Long Island emergency room visits now take nearly 4 hours — 75 minutes more than national average

A typical visit to a Long Island emergency room now takes just under four hours — 75 minutes longer than the national average — data that experts said shows hospitals are struggling with patient volume while coping with staffing shortages, an aging population and outdated facilities. 

Patients in emergency departments in Nassau and Suffolk counties spent an average of 3 hours and 58 minutes from the time they walked through the door until their discharges or admissions to the hospitals, according to a Newsday data analysis.

The Centers for Medicare and Medicaid Services released the most recent figures in July, covering October 2022 through September 2023. 

That figure is Long Island's highest going back to 2015 — the earliest CMS data available — and 18% longer than the 3-hour, 21-minute statewide average. It's also 46% higher than the national average of 2 hours and 43 minutes, the data shows. 

Merrick resident Eric Maltz said he waited five hours in March to be treated for an intestinal blockage at North Shore University Hospital in Manhasset while suffering from intense pain and vomiting.

"They took my information, saw the X-ray, saw the report. It didn’t make a difference," Maltz, 66, said.

He recalled a jammed emergency room waiting area, where his wife brought him after treatment at an urgent care center.

"It was packed and we were just waiting and waiting," Maltz said. "The pain was excruciating, and my wife keeps going over, saying, 'My husband is keeled over in the wheelchair and he's in extreme pain.' And they just said, 'Sorry, ma'am, we're very busy. You have to wait.' "

Maltz said he underwent emergency surgery hours later, having a foot-and-a half of his intestines removed.

North Shore University Hospital said in a statement, "The factors that lead to long wait times in an emergency department are complex and we deeply regret any distress this may sometimes cause."

CMS told Newsday "timely and effective care" in an emergency department "is essential for good patient outcomes" and said on its website that a lower number of minutes is better.

The federal regulatory agency, which provides health coverage to more than 160 million Americans, added in a statement provided to Newsday that waiting times at different hospitals "can vary widely, depending on the number of patients seen, staffing levels, efficiency, admitting procedures, or the availability of inpatient beds."

Patient 'bottleneck'

CMS reported data from 18 hospitals on Long Island. Mather Hospital in Port Jefferson had the longest average time spent in an emergency department at 4 hours and 52 minutes, followed by North Shore University Hospital in Manhasset at 4 hours and 50 minutes. Both hospitals are part of Northwell Health.

Mather has 52 beds in its emergency department and North Shore has 97, according to the state.

Dr. John D’Angelo, senior vice president and regional executive director of Northwell Health’s Central Region, said about a quarter of Northwell patients treated in the emergency room typically need to be admitted. When busy hospitals, such as North Shore, have high inpatient volume, patients in the emergency department often are forced to wait for "sometimes prolonged periods of time," he said.

"As more people continue to come in, there’s a bottleneck on the back end of getting patients out," D’Angelo added.

Mather, which had the 11th-longest average emergency room visit time in the state, has one of the oldest emergency departments among Northwell's family of hospitals, according to D'Angelo. He said a newly configured emergency room at Mather, with double the size and capacity, will open in May.

The $52 million facility will be 26,000 square feet, Newsday previously reported.

Mather also has Northwell’s oldest average emergency department patient — with about 40% over the age of 65, according to D’Angelo.

"When these folks need care, the care is much more complex," he said.

Glen Cove Hospital, another Northwell facility — which has 16 emergency room beds, according to the state — had the fastest average visit time, at 2 hours and 35 minutes. That was followed by Nassau University Medical Center in East Meadow, the region’s only public hospital, at 2 hours and 38 minutes, the data shows.

NUMC, which has faced severe financial issues in recent years, is a Level 1 Trauma Center that provides care to low-income and uninsured Long Island residents. It has 33 beds in its emergency department, according to the state.

Meg Ryan, interim president and chief executive of Nassau Health Care Corporation, the state public benefit corporation that runs NUMC, said in a statement that officials meet monthly "to review processes, patient data including triage to exam time and ER arrival to admission times." 

She added: "Nursing and practitioner staff are all well aware of the importance of expedited patient evaluation and potential danger associated with patients waiting for extended periods."

Industry experts said NUMC can move patients through its emergency room quickly because they're typically treated for less severe illnesses.

CMS didn't report data for at least six more hospitals, with numbers for some smaller facilities included with data for their larger affiliated hospitals. Syosset Hospital's numbers are part of North Shore University Hospital's numbers. Stony Brook University Hospital's data includes Stony Brook Eastern Long Island Hospital and Stony Brook Southampton Hospital.

