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Based upon document review and interview the facility did not comply with all of the provisions of recipient hospital responsibilities. Please reference findings under Tag 2411.

Based upon interview and document review the recipient hospital refused to accept Patient #1 in transfer despite the availability of the specialized services and the capacity to treat the patient.

Findings include:

Review of the transferring hospital's medical record for Patient #1 revealed the patient presented to the Emergency Department on 4/24/12 with complaints of abdominal pain. The patient was found to be in labor with no previous prenatal care. Due to the lack of obstetrical services at the transferring hospital, the plan was to transfer the patient to a hospital with obstetrical services.

Review of the transferring hospital's Emergency Department (ED) Physician Record dated 4/24/12 revealed that following a discussion of the case with the receiving facility perinatologist, it was decided that the patient was not a high risk patient and as such should be admitted directly to the OB service and that the OB service on-call physician would be contacted. At 10:55pm the transferring hospital received a follow-up call from the intended recipient hospital indicating the transfer would not be accepted and that another hospital should be contacted for transfer.

Interview with Staff #6 on 6/5/12 revealed a call was received from the transferring hospital ED physician requesting transfer of the patient. Gestational age was estimated to be 35-36 weeks based on measurements taken by the transferring hospital ED physician. Staff #6 informed the ED physician that based on the available information, the patient was not a high risk patient and as such could be admitted directly to the OB service. Staff #6 informed Staff #5, the on-call OB service physician, who disagreed regarding the patient's risk status due to the lack of ultrasound dating and prenatal care. Staff #6 contacted the transferring hospital and suggested they contact another hospital for transfer.

Interview with Staff #5 on 6/4/12 revealed he believed the perinatology service should have accepted the patient due to the patient's lack of prenatal care and questionable dating.

Review of the Labor and Delivery Suite Patient Classification and Report Sheet dated 4/24/12 revealed when the initial request for transfer was recieved, patient census was 4.

Interview with Staff # 3 on 6/5/12 revealed a capacity of 8 beds in the labor and delivery suite and 20 beds on the postpartum unit. The postpartum patient census on 4/24/12 was 18.

Despite having the specialized services required and the capacity to treat the patient, transfer was refused due to a difference in opinion as to which OB service the patient should be admitted to.