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Based on interview and record review, the facility failed to follow its policy and procedure for "Continuum Care" for Patient A, when the facility (Facility 2) refused to accept Patient A's transfer for stabilization after inquiring about Patient A's method of payment. This failure resulted in delayed treatment to stabilize Patient A's emergency medical condition and had the potential to adversely affect Patient A's health and safety.

Findings:

An unannounced visit was conducted on 6/24/21 through 6/25/21 to investigate a potential EMTALA (Emergency Medical Treatment and Labor Act) violation.

A review of Patient A's Emergency Room Physicians Note, dated 6/14/21 from Facility 1, indicated Patient A was diagnosed with bilateral obstructed kidney stones with pyuria (white blood cells present in the urine). Patient A required a higher level of care from a urologist (medical doctor with specialty training relating to kidneys) for stabilization.

During an interview on 6/24/21 at 1:24 PM, with Facility 1's emergency department Physician (Physician 1), who stated Facility 1 did not have a urologist and had transferred patients needing a urologist in the past to Facility 2. Patient A's condition required a higher level of care and was potentially life threatening. Physician 1 stated he spoke to the House Supervisor Registered Nurse (HSRN 2) at Facility 2 who confirmed a bed was available, but based on 2 Patient A's insurance, HSRN 2 declined the transfer.

During an interview on 6/25/21 at 9:30 AM, with HSRN 2 (Facility 2), acknowledged that he informed Facility1 that Facility 2 had an available bed and later declined to accept Patient A based on his insurance. HSRN 2 also stated he was later informed by his supervisors, Director of Acute Care 2, Chief Nursing Officer 2, and Director of Quality/Risk 2 that he should have accepted the transfer of Patient A for emergency medical stabilization.

A review of Facility 2's policy and procedure, dated 12/17, and titled, "Continuum of Care, IV Procedure B. Accepting transfers from other facilities 4. Emergency transfers may not be delayed or refused due to financial reasons."