HospitalInspections.org

Based on record review and interview the facility failed to follow the Emergency Department facility policy requiring patient acknowledgment along with a nurse and witness to document patient leaving Against Medical Advice (AMA) in 1 of 20 medical records.


The findings were:

A review of the document titled "Patient Roster" revealed the following: Three of the twenty patients left Against Medical Advice. One of the three who left against Medical Advice did not have a nurse or witness signature documented for Patient #1's AMA discharge. The facility documented the patient as leaving against medical advice. However, the facility did not ensure their policy was followed to obtain a patient acknowledgment on the AMA form.

A review of the document titled "ED Leaving Against Medical Advice / Left Without Being Seen Policy" page 2, subsection 4.1.3 reveals the following:
"If the patient refuses to sign the AMA form, the nurse should document on the form the patient's refusal to sign and have a second witness who was present in the room sign the form. Any patient who leaves prior to being triaged, after triage but prior to seeing the physician, or who elopes after placed in a room and prior to being seen by a physician, will be considered "Left Without Being Seen" (LWBS). If possible, the nurse should secure the patient's signature on the AMA form stating refusal of a Medical Screening Exam."

An interview with Staff #2, Emergency Room RN, on 10/15/2025 revealed the following: "Yes, I remeber the patient. She had hallucinations; she said she was seeing colors. Behavior Health evaluated her; she was low-risk, and no sitter was ordered. Behavioral Health's recommendation was for the patient to be placed in an in-patient setting. She had to wait quite a bit for a transfer because she had requested a specific place. She got tired of waiting and wanted to leave. She waited for her family to pick her up. I canâ Euro (Trademark)t remember if she signed leaving against medical advice (AMA) papers.