Freestanding Emergency Departments (FSEDs) are a new and evolving care delivery model. Popular in states such as Texas, these ERs may be owned and operated by the hospital (as a “hospital outpatient department,” or HOPD) or independently owned and operated by a group of physicians or other investors.

Hospital-Based Freestanding EDs

Many hospitals realize that building freestanding EDs allows them to extend high-quality emergency services at even higher levels of customer service into new or expanding markets at relatively low cost. Emergency Service Partners has experience working with a variety of hospitals to develop their FSEDs. Our involvement ranges from simply providing emergency physician services to helping conceive and choose locations for such facilities.

The FSED business model, when properly sited, has proven to successfully:

  1. Alleviate capacity issues in a hospital’s existing Emergency Department
  2. Extend services into underserved areas to capture or increase market share
  3. Establish a building block for future hospital development.

This model enables a health system to explore the potential in a given market and either grow or contract its services to match shifts in the population and demand of the local market. In many cases, the FSED is used as a building block toward future development of a full hospital. Emergency Service Partners’ FSED model is structured to create a strategic advantage by enabling hospitals to use the FSED development effort as a means to create and strengthen physician partnerships.

Independent Freestanding ERs

In 2015, Emergency Service Partners launched its own line of independently owned freestanding emergency centers, known as Five Star ER. These facilities provide 24/7 emergency medical care in a clean, comfortable, healing environment–typically with little or no wait. Not to be confused with urgent care centers, Five Star ER and other freestanding emergency centers offer the same high quality of care and the same resources found in a traditional hospital emergency department–including onsite x-ray, CT, and ultrasound. Fewer than 5% of patients typically require transfer or admission.

In Texas and in many other states, independent freestanding ERs are highly regulated and are sometimes held to a higher standard than hospitals. Each facility must fulfill an exhaustive list of legal and regulatory requirements pertaining to their construction, operation, equipment, staffing, and more. And, unlike urgent care centers, freestanding ERs are required to operate 24/7, have an emergency physician on-site at all times, provide around-the-clock lab and imaging services, and stock additional types of medications.

Learn more!

To learn more about freestanding EDs, please contact Jim Zaza, Vice President of Business Development, by phone at 888-800-8237, ext. 306 or by e-mail at