When Hunt Regional Healthcare closed its freestanding emergency departments in Commerce and Quinlan, the most common explanation circulating in Hunt County was that “too many people were using the ER for minor issues.”
Records released to KETR by Hunt Regional through a Texas Public Information Act (TPIA) request suggest a more complex picture.
The Data
Every emergency visit in Texas is coded using the Current Procedural Terminology (CPT) system, which classifies the medical complexity of care provided.
These codes range from Level 1 (minor, low-severity issues) to Level 5 (critical, potentially life-threatening emergencies).
Importantly, these designations are assigned by medical professionals after examination — not self-reported by patients — and are based on the risk, complexity, and resources used during treatment.
Hunt Regional’s data covered every emergency encounter at both facilities from October 2023 through September 2025, the month the ERs closed.
| Facility | Low-Acuity (Levels 1–2) | Moderate–Critical (Levels 3–5) | Total Visits |
|---|---|---|---|
| Commerce | 2,795 (11.7 %) | 21,150 (88.3 %) | ≈ 23,945 |
| Quinlan | 4,358 (14.4 %) | 25,940 (85.6 %) | ≈ 30,298 |
Findings
Only about one in eight visits to either emergency department were confirmed by medical staff as low-acuity — the sort of cases that might have been handled in a clinic or urgent-care setting.
The remaining visits — roughly nine in ten — were classified as moderate, high, or critical emergencies under standard clinical coding guidelines.
This distribution of cases indicates that both ERs primarily treated patients whose conditions met the medical definition of an emergency.
Clarifying the Record
Hunt Regional Healthcare has not attributed the closures to misuse of the emergency departments by local residents. In its public statements, the hospital district cited rising labor and supply costs, increasing numbers of uninsured patients, and declining reimbursement rates as the primary factors behind the decision. Officials said the two freestanding ERs had operated at a financial loss for years and that closing them would help preserve inpatient and outpatient services at the main Greenville hospital.
Understanding the Context
Many Hunt County residents face barriers to primary care.
According to U.S. Census Bureau estimates from the 2023 American Community Survey, about 19 percent of county residents under age 65 lack health insurance, and roughly 12 percent of all residents live below the federal poverty line (U.S. Census Bureau, ACS 2023 5-Year Estimates).
In communities where primary-care providers are limited or appointments take weeks to schedule, emergency departments often function as the only reliable point of access for acute medical needs.
The data from Hunt Regional illustrate that reality — not as an indictment of public behavior, but as a reflection of local health-care access and demand.
How CPT Levels Work
| CPT Code | Description | Typical Case Examples |
|---|---|---|
| 99281 | Minor problem; minimal evaluation | Small abrasion, medication refill |
| 99282 | Low complexity | Ear infection, mild sprain |
| 99283 | Moderate complexity | Laceration repair, fever requiring labs |
| 99284 | High complexity | Dehydration, possible fracture |
| 99285 | Critical or life-threatening | Chest pain, shortness of breath, stroke symptoms |
Each level reflects the professional judgment of the treating provider, not the patient’s self-assessment.
Public Discussion and Previous Commentary
Much of the public discussion that followed Hunt Regional’s announcement centered on the idea that the Commerce and Quinlan emergency rooms had been “overused for minor conditions” that could have been treated elsewhere.
In a subsequent Greenville Herald-Banner editorial, former state senator and physician Dr. Bob Deuell—who also serves as Hunt Regional’s chief medical officer—wrote that the facilities had seen “lower numbers of true emergency patients than expected,” contributing to their financially untenable status.
KETR reported on that editorial at the time as part of its coverage of community perspectives on the closures.
Data released to KETR by Hunt Regional Healthcare now provide the first quantifiable look at those assumptions.
According to the hospital district’s records, fewer than 15 percent of visits to either facility were low-acuity cases, and that proportion remained essentially unchanged throughout the final two years of operation. Roughly nine in ten visits involved moderate to critical medical needs.
These findings do not address the broader fiscal pressures facing rural hospitals, but they do clarify how the Commerce and Quinlan emergency departments were actually used in their final years — and how that reality compares with public perception.
Key Takeaway
The records released by Hunt Regional Healthcare show that the emergency departments in Commerce and Quinlan were used predominantly for moderate-to-critical medical needs, not for low-acuity conditions.
While these findings do not speak to Hunt Regional’s internal financial or operational decisions, they clarify how residents were actually using those facilities during their final two years of operation.
