HospitalInspections.org

Based on record review and interview, the hospital failed to ensure a Medical Screening Exam was performed for one (Patient #21) of 21 patients presenting to the emergency department via emergency medical service requesting a MSE.

This failed practice had the potential to result in a delay of treatment and deterioration of the patient's condition that presented to the ED for a MSE.

Findings:

A review of policy titled "EMTALA" read in part: "The Emergency Department Log entry is required including disposition of the patient ... All patients shall receive a medical screening exam ..."

A document showed: "Patient # 21 was transferred to this hospital ED on 08/26/22 at 7:31 p.m. with complaints of left hip pain."

There was no documentation to show Patient # 21 was:

- entered in the emergency log
- received a medical screening exam
- refused a medical screening exam
- transferred to a receiving facility

On 09/06/2022 2:00 p.m., Staff D stated, "Resident did not meet criteria for the skilled unit and would be admitted to the nursing home side of facility. The resident complained of pain in her hip. Ambulance was called, and resident was sent to Drumright hospital via EMS."

On 09/07/22 at 11:15 a.m., Staff A stated, "Patient # 21 wanted to be admitted to our swing bed unit. I explained the process of our swing unit, however the daughter for patient # 21 wanted a transfer to a local hospital. Typically, anyone presenting to the emergency room requesting to be seen receives a medical screening exam. Since Patient # 21 could not be admitted to the swing bed unit, we did not document but I think we will start."

09/07/22 at 1:00 p.m., via phone Staff E, stated "Resident was transferred to Drumright Regional Hospital from the Drumright Nursing home to be evaluated for complaint of hip pain. Drumright Regional Hospital refused to evaluate and treat patient. Patient was transported via non emergency to another hospital.

On 09/07/22 at 2:30 p.m., Staff B, "Patient # 21 was not screened, she was not our patient. I think the sending hospital failed to communicate with patient # 21 and family. I think we got the fall out of someone else's mistake. If someone is seeking treatment then we are to provide treatment."

On 09/07/22 at 3:05 p.m., Staff C stated, "To cover self from an EMTALA, documentation must be completed. The process should be if patient presents for evaluation and want to be evaluated and medically screened by a provider EMTALA prevents patient dumping."