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Based on record review, observation and interview facility staff failed to ensure all patients who present on hospital property requesting treatment were documented on the Emergency Department (ED) central log for 3 of 20 patients (Patients #1, 2, 3), and failed to complete a Medical Screening Exam for 3 of 20 patients (Patients #1, 2, 3) who presented on hospital property requesting treatment in a total sample of 20 medical records reviewed.

Findings Include:

The facility staff failed to ensure patients who presented on hospital property requesting treatment were documented on the ED central log. See Tag A-2405.

The facility staff failed to provide a Medical Screening Exam for patients who presented on hospital property requesting treatment. See Tag A-2406.

Based on record review and interview facility staff failed to ensure all patients who present on hospital property requesting treatment were documented on the Emergency Department (ED) central log for 3 of 20 patients (Patients #1, 2, 3) in a total sample of 20 medical records reviewed.

Findings Include:

A review of Hospital A's policy titled, "FHFMH Case Management EMTALA (Emergency Medical Treatment and Labor Act) and Inter-Hospital Patient Transfer Policy" last reviewed 03/20/2025 revealed, "... A. Upon arrival to ED all patients seeking care in the ED are registered as an ED patient ..."

Observation of Hospital A's ED security footage on 06/04/2025 revealed:
06/04/2025 at 5:09 PM: Driver I (accompanied by Patients #1, 2, 3) pulls up via car to ED entrance (leaving Patients #1, 2, 3 in the car) and enters the ED and speaks to Registrar G (no audio).
06/04/2025 at 5:10 PM: Driver I goes back to car outside, Registrar G leaves desk and goes back into the ED. Driver I comes back into ED entrance and sits in ED waiting room.
06/04/2025 at 5:12 PM: Driver I and Registrar G have a conversation (no audio) at ED registration desk.
06/04/2025 at 5:14 PM: Driver I drives away from ED entrance with Patients #1, 2, 3 in the car.

A review of Hospital A's ED patient log revealed Patients #1, 2, 3 were not registered as ED patients at Hospital A on 06/04/2025.

During an interview on 07/22/2025 at 1:41 PM with CNO (Chief Nursing Officer) E, when asked about the ED patient log on 06/04/2025, CNO E confirmed that Patients #1, 2, 3 were not on the log and were not registered as ED patients.

During an interview on 07/22/2025 at 2:45 PM with Registrar G, when asked about Patients #1, 2, 3 and Driver I on 06/04/2025, Registrar G stated that Driver I came to the registration desk stating that he had 3 patients in the car outside that had possible carbon monoxide poisoning. Registrar G stated that she went back to the ED to ask the nurse and doctor what they wanted to do with these patients and Registrar G stated that they told her that Hospital A does not have a hyperbaric chamber (a specialized room or enclosure where the atmospheric pressure is increased, and the patient breathes 100% oxygen) but that they are happy to see the patients, or they can go to Hospital B for treatment. Registrar G stated that she relayed the information to Driver I and gave Driver I directions and the phone number for Hospital B, and Driver I left the ED.

Based on record review, observation and interview facility staff failed to complete a Medical Screening Exam for 3 of 20 patients (Patients #1, 2, 3) who presented on hospital property requesting treatment a total sample of 20 medical records reviewed.

Findings Include:

A review of Hospital A's policy titled, "FHFMH Case Management EMTALA (Emergency Medical Treatment and Labor Act) and Inter-Hospital Patient Transfer Policy" last reviewed 03/20/2025 revealed, "... B. Hospital Campus: ... The physical area immediately adjacent to the provider's main buildings... but are located within 250 yards of the main buildings... to be part of the provider's campus... A. An appropriate Medical Screening Exam (MSE) is provided to individuals of any age who present to the Emergency Department or other hospital property requesting or requiring an examination of treatment for a medical condition ..."

Observation of Hospital A's ED security footage on 06/04/2025 revealed:
06/04/2025 at 5:09 PM: Driver I (accompanied by Patients #1, 2, 3) pulls up via car to ED entrance (leaving Patients #1, 2, 3 in the car) and enters the ED and speaks to Registrar G (no audio).
06/04/2025 at 5:10 PM: Driver I goes back to car outside, Registrar G leaves desk and goes back to the ED. Driver I comes back into ED entrance and sits in ED waiting room.
06/04/2025 at 5:12 PM: Driver I and Registrar G have a conversation (no audio) at ED registration desk.
06/04/2025 at 5:14 PM: Driver I drives away from ED entrance.

Record review of Patient #1, 2, 3's ED medical record from Hospital B revealed Patients #1, 2, and 3 presented to Hospital B's ED on 06/04/2025 at approximately 5:25 PM (10 minutes later), received treatment for their symptoms, and were all discharged home at approximately 8:30 PM.

During an interview on 07/22/2025 at 2:45 PM with Registrar G, when asked about Patients #1, 2, 3 and Driver I on 06/04/2025, Registrar G stated that Driver I came to the registration desk stating that he had 3 patients in the car outside that had possible carbon monoxide poisoning. Registrar G stated that she went back to the ED to ask the nurse and doctor what they wanted to do with these patients and Registrar G stated that they told her that Hospital A does not have a hyperbaric chamber (a specialized room or enclosure where the atmospheric pressure is increased, and the patient breathes 100% oxygen) but that they are happy to see the patients, or they can go to Hospital B for treatment. Registrar G stated that she relayed the information to Driver I and gave Driver I directions and the phone number for Hospital B, and Driver I left the ED.