HospitalInspections.org

Based on interview and record review the hospital's dedicated emergency department (ED) failed to comply with the requirements for the Emergency Medical Treatment and Labor Act (EMTALA) at §489.24.

Findings include:

The hospital failed to provide an appropriate medical screening examination to an individual who presented by ambulance to the hospital campus ED Driveway for 1 of 21 patients presenting to the emergency department over the previous six months. (Patient #21). Refer to TAG: 2406.

Based on record review and interview, the hospital failed to provide an appropriate medical screening examination to an individual who presented by ambulance to the hospital campus of the emergency department (ED) for 1 of 21 sampled patients presenting to the ED over the previous six months. (Patient identifier is #21)

Findings include:

Review on 3/8/2023 of statements from the ambulance driver revealed Patient #21 was transported to the hospital via ambulance and had arrived on the hospital campus. The ambulance driver had called the hospital main number and spoke to the ED doctor when arriving on the hospital campus and was told to take the patient another hospital.

Review on 3/8/2023 of the hospital video footage revealed the ambulance arrived on the hospital campus on 2/23/2023 during a snow storm, came to a rolling stop at the ED ambulance bay entrance, and then drove away.

Review on 3/29/2023 of the facility's policy and procedure titled "Emergency Medical Treatment and Active Labor Act (EMTALA) Policy", revised 9/2022, revealed the following under Procedure: "1. VRH will provide every individual who presents at the Hospital's Emergency Department (ED) and requests examination or treatment for a medical condition, or that presents on Hospital Property (other than the Emergency Department) and requests an examination or treatment for what may be an Emergency Medical Condition, with an appropriate Medical Screening Examination (MSE) to determine if an Emergency Medical Condition (EMC) does or does not exist. 2. VRH will not take any action or fail to take any action intended to discourage any individual from seeking emergency medical care."

Review on 3/29/2023 of ED patient logs revealed no record for Patient #21.

Interview on 3/29/2023 at approximately 1:45 p.m. with Staff A (Risk & Compliance Manager) and Staff B (ED Clinical Manager) confirmed the video footage and revealed that the ambulance company had notified the hospital about the above incident. Staff A stated that ED staff were interviewed and denied that they were aware that the ambulance had arrived on hospital property. Staff B confirmed that staff in the ED denied knowledge that the ambulance had been on the property and stated that ambulances communicate with the hospital via a radio, a recorded controlled phone line, and the main number (unrecorded). Staff A stated that had called and spoken to the ED prior to arrival but there is no documentation of the ambulance call to the ED when they arrived. Staff A stated that since the incident there has not been any EMTALA training or revisions to policies and procedures because he/she did not believe it was an EMTALA violation.