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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 to the hospital campus ED for 1 of 21 patients reveiwed presenting to the ED over the previous six months. (Patient #1). Refer to TAG: 2406.

Based on record review and interview, the hospital failed to provide an appropriate medical screening examination (MSE) to an individual who presented 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 #1)

Findings include:

Review on 6/20/23 of the hospital's letter self reporting an EMTALA violation revealed the following:
On 5/10/23, Patient #1 arrived at the hospital ED, accompanied by the sheriff, and was told that they did not have behavior inpatient beds and was directed to another hospital ED. The patient left without receiving a MSE. The patient did return to the ED later that day and received an examination.

Review on 6/20/23 of the facility's policy and procedure titled "EMTALA [Emergency Medical Treatment and Active Labor Act] - Medical Screening Examination and Patient Transfer Policy", effective 11/22/2022, revealed the following: "4.1 Medical Screening Examination", 4.1.1 Any individual who comes to Concord Hospital, Concord Hospital - Laconia, or Concord Hospital - Franklin's Emergency Departments, including those who are in need of assistance in the physical areas within 250-yards to Concord Hospital, Concord Hospital - Laconia, or Concord Hospital - Franklin's main building and other structures on these campuses, including parking lots, sidewalks, driveways, requesting examination or treatment shall be provided with an appropriate medical screening examination by a QMP [Qualified Medical Provider]".

Interview on 6/20/2023 at approximately 3:00 p.m. with Staff A (Director, Regulatory & Accreditation) confirmed the above findings.

Review on 6/21/2023 of ED patient logs revealed no record for Patient #1's first visit to the ED on 5/10/23.

Interview on 6/21/2023 at approximately 11:00 a.m. with Staff B confirmed no record of Patient #1's first visit to the ED on 5/10/23.