Are there any rules for urgent care walk-in facilities?

What I'd like to know is how the receptionist and whoever she popped her head round the door to ask both knew that James's mother wasn't shyly going to confide in the doctor that she hadn't been able to pass urine for 36 hours but she didn't want to worry her son.

Or similar.

If you stick a sign on your door advertising urgent care for the general public you'd better have a flipping good reason for turning a patient away unseen. I'll be interested to hear how James gets on with his complaint.

Mind you, there are some very odd goings-on in primary care all over. There always *have* been, of course, but these times we're living in do seem to be particularly "interesting" in the Chinese curse sense of the word. In our little backwater city, five or six general practices have amalgamated into one brave new corporate group with a grand shiny tower block of a building supposed to house one-stop access to every conceivable healthcare service short of acute care. Exciting! Except I'd heard rumours from clients about how difficult it was to speak to a GP now - about prescriptions, new side effects, problems with taking medication, all the little ills you're supposed to ask your doctor about - and then last Monday I needed to ask one simple admin question that anyone there could have dealt with. From 08:00 to 17:00 I called their number at regular intervals. Normally you join the waiting system - "you. are. caller number. thirty NINE. in the queue" - and you sit there with a nice cup of coffee and the crossword and leave your phone on speaker and it's not really a problem. But on Mondays you can't even join the wait. The outgoing message says something like "all our reception team are working at capacity to help our patients. If your requirements are urgent go to your nearest Emergency Department, or call back later." There is also an online form you can fill in, and then when you submit it you get a message saying they aim to respond within 48 hours. And where does that leave my little old lady client who's been sick an hour after she took her new medication and doesn't know if it matters or not, eh?

My advice is that on the occasions when you come across a doctor or allied healthcare professional who is both helpful and effective, write the name down, get their number or email address and then don't let them out of your sight.

James,
You’ve already taken this to the providers employer. You got a written communication back saying they are looking into it. Work with them.

The anger you’ve displayed here won’t be conducive to further talks, and you suspicions about illegal discrimination could well be unwarranted because you can’t know the whole situation.

I know someone who had a large cyst lanced at an urgent care. It exploded, sending bloody smelly pus all over the room. Other medical maladies could involve Explosive and messy vomit, poo or pee, and that wouldn’t be something a clinic would typically share especially amidst handling the situation. Or the doctor may have himself been feeling under the weather or managing an emergent situation.

Not saying any of those are true, but they could be equally or more plausible than your immediate assumption this is age discrimination.

Have you contacted the appropriate folks at Hackensack and complained?

Does your mother have a primary care medical provider? It sounds that the urgent care MD first treated her when she was 72, and continued to manage ordinary small problems. It worked out well, it seems. He is gone, and the medical landscape has changed a lot. It is a business, so that there are all sorts of new 'unspoken rules" that are now in place. The reasons sound vague but like good ideas...but there is no flexibility for individual patients and their families.
They did not refuse care to her, they felt that her problem could be beyond the level of care that they provide, and that it would be wrong to go through the whole urgent care workup and THEN be told to go to the ER.
At 84, she is medically frail (no matter how she seems to a lay person). Good care would be to have a PCP, and once she has scheduled an initial appt with one, she may wait 3 weeks. However, once she is on that wait list, that practice can advise you what to do. It might have saved a trip to urgent care.
A pharmacist can give information about an over the counter product for you to choose to you. That is not a substitute for medical advice.
Her sx could be reaction at COVID injection site, some sort of tick or insect bite that could cause both infection in the soft tissue of her arm and systemic infection, or some unusual skin cancer manifestation. And plenty of other things.
No provider can make decisions about diagnosis and treatment without both examining the patient and getting relevant lab work, checking previous medical records, etc. No provider will risk their own hard earned license to practice their skill and earn a living by failing to meet the basic standard of care.

The reason they gave you for declining to see your mother was utter nonsense. If she'd been having a severe adverse reaction to a new px from another doctor, would they have refused her treatment for that too? Tosh. I've never heard the like.

That said, and partly because it is such transparent tosh, it also sounds to me like the third or fourth argument a stressed-out receptionist might put up in defence against a frustrated and annoyed relative trying to get his mother seen when for other reasons it wasn't possible to offer her a slot. How busy was the clinic that day?

I suppose even private providers who describe their services as Urgent Care are regulated and have to have some sort of approved triage system. I have to go to bed in a minute because I have a week's work to fit in to tomorrow, but if you have more time at your disposal you could have a trawl through
https://nj.gov/health/healthfacilities/
and see if there are any pointers there.

James, what kind of insurance does your mother have?

I too was turned away from urgent care in the early weekday afternoon with a more urgent issue than the one described. There was no recourse besides traveling many more miles across state lines to find one that would take me or go to the local ER. As with any business, as long as they do not deny services based on the Federal and State-specific protected lists, they can deny services. They are allowed to run their business as they choose. They referred you to ER. They didn't have to do anything more than that as not all businesses desire to see as many patients/customers as possible.

