Nason Medical Center must scale back the scope of services offered at five Lowcountry locations and stop marketing itself as an emergency care provider, a spokeswoman for the urgent care network confirmed Monday.

Nason Medical Center fired all of its imaging specialists on Friday after receiving instructions from a "government entity" that it can no longer provide CT scans or ultrasounds. Nason spokeswoman Cheryl Smithem would not confirm which agency mandated that they discontinue imaging services or say how many employees lost their jobs.

The federal Medicare program does not comment on individual providers, a spokesman said Monday. According to public data released by the federal government in April, Medicare paid Dr. Barron Nason more than $240,000 in 2012. He ranked 10th for the total amount paid by Medicare of 576 emergency medicine providers in South Carolina that year. This does not include the amount other providers employed by Nason Medical Center were paid by Medicare.

Even though CT scans and ultrasound services have been discontinued, X-rays are still available at Nason Medical Center, Smithem said.

"Nason operates in a complex regulatory environment and we've provided all the information that we can," Smithem said.

While Smithem said "all urgent care centers" were given the same order to stop providing imaging services, a spokeswoman for the Urgent Care Association of America said she was not aware of any such directive.

Dr. Radwan Hallaba, who owns six urgent care centers in South Carolina, said the government has not ordered his business to stop offering imaging services.

Meanwhile, Nason Medical Center is also busy changing signs at five locations in Mount Pleasant, North Charleston, James Island and Summerville after the S.C. Department of Health and Environmental Control ordered it to stop using the word "emergency" to market its business earlier this year.

The word "emergency" confuses patients, DHEC Director Catherine Templeton explained.

Hospital emergency rooms accept patients transported by ambulance and are open 24 hours a day. Nason Medical Centers don't accept patients by ambulance. They're not open past 8 p.m. and are not equipped to handle the most serious medical emergencies, she said.

"We've got them all under corrective action," Templeton said.

On Monday, the S.C. Hospital Association applauded DHEC's decision to address this issue.

"Urgent care centers play an important role in the delivery of care to patients who don't need the intensive services of a hospital emergency department," said Jimmy Walker, senior vice president of regulatory and workforce for the hospital association.

"Each of these settings is a critical part of the health care delivery system. However, patients need to understand the difference between each and should go directly to a hospital emergency department when the illness or injury is serious," he said.

Smithem said Nason Medical Center has replaced the word "emergency" with "ambulatory" on its website and outside two of its five medical centers. Signs on the remaining centers will be changed by the end of May, she said.

On Monday, Dr. Barron Nason, who co-founded Nason Medical Center with partner Bob Hamilton in 2005, said he could not legally comment on these issues.

During an interview with The Post and Courier in February, he said most patients don't know when they're experiencing an emergency, making it difficult to determine when they should visit an urgent care center or a hospital emergency room.

"If everybody knew whether or not they were having a heart attack, it would be pretty dang straightforward," Nason said. "My job would be pretty easy, but we don't. The vast majority of the time when people think they're having emergencies, they're not having emergencies, but that potential exists. This is one of the issues with the emergency department; the ERs are overwhelmed with patients that have a very low risk for having a life-threatening problem. It is a tremendous, tremendous burden."

In a prepared statement Monday, Hamilton said, "Nason Medical Center is committed to providing high quality medical care and is also committed to delivering that care in a manner that is in compliant with all applicable laws and regulations. As you know, the medical regulatory environment is changing and we are changing with it, and we intend to continue to do so in the future."

A spokesman for Nason Medical Center said the partners could provide more information when documents are unsealed "by regulatory authorities" on May 25.

Reach Lauren Sausser at 937-5598.