Mount Sinai South Nassau in Oceanside merges its data with numbers for its free-standing emergency department in Long Beach. Long Island Jewish Medical Center in New Hyde Park includes numbers for Long Island Jewish Valley Stream. 

In addition, the federal agency didn't break out data for NYU Langone Hospital-Long Island in Mineola because the hospital system combines data from its family of hospitals together. 

'A real challenge'

Medical experts said the data for Long Island hospitals reflects a national trend in which the combination of the health care needs of an aging population, physically outdated emergency departments and nurse and physician shortages add up to patient backlogs. 

State health officials told Newsday the department doesn't collect data on staffing vacancies at hospitals. Most Long Island hospitals didn't respond to questions about potential staffing shortages in their emergency rooms or said they couldn't provide data because their staff overlaps in other facility areas.  

Wendy Darwell, president and CEO of the Suburban Hospital Alliance of New York State, a nonprofit that lobbies for a consortium of public and private hospitals, said while some facilities are making major investments to expand their emergency departments to increase patient capacity, workforce issues remain a problem.

"Your emergency room is the front door of the hospital so that’s always going to be where you prioritize having staff meet the needs of who walks through the door," Darwell said. "And you’ve got to assess what the staffing needs are at every hour because you never know what’s going to come through the door. You never know how complex those patients are going to be."

Dr. Kraftin Schreyer, a board member of the American Academy of Emergency Medicine in Wisconsin, said patients also are getting admitted more often.

"The patients that are getting admitted are sicker. And as a result, they’re staying in the hospital longer," she added.

The problem isn't new.

Long Island emergency room visit times have been rising steadily for nearly a decade, exceeding the statewide average in each of the past nine years, CMS data shows.

In 2015, Long Islanders spent an average of 3 hours and 5 minutes in the emergency room. By 2019, that number grew to 3 hours and 18 minutes — more than 20% faster than in 2023, the data shows.

Steven Clarke, of Holbrook, a registered nurse who has worked for a decade in emergency rooms across Long Island, said patients who don't belong in the emergency department inflate wait times. They include addicts seeking pain medication, the mentally ill and homeless, patients who come in to avoid court or to sell drugs and those who arrive with minor injuries or anxiety issues, he said.

"It's definitely a major problem because those patients take up a lot of time," said Clarke, 40. "These things take up a massive amount of time and resources, which cause other people to have to wait."

CMS categorizes emergency departments based on annual patient volumes — low is 0 to 19,999 patients, medium is 20,000 to 39,999, high is 40,000 to 59,000 and very high is more than 60,000.

The data shows patient volume isn't the only factor influencing the average emergency room waiting time. Among the 10 Long Island hospitals with the longest wait times, four were ranked very high for patient volume and one was high volume. Five were in the medium category — including numbers one and three.

More nurses needed

Kathleen Rauch, vice president of quality advocacy, research and innovation at the Healthcare Association of New York State in Albany, which lobbies for hospitals, said turnaround times in emergency departments have been a problem nationally for more than a decade. She said the pandemic exacerbated the problem.

"We know that after the pandemic, many of our emergency room providers ended up making the decision to leave their emergency practice," Rauch said. "It's been a real challenge trying to make sure the gaps are being closed down as quickly as possible."

Lacking sufficient nursing staff, Rauch said, many hospitals are unable to open all of their emergency department beds to patients in need.

"So we're faced with a bottleneck," she said. 

Federal authorities project a nationwide shortage of 78,610 full-time registered nurses in 2025, according to the U.S. Department of Health and Human Services. In New York, there are more than 14,000 projected annual openings for registered nurses, according to a report the Center for Health Workforce Studies at the University of Albany issued in April.

Some Island patients said little contact with medical personnel can be frustrating as they wait for emergency care.

Amanda Morris, 40, of Stony Brook, said she woke up feeling sick and dizzy in December after seeing large amounts of blood while using the bathroom.

She rushed to Stony Brook University Hospital’s emergency room and, while she said she was seen quickly, she waited 36 hours before admission to the hospital for treatment of ischemic colitis, when blood flow to part of the large intestine is reduced. 

"I don't mind so much that it took them a little while to figure what's wrong and what needed to be done," Morris said. "But I was really anxious and nobody was coming to talk to me."

Stony Brook University Hospital, which the state says has 120 emergency room beds and is ranked 11th in terms of patient wait times on Long Island, didn't respond to a request for comment.

Longer visits for psychiatric patients

CMS data shows Long Islanders who arrive at emergency rooms with psychiatric emergencies wait almost 50% longer than other patients. The average time spent in emergency departments for mental health and psychiatric patients on Long Island was 5 hours and 54 minutes — 32% above the national average.