James, the er is the only place that can’t decline patients. As far as discrimination against a protected class, all they would have to do is show during that period was that a person over 65 had been seen. That would, of course, blow your lawyers legal argument out of the water. Plus said lawyer would not be pleased that you threw all sorts of identifying info up here where anyone can google it.

I'm sorry to hear about this experience. Experiences and "rules" for clinics and networks vary by state and by insurer. An important question: is your mother on Medicaid? Because many doctors and clinics do not accept Medicaid patients.

Another issue is that doctors schedules are so full that they often don't accept new patients, no matter what (this is how it is in my state, MN).

Your statement that healthcare is a "right" in NJ is not accurrate. This is from your governor's website:

“New Jersey has advanced strong policies to protect access to health care for our residents, access which I **believe** is a human right. With this law, we take another step in securing the access families need to gaining more affordable health coverage."

Someone believing something is a "right" is not the same as it actually being a legal right. Your state protects *access* to healthcare, but it's not codified into law as a right that I'm aware of. FYI if it was a right and the government provided the "free" healthcare to all, it would basically be Medicaid. Many of us on this forum who have to deal with Medicaid have a few choice words about it's quality and bureaucracy.

One more fact to ponder: the US is short 30,000 doctors because of the increase in the boomer and somewhat large millenial population, and due to med school being so outrageously expensive, and also the US having a very strict policy about what it takes to permit non-citizen doctors to practice medicine here.

You bringing your LO so that a very busy doctor can meerly "reassure" her when her issue was clearly not urgent was not a productive decision for anyone. Does your state have a nurse's hotline where in the future you can first call to get guidance from a licensed nurse who can tell you whether you can do home care remedies, need to go to Urgent Care or go straight to the ER? My state has this. Please see if this is a resource for your mom for future medical issues. It's not a doctor or medical staff's job to talk your mom off the edge — it's your responsibility. Our elderly LOs need us to do this a lot and we all need to learn how to do it so we don't exhaust ourselves and others.

I will be honest here: if I was the person waiting after you in that clinic office knowing your mom's case was not truly urgent when I or my child had an actual medical issue, I'd be pretty pissed and rightfully so. FYI I've sat in an empty ER *for hours* when my mom broke her arm and another time when she needed stitches in her head. We have no idea what's really going on behind the scenes.

When people perceive things as a "right" or get something for free, they tend to overuse the resource. That's been proven over and over. Finally, "free" healthcare is not really free, it is paid for by taxpaying citizens.

I think this Urgent Care gets to make their own rules, which is obvious by the way your mother was treated. They probably saw a "Covid vaccination issue" and backed away from IT rather than HER being an elder, that's my guess. In any event, your only recourse is to contact their Office of Patient Experience at if you wish to discuss this matter further. In other words, you'll probably get another apology from them and sent on your merry way. And treated the exact same way if you showed up again with your mother in tow with a red swollen circle on her arm! Who knows WHAT scenario they had conjured up in their mind when they saw her? It's sad these days when we're turned away from MEDICAL FACILITIES for whatever reason they come up with as an excuse. And that's how I view it: an excuse.

I remember when our insurance provider, Kaiser, shut DOWN their building entirely during the pandemic. When they finally FINALLY reopened, I told my doctor I thought it was horrifying that in the middle of a pandemic, my INSURANCE PROVIDER decided to SHUT THEIR DOORS leaving me totally stranded in the event I needed medical care! Know what she said? "Oh the CDC told us we had to shut down." Okaaaay, then let me rephrase: I think it was horrifying that in the middle of a pandemic, my INSURANCE PROVIDER took orders from the CDC and decided to SHUT THEIR DOORS leaving me totally stranded in the event I needed medical care. Truth is, the medical industry these days uses the CYA principle instead of doing the right thing oftentimes, which is giving US the medical care we are seeking! Ain't that the truth?

Sorry this happened to you and your mom, James. Seeking justice often leaves us depleted, doesn't it?

James, regardless of the experience, how your mother was treated, and your frustration if not anger at the situation, you should NEVER identify specific people and/or entities on a public forum when you're making accusations.

Your comments could be construed as libel.

I would call Nicole in the Office of Patient Experience and ask her what she was going to do about their receptionist/urgent care center. An apology isn't enough detail about how they'd remedy the situation, nor what you should expect from their UC location.

I can only think of one time I didn't wait at least an hour in an urgent care clinic, and that was when my husband darned near cut off one of his fingers with a power saw. Still, they did take us in and look at it before sending us to the ER. It was clearly out of their league.

If any urgent care md or any md feels that the situation would be best seen in the er, it’s their right to make that judgment. Ers have hospital labs attached to them plus all sorts of other stuff urgent cares do not have for diagnosis.