HospitalInspections.org

Based on interview and record review the facility failed to meet the requirements for EMTALA by failing to provide a Medical Examination as evidenced by the following:


This failed practice delayed care for P#21 who was in crisis and needed a medical screening examination to determine appropriate diagnosis and treatment. Refer to tag #2406

Based on interview and record review, the facility failed to accept and provide care for Patient (P) #21 even though the Facility had the capability to evaluate and determine appropriate treatment for P#21. This failed practice delayed care for P#21 who was in crisis and needed a medical screening examination to determine appropriate diagnosis and treatment. P#21 was transferred to a behavioral hospital by Law Enforcement where an evaluation was performed and treatment was provided for P#21. The findings are:

A. Record review of the facility's "EMTALA Policy - Medical Screening and Stabilization" Last Revised Date 12/9/19 revealed, a medical screening examination includes both a generalized assessment and a focused assessment based on the patients' chief complaint.

B. On 10/23/20 at 11:00am during interview with S#5 (ED Director) confirmed that P#21 asked the staff to use a phone and then called 911, Law Enforcement and EMS responded to P#21's call.

C. On 10/28/20 at 8:30am during interview with Law Enforcement officer #1;
1) Confirmed on 10/04/20 at 12:26am, P#21 stated that she there were people outside of the lobby of the facility waiting to kill her, this was stated in the presence of Law Enforcement officer #2, medical staff from the facility and security staff from the facility.
2) Confirmed that P#21 also stated that she wanted to killed herself to Law Enforcement Officer #1.
3) Confirmed that he overheard S#6 (ER Doctor) state to the patient if she was admitted to the facility that he (S#6 ) would discharge her to avoid further conflict. Law Enforcement officer #1 placed P#21 into protective custody and transported her to a behavioral facility.

D. Record review of P#21 medical chart dated 10/03/20 revealed, P#21 was discharged to the lobby of the facility and the mental health assessment had no documentation of P#21 fearing of being killed or hurting herself, P#21's chief complaint was having "psych issues and does not feel safe on the street".

E. On 10/28/20 at 8:30am during interview with Law Enforcement officer #1 confirmed that the medical staff advised Law Enforcement officer #1 that P#21 was discharged to the lobby of the facility.

F. Review of Law Enforcement officer #1 AXON body camera footage of 10/04/20 at 12:26am revealed that at time period 8:10 into the video S#6 says to P#21 he can sign her in and then he will turnaround and discharge her.