Legacy Children’s Hospital: Pediatric Care & Info

Why the children’s ER is different

Randall Children’s Emergency Department is designed for children and gives emergency clinicians immediate access to pediatric specialists, pediatric critical care, pediatric surgery, imaging, laboratory services and the hospital’s trauma program.

Children’s ER valet

Legacy currently lists additional valet parking directly outside the Randall Children’s Emergency Department.

Mental-health emergencies involving a minor

Legacy’s current hospital guidance states that minors should first be evaluated by a pediatric provider before going to Portland’s Unity Center for Behavioral Health. For immediate danger or a life-threatening emergency, call 911.

Randall Children’s is part of Legacy Emanuel’s regional trauma system and is an American College of Surgeons-verified Level I Pediatric Trauma Center. Level I status reflects the ability to provide comprehensive care for the most severely injured children, including immediate surgical and subspecialty support.

Trauma patients can access:

• Pediatric emergency medicine.
• Trauma surgery.
• Pediatric surgery.
• PICU.
• Neurosurgery.
• Orthopedics.
• Imaging and laboratory services.
• Rehabilitation.
• Child Life and family support.

Parent and guardian access

Parents and guardians are welcome at any time, day or night. Staff may occasionally ask family to step outside during procedures, treatment or clinical evaluation.

Other PICU visitors

• General PICU visitor hours: 9 a.m.–9 p.m..
• All visitors must check in with security in the lobby.
• Normally two to four visitors age 18+ may visit at one time.
• At least one visitor should be a parent.
• The clinical team may limit visitors to two depending on the child’s condition.
• Siblings younger than 18 must remain with an adult.
• Anyone who is ill should not visit.

Family facilities

PICU rooms include sleeping space for two family members and private bathrooms. Family-support areas include lounges and showers.

The NICU provides continuous specialty care for premature and critically ill newborns and can support babies who require advanced neonatal medicine or surgery.

Family-integrated care

Randall’s NICU is designed around family participation. Parents are considered members of the care team and are encouraged to participate in their baby’s care as early and as often as possible.

NICU rooms

• 31 single-family rooms.
• 7 twin rooms.
• Two transition rooms for babies needing additional observation after delivery.

NICU visitor rules

• Siblings must remain with an adult.
• Visitors must be free of illness.
• Families should respect the privacy of other NICU babies and families.
• A dedicated scrub area is located outside the main family entrance.

Children’s Heart Program doctors

Pediatric hematology/oncology doctors

Pediatric spine and neurosurgery team

Pediatric plastic and reconstructive surgery

Finding every current provider

Because Randall Children’s has a large pediatric medical staff, names can change more quickly than a static article. For specialties not shown above, use the current Legacy provider directory and select the Randall Children’s/Legacy Emanuel location.

The Children’s Heart Program treats congenital and acquired heart conditions from fetal diagnosis through young adulthood.

Heart services include

• Fetal echocardiography.
• Pediatric echocardiography.
• Cardiac MRI.
• Cardiac CT.
• Diagnostic cardiac catheterization.
• Interventional catheterization.
• Electrophysiology.
• Heart-rhythm device implantation.
• Congenital heart surgery.
• Pre- and post-operative cardiac care.

Legacy reports that the pediatric heart program performs more than 200 cardiac catheter procedures and more than 200 heart surgeries annually.

Outreach cardiology appointments

Heart specialists also see patients at outreach clinics across Oregon and Southwest Washington. Call 503-280-3418 for the current date when a specific cardiologist will be at an outreach location.

The program treats childhood cancer and blood disorders and participates in pediatric clinical research through the Children’s Oncology Group.

Where chemotherapy is given

Treatment location depends on the length and type of therapy:

• Short chemotherapy: specialty clinic.
• Medium-length chemotherapy: Day Hospital / Day Treatment.
• Long treatment: inpatient overnight care when necessary.

Day Treatment uses private family rooms overlooking a garden terrace for infusions and treatments.

Pediatric neurology

Legacy pediatric neurologists evaluate children with seizures, epilepsy and other disorders of the brain, spinal cord and nervous system.

