Registration should have zero to do with providing patient care; if it does, you’ve got a great grounds for a lawsuit if anything goes wrong, and it’s also blatantly illegal for an ER to do that.

Last few times I’ve been in the ER, the registration guy didn’t come around until we were already in an ER hospital bed and waiting around after being triaged.

There may be really terribly run hospitals who risk lawsuits (or have already been sued for millions) - I would avoid such places.