HospitalInspections.org

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Findings included:

Based on interview, review of hospital policies and procedures, document review, and review of the medical staff bylaws, the hospital failed to develop and implement policies and procedures for evaluation and treatment of patients presenting for emergency care in accordance with the Emergency Medical Treatment and Labor Act (EMTALA).

Failure to ensure patients receive a comprehensive medical screening examination MSE) by a qualified medical professional risks poor health outcomes, injury and death.

Findings included:

ITEM #1 Medical Screening Examination

The hosptial failed to provide evidence that 2 of 27 patients received medical screening examinations when they presented for emergency care.

ITEM #2 Governing Body authorization of who can perform medical screening examinations

The hospital failed to ensure that the hospital's medical staff bylaws identified who was authorized by the governing body to perform medical screening examinations and to ensure MSEs were performed by qualified health care providers.

Cross Reference Tag # 2406
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Based on interview, review of hospital policies and procedures, document review, and review of the hospital's medical staff bylaws, the hospital failed to show evidence that 2 of 27 patients who presented to the hospital for emergency care received a medical screening examination (MSE) by a qualified medical professional.

Failure to ensure patients receive a comprehensive medical screening examination by a qualified medical professional risks poor health outcomes, injury and death.

Findings included:

ITEM #1 Medical Screening Examinations

1. Review of the hospital policy titled, "Emergency Medical Treatment and Active Labor Act (EMTALA) #10680525 effective date 11/04/21, showed that a physician or qualified medical professional (QMP) provides an appropriate MSE to all individuals seeking emergency services. A Family Maternity nurse is designated as QMP and performs MSE for pregnant women having contractions.

2. Review of the Emergency Department log for 05/27/22 through 05/29/22 showed that the two patients named in the complaints were not registered. The complaint listed 05/28/22 as the date the two patients presented for emergency care.

3. On 06/09/22 at 2:45 PM, during an interview with the investigator, the Director of Quality (Staff #2) stated that they had received information from another facility that two patients had left Mt. Carmel Emergency Department due to inability to receive care because of telephone and computer issues. Staff #2 stated they immediately initiated an investigation and reported the incidents to the Department of Health. The hospital's investigation is ongoing. The staff nurse involved (Staff #14) was interviewed and said that because of the anticipated delays, that they felt that the patients and patient's parent deserved to know but assured them that the hospital was willing to see them. The conversation was witnessed by several staff members who corroborated the events as described.

ITEM #2 Governing Body authorized personnel performing Medical Screening Examinations

1. Review of the Medical Staff Bylaws and Rules and Regulations showed that there was no identification of who was authorized to provide medical screening examinations approved by the governing body.

2. On 06/09/22 at 9:18 AM, during an interview with the investigator, the medical staff coordinator (Staff #8) stated that there is no mention in the bylaws or rules and regulations regarding who can provide medical screening examinations.
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