HospitalInspections.org

Based on a review of documentation and an interview with staff, the facility failed to maintain a list of physicians who are on call for duty after the initial examination to provide further evaluation and/or treatment necessary to stabilize an individual with an emergency medical condition.

Findings were:

During a review of emergency department on-call schedules for physicians for July 2016 through January 2017, the on-call schedule for October contained 6 shifts and the January schedule contained 7 shifts where a physician (other than a physician noted on the current emergency department physician roster) was scheduled to work.

In an interview with staff #10 on 1-3-17, staff #10 stated that the name noted for the above mentioned shifts was a nickname used for staff #3 and not staff #3's actual name.

The above was confirmed in an interview with the Assistant Administrator on the evening of 1-3-17.

Based on a review of documentation and an interview with staff, the facility failed to provide provide an appropriate medical screening examination within the capability of the hospital's emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists.

Findings included:

A review of the clinical record for patient #1 revealed that the patient had presented to the emergency department of Falls Community Hospital on 12-17-16 at 2:04 pm. The patient was triaged at 2:07 pm by the triage nurse and placed in an exam room at 4:30 pm. At 4:40 pm, the record notes that staff #1 was notified that the patient was ready and waiting in a room. At 5:30 pm, the nurse's notes state "waiting in room to see provider." At 5:40 pm, notes state "[Staff #1] notified by [staff #8] of patient still waiting to be seen." The patient then left without being seen at 6:35 pm.

In an interview with staff #10, staff #10 stated that staff #1 was upstairs, asleep during the time period. Staff #10 confirmed that staff #1 was called and notified twice without responding and providing the patient with a medical screening exam. When asked if the Emergency Department Director or Administrator had been notified (per policy), staff #10 stated that they had not.

Facility policy titled "Assignment of Medical Staff for Emergency Room" stated, in part:
"METHOD
1. Upon arrival in the Emergency Room, the on-call physician will be notified.
2. If the on-call physician is not readily available, (within 30 minutes) the Chief of Staff or his designee will be notified."

Facility policy titled "Failure of Physician to Provide Medical Screening" stated, in part:
"Procedure:
1. A patient presents to the Emergency Room requesting treatment, the RN will assess the patient and notify the physician.
2. In the event the provider fails to provide the patient with a medical screening, the Emergency Department Director and Administrator will be notified."

The above was confirmed in an interview with the Assistant Administrator on the evening of 1-3-17.