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Based on staff and patient interviews, hospital policy and complaint report review, the hospital failed to ensure there was no delay in examination or treatment to Patient #1 by discussing co-pays for uninsured patients prior to admission to the Emergency Department (ED). This had the potential to affect all patients served.

Findings Include:

Refer to C2408 for findings.

Based on staff and patient interviews, hospital policy and complaint report review, the hospital failed to ensure there was no delay in examination or treatment to Patient #1 by discussing co-pays for uninsured patients prior to admission to the Emergency Department (ED). This had the potential to affect all patients served.

Findings Include:

During a telephone interview on 09/22/2021 at 2:37 p.m., Patient #1 revealed around 9:30 p.m. on 08/11/2021, he rang the buzzer at the hospital Emergency Department (E.D.) entrance because he was having COVID symptoms. He revealed he stood at the door for a couple of minutes without an answer. He then walked to his truck in the parking lot and called the number on the door and talked to the E.D. clerk. Patient #1 revealed it seemed as if the person he was talking on the phone did not want to be bothered. Patient #1 revealed he was told he would have to pay three hundred ($300) or "something" that night to be seen. Patient #1 revealed he just decided to go home and go to a clinic the next day, where he tested positive for COVID and was quarantined for fourteen (14) days. Patient #1 revealed the night he contacted the E.D. he was unemployed and did not have insurance. He was starting a new job the day after his visit and would be insured then.

During an interview on 09/22/2021 at 3:30 p.m., the Emergency Department Clerk (E.D. Clerk) revealed on 08/11/2021 around 9:30 p.m. she received a phone call from the parking lot from a person who said they had been tested for COVID in (city) the day before and was waiting on the results and wanted to know if our hospital provided any COVID relief. The E.D. Admissions Clerk stated "he said he just started a new job and did not have insurance yet". The E.D. Admissions Clerk verbalized telling him the facility did not have any COVID relief that she knew of, but she could not discuss any financial information with him up front, "but we cannot refuse to see him if he did not have insurance". The E.D. Admissions Clerk told him she just checked patients into the ED and did not know what the MD would do as far as relief. The E.D. Admissions Clerk revealed Patient #1 then said he just did not want to get a bill and she replied he would receive a bill for the visit. Patient #1 asked if they provided financial assistance and she replied she would give him the forms to fill out for that. The E.D. admissions Clerk confirmed she told Patient #1 after a patient is discharged, they ask to pay a co-pay of $300.00 or whatever the patient could pay is what is collected but a patient could not be denied treatment for any reason. Patient #1 then told E.D. Admissions Clerk he would go see an MD tomorrow because he did not want a large bill. The E.D. Admissions Clerk verbalized Patient #1 did not ring the buzzer outside the E.D. department but notified her by phone. She confirmed the E.D. door is locked at 23:00 (11:00 p.m.) every night and unlocked at 07:00 a.m. She revealed when a patient rings the buzzer, she unlocks the door and asks how she can help them. The E.D. Admissions Clerk verified the E.D. department door was not locked at 9:30 p.m. on the night of the alleged incident.

Review of "Complaint Report" (date 08/13/2021) revealed the facility received a telephone call from Patient #1's mother on 08/13/2021 concerning her sons experience at (facility). Mother verbalized son had COVID and came to facility around 9:30 p.m. on Wednesday August 11, 2021. Mother verbalized her son rang the buzzer at the Emergency Department entrance and the clerk asked him what he was there for. Mother verbalized the clerk then asked if he had any insurance and son answered no. Mother verbalized that clerk replied to son would have to pay three hundred dollars to be seen. Mother verbalized that son replied he did not have any money. Mother verbalized clerk replied that he had to pay something or could not be seen. Mother verbalized her son was very sick now with COVID with an oxygen saturation of 90%. Mother verbalized by law its illegal to refuse a patient due to payment.

Review of facility policy "Emergency Department Policy and Procedure Manual" dated (06/2020) revealed ....each patient presenting to the Emergency Department requesting emergency services is triaged and receives a medical screening exam (MSE), by the Emergency Department Physician or his /her designee (Nurse Practitioner or Physicians assistant). If a patient refuses an MSE, a Form C is completed.