Ok, just got home from my job at the ER. So here goes.
BTW, alleycat is right about each hospital being different. Depends on when it was last remodeled, is it a smaller community hospital in a suburb or is it an inner city facility with trauma care, is it a teaching hospital ... a lot of variables.
In a large American city, either current day, or just a few years ago, when an uninsured patient was treated to emergency care only if they didn't produce a means of payment.
Here's the situation as I'm planning it.
Teenager took a beating and suffered a concussion. He was taken to hospital and given basic care until he recovered consciousness. He can get MRIs and such, or not, I don't really care about treatment while he's under since he's unconscious and the story is from his POV (though if there's anything he would notice upon waking in his hospital bed that'd be good to know). Once he's up and about the hospital discharges him immediately.
Does that sound about right?
How old is the teenager? Over 18 is considered an adult and would be treated in the adult side. Under 18 would be treated in pediatrics side, or transferred to a children's hospital. That's if he is admitted as an inpatient (out of the emergency room, into a regular room upstairs).
CT scan more likely than MRI for a concussion. Most concussions don't require overnight stay. Not much can be done, really - it's just rest for recovery. Only reason I know of that someone would stay over is if the CT shows a brain bleed.
If he's under 18, parents or guardians would be located to approve the treatment, if possible. We still treat without parents' permission in cases of emergency, but for anything beyond that, wait for parents. UNLESS the patient is 15 or older and asks that parents not be notified. State law here says 15 years old is age of consent for medical care.
At the hospital group I work at (5 non-profit hospitals) we take uninsured patients with medically necessary treatments. We give you a packet of info about applying for financial assistance. You fill it out and mail it back. That puts you into the system for our financial counselors to consider. Last year we provided $67 million dollars of charity care to uninsured patients. It's based on patient income and their ability to pay.
There are some for-profit hospitals (none around here that I know of) in some places, and their financial dealings are handled differently. Don't know about that.
Is there anything else? What kind of ward would he awake in? Long room with multiple curtained-off beds or something?
The hospital where I work has only private rooms, both in emergency and in the upstairs rooms. Rooms have both doors and long curtains for privacy. Two of our downtown hospitals have semi-private rooms, two beds per room, separated by curtains. That's also how it was when I was a patient in another state, several years ago. In a different state, all private rooms. I don't think any hospitals in the US have long rooms with many beds, at least not that I'm aware of.
Hope this helps.