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Based on interview and record review with regard to to Complaint # TX00434909, the hospital did not abide by the provider's agreement that required a hospital to be compliant with §42 CFR 489.24, Special Responsibilities of Medicare Hospitals in emergency cases. The hospital was not in compliance with the EMTALA (Emergency Medical Treatment and Labor Act) requirements in that, Patient #1 was not provided an appropriate medical screening examination on 10/18/22.

Based on interview and record review, the hospital failed to provide a medical screening for one of two patients (Patient #1) who left without being seen by a provider on 10/18/22.

Findings included:

Patient #1 presented in the emergency department on 10/18/22 with a chief complaint of "pressure and pain in his head along with depression and SI (suicide ideation)." An order for Consult Case Management was initially ordered at 3:04 AM. Triage was conducted at 3:19 AM and having not seen by a physician for medical screening examination, Patient #1 left at 4:10 AM. No psychiatric exam was done by a physician given patient's complaint initially of Suicide Ideation and no further suicide risk assessment was noted in the medical record. Lab work was indicated to include Tylenol levels, urine drug screen, and aspirin levels as well as CBC, CMP in order to establish that no overdose or other self-harm had occurred. These were ordered but canceled when Patient #1 left.

During an interview on 10/20/22 at 10:05 AM, Personnel #1 stated she did not review Patient #1's medical record. Upon review of Patient #1's medical record on 10/20/22 at 10:15 AM, Personnel #1 confirmed there were orders placed by the ED physician at 4:04 AM for Acetaminophen, Alcohol, and Salicylate levels, Urine Drug Screen and etc. that were later canceled when Patient #1 left.