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MCLAREN GREATER LANSING
COMPLIANCE WITH 489.24
Tag No.: A2400
Based on record review and interview, the facility failed to comply with the requirements of 42 CFR 489.24 [special responsibilities of Medicare hospitals in emergency cases], specifically the failure to provide an appropriate transfer to another facility, for 1 (P-6) of 3 patients reviewed for transfer resulting in the potential for uninformed decisions and poor patient outcomes. Findings include:
See Specific Tag:
A-2409 Failure to address the risks and benefits of transfer
APPROPRIATE TRANSFER
Tag No.: A2409
Based on record review and interview, the facility failed to address the risks and benefits of transfer for 1 (#6) of 3 patients reviewed for transfer resulting in the potential for uninformed decisions and poor patient outcomes. Findings include:
On 10/9/2023 at 1434, review of the medical record for P-6 revealed she was a 2-year-old female who presented to the emergency department (ED) 5/5/2023 at 2235 after accidentally backing up and falling into a bucket of boiling water that had bleach in it. Assessment and examination of P-6 revealed she had sustained second degree burns over her abdomen, back, buttocks, and legs covering approximately 20-25% of her body. Following treatment and stabilization, the decision was made to transfer P-6 to a burn unit at a children's hospital.
Review of the facility's Patient Transfer Consent Form revealed Section III, which addresses the risks and benefits of transfer, was left blank.
On 10/10/2023 at 1054, ED Medical Director Staff S agreed that risks and benefits of transfer should be addressed with the patient/patient representative prior to transfer.
Facility policy #MHC_CC0125 titled "EMTALA: Treatment of Emergency Medical Conditions and Patient Transfers" last revised 9/13/2022 states, "Transfers. Execution of an appropriate transfer from Hospital to another facility... The attending physician will: 5.7.1.1. Review the risks and benefits of transfer with the patient... Complete the Patient Transfer Consent Form... Staff will ensure that... The Patient Transfer Consent Form has been completed in its entirety..."