The average time spent in Long Island emergency departments for such patients has gone up 22% since the period from October 2016 through September 2017 — when CMS began collecting that data. 

Long Island Community Hospital in Patchogue had the longest average visit time for psychiatric patients at 10 hours and 34 minutes, followed by Good Samaritan University Hospital in West Islip, at 10 hours and 24 minutes.

Long Island Community Hospital spokesman James Iorio said in a statement that in September 2023, the facility reopened an inpatient behavioral health unit that had been closed for several years. 

"This unit provides patients in our ED who require inpatient psychiatric care with this service without having to leave the hospital, resulting in a nearly 30% decrease in median length of stay in our ED," he said. "Previously, these patients remained in the ED while awaiting transfer to facilities that provided the necessary services."

Kate LeCardi, a spokeswoman for Catholic Health Systems, which operates Good Samaritan, attributed the high emergency room visit time for patients who need mental health and psychiatric care to the hospital's lack of an inpatient psychiatry unit. She said the emergency medicine team "provides initial stabilization and treatment," and if a patient needs to be admitted, he or she is placed at another hospital.

To mitigate wait times, LeCardi said, Good Samaritan offers programs including a telepsychiatry service "that has significantly reduced ED stays."

Dr. Andrew Sama, a doctor who has privileges at Good Samaritan and is past president of the New York American College of Emergency Physicians, said resources are lacking statewide for mental health patients.

The regulatory standards the State Office of Mental Health sets "are very rigid" and rarely allow for innovation, he said.

"If you go to other states, particularly for psychiatry, there are a variety of different resources that they allow, including but not limited to pilot programs that move these people immediately out of the emergency department," Sama added.

The State Office of Mental Health said in a statement it has strengthened emergency mental health care on Long Island, including by establishing seven Assertive Community Treatment teams this year that provide outpatient mental health services to patients in community settings instead of in emergency departments. 

Left without treatment

The federal data shows a small percentage of emergency room patients leave without treatment.

At Mount Sinai South Nassau hospital in Oceanside, 6% of patients who came to the emergency room left without seeing a physician — the highest rate on Long Island, according to CMS data for 2022, the latest numbers available.

Hospital officials attributed the "walkout rate" to a limited number of beds available during a five-year, $60 million expansion project they said began in 2022 and will bring the number of emergency department beds to 70. The state now lists the facility as having 45 beds.

CMS data ranks the hospital as the fourth-highest on Long Island in terms of emergency room visit times, with an average wait for all patients at 4 hours and 28 minutes, and an average wait for mental health and psychiatric patients at 5 hours and 32 minutes.

The hospital said in a statement officials cut the walkout rate to 1.5% by June and also had "reduced arrival to discharge time by 19%," since January for emergency patients, including by dedicating treatment space to patients with minor conditions and illnesses.

Among Long Island hospitals, only Peconic Bay Medical Center in Riverhead, a Northwell hospital, also had a rate — 4% — exceeding the Island, statewide and national averages of 3%. 

D'Angelo, the Northwell official, pointed to an influx of new residents who moved to Suffolk's East End, which he said has boosted the hospital's annual patients by about 10,000 since 2019.

"That took a lot of adjustment in workflow and staffing models," D'Angelo said, adding that Peconic added 11 new emergency department beds in August following an expansion project. 

Rather then walking out, the majority of Long Islanders who come into an ER end up enduring the often long waits.

Meaghan Tully, 31, of Bellmore, waited several hours during four experiences at three Long Island emergency rooms in late 2021 and 2022. Each time, she said, the wait was grueling.

First was a December 2021 visit to Northwell Health's Long Island Jewish Medical Center in New Hyde Park, when she was one month pregnant with her first child and suffering from hyperemesis gravidarum, an extreme case of excessive nausea and vomiting during pregnancy.

Tully said she was in the waiting room for three hours and discharged after a total of 10 hours after getting intravenous fluids. A Northwell representative said in a statement hospital officials "are always looking for ways to improve so that we can see all patients as quickly as possible according to the severity of their needs."

Tully said she continued suffering throughout her pregnancy and went to the emergency room at Mount Sinai South Nassau in February and March 2022, with the two visits taking more than eight hours.

Tully said she also spent more than two hours in the waiting room at Mercy Hospital in Rockville Centre in November 2022 before having gallstone surgery.

The other hospitals she visited either didn't respond to requests for comment or didn't address the specifics of her case.

"You go there because you need help now," she said, "and then you don't get help for hours and hours."