HospitalInspections.org

Based on review of facility documents, medical records (MR), and interview with staff (EMP), it was determined that the facility failed to ensure each patient presenting to the Emergency Department was provided with an appropriate medical screening examination by a physician, or other qualified medical personnel, for one of 23 medical records reviewed (MR1).

Findings include:

Review on July 9, 2014, of facility policy "Admission and Registration of Patients to the Emergency Department," last reviewed November 2010, revealed " ... All patients that present to the Emergency Department will be seen by the Emergency Department physician in the order of their severity as determined by the triage nurse. No one is refused treatment, regardless of condition, race, religion or ability to pay. ..."

Review on July 9, 2014, of facility document "Rules and Regulations of the Medical Staff of Nazareth Hospital," last revised November 2012, revealed "... V. EMTALA Regulations 1) Medical Screening Exams and Transfers a) Presenting for Care and Medical Screening Examination (1) Any individual who comes to the Hospital Emergency department requesting examination or treatment shall be provided with an appropriate medical screening examination. ..."

Review on July 9, 2014, of MR1 revealed that the patient arrived to the Emergency Department on June 29, 2014. Further review of MR1 revealed "Triage Date/Time: 06/29/14 - 2017 ... State Complaint: Dizziness, Palpitations, Weak Chief Complaint: Palpitations Cardiac Complaint Priority: 3 ... Patient Outcome: Patients Complaint And Disposition AMA [Against Medical Advice]/ LWOT [Left Without Treatment] ... PT walked out of ED at 2023, Stating [patient] is not going to be seen. " There was no documented evidence that the patient was provided an appropriate medical screening examination by a physician.

Interview on July 15,2014, at 11:00 AM, with EMP1 and EMP3 confirmed that EMP6 entered the triage area while EMP5 was completing the triage assessment on the patient. EMP4 told the patient to the leave the hospital and that the patient was "banned" from the facility. The patient walked out of the Emergency Department. EMP1 and EMP3 confirmed that the patient was not provided an appropriate medical screening examination by a physician.