Brain surgery / neurosurgery

Randall Children’s neurosurgery treats conditions including:

• Brain and spinal-cord tumors.
• Chiari malformation.
• Craniosynostosis.
• Epilepsy requiring surgical evaluation.
• Hydrocephalus.
• Head injuries.
• Spina bifida.
• Tethered spinal cord.
• Pituitary tumors.
• Vascular malformations.

Some children requiring Gamma Knife treatment receive the procedure at Legacy Good Samaritan Medical Center with Randall Children’s clinical support.

Where to park for surgery

Randall’s current surgical-preparation instructions direct families to the orange parking structure. After parking, check in at Main Admitting in the Randall Children’s lobby; families are then directed to Children’s Day Surgery on the lower level.

The night before surgery

Current hospital guidance says not to give the child anything to eat or drink after midnight unless the child’s doctor gives different instructions. Procedure-specific instructions always take priority.

What to bring

• Insurance card.
• Current medication list.
• Parent/guardian identification.
• Required copay, deposit or deductible information.
• A freshly cleaned comfort toy or blanket if desired.
• Any procedure-specific documents requested by the surgical team.

Before surgery

A nurse performs a brief exam and reviews medical history and medications. The parent and child receive matching identification bracelets. Families can talk with the surgeon, anesthesiologist and operating-room nurse before the procedure.

After surgery

Children recover in the Post-Anesthesia Care Unit before discharge or admission. When going home, nursing staff provide instructions for activity, diet, medication and follow-up. Randall currently states that families receive a follow-up call approximately 24–48 hours after surgery.

Primary-care services

• Well-child visits.
• Growth and developmental screening.
• Sports physicals.
• Immunizations.
• Same-day appointments for acute illness.
• Chronic-condition management.
• Behavioral-health support.
• Specialty-referral coordination.
• Foster-care coordination.
• Social-needs support.

Established patients can contact an advice nurse or on-call provider 24/7.

Birth options

• Obstetric care.
• Midwifery.
• Water-birth options for appropriate patients.
• Nitrous oxide.
• Personal doula support.
• High-risk pregnancy expertise.
• Maternal-fetal medicine access.
• Level IV neonatal intensive care.

Pre-registration

Expectant parents can pre-register for delivery with their Legacy obstetrician or midwife or through MyHealth.

Birth-center tours

Legacy currently offers Family Birth Center tours, including in-person options in English and Spanish. Tour registration is free and includes the patient plus one adult.

Midwifery

Legacy Medical Group Midwifery at Emanuel can be reached at 503-413-4500.

Randall Children’s has child-focused imaging services with pediatric radiologists and participates in radiation-safety practices designed to keep exposure as low as reasonably achievable.

When scheduling imaging

Legacy asks for information including:

• Patient’s full legal name.
• Date of birth.
• Ordering physician.
• Imaging exam requested.
• Reason for the exam.
• Insurance information.
• Authorization number when required.

Bring the child’s insurance information and arrive according to the preparation instructions provided when the exam is scheduled.

Why an ER bill varies

A pediatric emergency visit can include charges for:

• Emergency Department facility services.
• Emergency physician care.
• Laboratory testing.
• X-ray, ultrasound, CT or MRI.
• Medication.
• Medical supplies.
• Procedures.
• Specialist consultation.
• PICU or inpatient admission.
• Surgery or anesthesia when required.

Hospital-based specialty clinic fees

Legacy explicitly notes that some clinics operating under a hospital’s license can generate a facility charge in addition to the physician charge. This applies to some hospital-based Randall Children’s clinics.

MyHealth message fees

Most ordinary scheduling, refill and simple follow-up messages remain free. A patient-initiated message requiring significant clinical assessment can be billed as telehealth care.

Legacy currently publishes examples showing that, when a qualifying message is billed, potential patient responsibility can vary by insurance. Self-pay message charges can range from approximately $40–$77, with a published maximum of $126.

Request an individualized hospital estimate

Oregon patients can call 503-413-4048 or toll-free 800-495-7076, Monday through Friday from 8 a.m.–5:30 p.m.

