Patients at Hospital Enrique Baltodano Briceño in Liberia, the main public hospital for Guanacaste, say they have spent days sleeping in emergency-room chairs while waiting for a bed. Images and video shared by a patient show more than 10 people asleep in chairs in the hospital’s emergency area in the early hours of Tuesday.
They are dressed in hospital gowns and covered with sheets, some connected to IV stands, with their names written on paper taped to the wall or the backs of the chairs. One patient said he had been waiting five days and did not know what would happen next with his care. Another, in a separate video, said he had been waiting six days.
A young man with an 8-millimeter (0.3-inch) kidney stone said Monday that he had been sitting in a chair since the morning of Friday, October 9, waiting to be admitted so a urologist could see him. He estimated that about 30 people were in the same situation and said some were sleeping on the floor on improvised sheets because no stretchers were available.
The same patient said the public health system had scheduled his ultrasound for 2028, so his employer paid for one with a private doctor before he went to the hospital. The Costa Rican Social Security System (CCSS), which runs the hospital, had not responded to questions from local media sent Monday morning, and the hospital has not commented publicly.
The strain is not new. In December 2025, then-CCSS executive president Mónica Taylor told a legislative commission that the Liberia emergency department was collapsed and saturated and acknowledged that the institution had not even prioritized a project to expand it. At the time, the emergency department was running at 143% of capacity, the fifth most overcrowded in Costa Rica, according to figures presented to lawmakers. Hospitalization and surgery beds were 91% to 100% full, and some patients remained in the emergency department for up to 15 days.
A plan to expand and remodel the hospital’s emergency service dates to 2013 but had not reached the pre-investment stage as of late 2025. The hospital serves the entire Chorotega health region. Waiting is a national problem for the CCSS. The institution had 1,476,536 cases on its waiting lists as of July 31.
The CCSS has not said how many patients are currently waiting for beds in Liberia or when the expansion project will move forward.
