There is also a possibility that you may need to be transferred to another hospital.

I called my doctor's office and they can't see me today. They suggested I go to the emergency department. How would I be affected if the hospital is on diversion?
If your experience a serious medical emergency or injury that needs immediate attention, going to a hospital emergency room is the right choice. However, if your condition is one that can normally be managed by your family physician, it may be better to wait until you can get an appointment or, you should consider going the nearest urgent care clinic.

Keep in mind that patients who go to the emergency room are seen based on the severity of their medical condition, not their time of arrival to the hospital. You may, therefore, be in the waiting room a long time if you go to a hospital. Also, if the hospital is on diversion, it is because they are very busy and/or short of staff.

I called an ambulance and the EMS personnel suggested I go to a different hospital than the one I prefer. Why don't they want to go to my hospital?
Unless there is a medical reason to go to a different hospital, most EMS units will transport you to the hospital of your choice. However, when your preferred hospital is on diversion, EMS personnel will explain that care at that hospital is likely to be delayed.

Does this mean when I call an ambulance that I can't go to the hospital of my choice?
No. You still have the right to request transportation to the hospital of your choice. However, as mentioned earlier, going to a hospital on diversion means that you may have a lengthy wait before you receive treatment.

What if my doctor doesn't go to a different hospital?
Even when you go to your preferred hospital's emergency room your doctor will not come to the hospital's emergency room to evaluate you. Instead, a highly qualified emergency physician will see you. The doctor at the hospital will consult with your family physician if necessary. The staffs at all San Antonio area hospital emergency rooms are able to care for your medical needs regardless of the hospital where your family physician practices.

If the hospital is on diversion does that mean the emergency room is closed?
No. Hospitals always accept patients who arrive on their own, or who are brought by family or friends to the emergency room. Remember that if the illness or injury is not serious, the patient may have to wait longer than usual to see a doctor. Hospitals always accept unstable patients who are bought by ambulances.

Why don't the hospitals just add more beds and hire more people?
It would be great if the situation were this simple. Unfortunately, it is not. The San Antonio area, like many other large metropolitan areas, is experiencing a shortage of qualified medical personnel such as nurses. Also, a number of hospitals across the United States have closed and the others have had to actually cut back on beds and monitoring equipment because of decreasing health insurance, Medicare, Medicaid payments to hospitals. Although a number of hospitals have plans to add beds and medical monitors, the staff shortages cannot easily be resolved in the short-term. Therefore, there are times when hospitals may have beds, but do not have qualified personnel to take care of all of the patients. The Greater San Antonio Hospital Council is working in collaboration with all area hospitals and many health care personnel training programs to remedy these staffing issues. Even with these efforts in place, the solutions will not be effective overnight. At this time, diversion remains a safeguard for emergency care.

Will my insurance pay if I go to a different hospital?
If your condition requires care in an emergency room, health insurance plans generally cover that care regardless of which hospital you visit. This includes the situation in which the hospital covered by your plan is on diversion and you are taken to a hospital that is not ordinarily covered by your insurance plan.

Remember, even if hospitals are on diversion, you should always call 911 in the case of a true medical emergency.

Adapted with permission from the Greater Cincinnati Hospital Council by the Greater San Antonio Hospital Council.