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Based on review of hospital policies and documents and interviews with staff, the hospital failed to enforce its policy concerning recipient hospital responsibilities.

Findings:

1. The hospital's policy, Inter-Facility Transfer to OSUMC (Oklahoma State University Medical Center), policy number 302-CC-106, detailed that requests for transfers would be coordinated and facilitated by the Transfer Coordinator. The policy recorded that if the transferring hospital does not have appropriate physician specialist or appropriate equipment, but OSUMC does, the patient will be accepted.

2. On 02/03/2010 at 1800, a hospital requested to transfer Patient #A who needed the surgery specialty. The transferring facility did not have surgery on-call coverage. OSUMC had the capability and capacity to accept the patient. The hospital did not follow it's policy.

Based on review of medical records and hospital documents, and interviews, the hospital failed to accept from a referring hospital an appropriate transfer of an individual who required the specialized capabilities and facilities of the hospital in one of fourteen medical records (Patient #A of Patients #A, 1, 2, 3, 4, 7, 8, 10, 11, 12, 14, 15, 116, and 17) reviewed. On the date and time of the proposed transfer for one patient (Patient #A), the hospital had the capability and capacity to treat the individual.

Findings:

1. Patient #A presented to another emergency department (ER) on 02/03/2010 at 1610 with complaints of abdominal pain radiating to his back that started about one hour prior to arrival. The patient was diaphoretic and had decreased pulses to his extremities and had experienced nausea and vomiting prior to arrival. Medical history included peripheral arterial disease with femoral stent. The computerized tomography, read by the radiologist at the time, indicated the patient had twisted small bowel. The ER physician documented he called Oklahoma State University Medical Center (OSUMC) at 1800 and was refused transfer of the patient.

2. Review of the on-call specialty schedule showed the hospital did have surgery coverage on 02/03/2010. Review of the surgery schedule for the same date showed the surgeon did not perform surgeries that day.

3. Review of OSUMC Transfer/Admission form documented the transfer coordinator called the on-call surgeon and he denied the transfer. This finding was confirmed with the transfer coordinator on 03/05/2010 by telephone interview.

4. On 03/04/2010 at 1030, the surveyors interviewed the surgeon on-call for 02/03/2010. He stated he did have privileges to perform the required surgery. (This was confirmed with file review.) He stated he refused the transfer because he felt the sending hospital had a surgeon and could take care of the patient.