Before calling for an estimate

Ask the doctor’s office for the CPT/procedure code for a planned outpatient procedure when possible.

What an estimate may not include

Legacy warns that its hospital estimate may not include:

• Physician professional fees.
• Anesthesiologist fees.
• Radiologist fees.
• Other specialist professional fees.

The final bill can also change if the treatment, diagnosis, complications or insurance benefits change.

Legacy’s financial-assistance program can reduce or eliminate qualifying charges for medically necessary Legacy services based on household size, income and program rules. The assistance can include eligible Legacy physician charges as well as hospital charges.

Ways to apply

Mail application to

Payment plans

Legacy also offers flexible, interest-free payment plans for patients who need more time to pay.

Legacy Health contracts with many Oregon insurance products. Its current system-level information includes plans from organizations such as:

Questions to ask insurance

1. Is Randall Children’s Hospital at Legacy Emanuel in network?
2. Is the specific pediatric doctor in network?
3. Is a referral required?
4. Is prior authorization required?
5. Could a hospital facility fee apply?
6. What are my deductible, copay and coinsurance amounts?

Randall Children’s pages consistently direct families to MyHealth for access to children’s records, results, diagnoses, medications, follow-up instructions and appointments.

Mail records request to

Current patient-copy fee

Legacy’s current patient-request instructions list a $6.50 flat rate for a patient’s own records supplied in paper or electronic format when the charge applies.

Records that can be sent directly into the patient’s MyHealth account are listed at no charge.

Processing time for Oregon facilities

Legacy states that Oregon record requests should be allowed up to 30 days for processing, although the Release of Information team makes efforts to complete them sooner.

Minor signatures

Legacy’s current instructions say that when the patient is a minor age 13–17, the minor’s signature is required on the applicable patient medical-record request.

Valet parking

Legacy currently lists valet service at:

• 501 N. Graham St. at the Legacy Emanuel Medical Center Atrium.
• Outside the Randall Children’s Emergency Department.

Security escort

If you need help getting safely to a vehicle or another campus location, call 503-413-7911.

Public transportation

The Legacy Emanuel/Randall Children’s campus is served by TriMet. TriMet information: 503-238-7433.

Important campus locations

Security screening

Current hospital policy requires patients and visitors to:

• Pass through a metal detector.
• Consent to bag inspection.
• Follow current bag-size restrictions.
• Check in as required by the hospital or unit.

Prohibited items

Legacy specifically prohibits:

• Weapons, including weapons carried with permits.
• Sharp objects.
• Illegal substances.

PICU rules

Parents/guardians can generally stay at any time. Other visitors use the 9 a.m.–9 p.m. schedule and must check in with security.

NICU rules

Siblings must remain with an adult, and anyone with signs of illness should not visit because premature and critically ill newborns are particularly vulnerable to infection.

Child Life can help with

• Fear and anxiety before procedures.
• Preparing children for surgery.
• Painful procedures.
• New diagnoses.
• Chemotherapy.
• Hospital play and normalization.
• Helping siblings understand illness or injury.
• Grief and loss.

Child Life specialists work with children and families dealing with chronic illness, injury, trauma, disability and hospitalization.

Randall Children’s surgical guidance directs families to the Emanuel Apothecary on the first floor of the Atrium for discharge prescriptions when they prefer to fill medication before leaving campus.

Legacy also operates a Meds-to-Beds service in which eligible discharge prescriptions can be filled by the health-system pharmacy and delivered before the patient leaves the hospital.

Legacy Health states that interpreters are available for approximately 200 languages.

Interpreter service is provided without charge to the patient or family. Tell the registration team, nurse or specialty clinic that you need an interpreter.

Clinical Ethics help

Families facing a difficult medical decision can request Legacy’s Clinical Ethics Program. From a hospital phone, dial 0 and ask for the ethics representative on call.

Admission process

A registration specialist collects patient and insurance information and addresses applicable financial arrangements. Families are asked to sign the hospital’s Conditions of Patient Registration before care when appropriate.