HospitalInspections.org

Based on policy review, observation, and staff interview, the hospital staff failed to ensure Emergency Medical Treatment and Labor Act (EMTALA) signage was posted conspicuously and visible to all patients who entered the Labor and Delivery (L&D) suite for evaluation of labor or other pregnancy related conditions at one of two L&D entrances (entrance used when coming to L&D from the Emergency Department (ED).

The findings included:

Review of the hospital's EMTALA policy, effective 11/2022, revealed "...General ....The hospital will maintain appropriate signage that specify the rights of the individuals with emergency medical conditions and women in labor who come to the emergency department for health care services .... This sign will be sufficiently large to be visible to patients and family in waiting areas where patients present for an emergency medical condition including ED lobby, ED ambulance entrances, or Labor & Delivery waiting areas. ... "

Observation on 09/12/2023 at 1045 hours of the Labor and Delivery Unit (L&D) revealed two entrances to the ED. A posting of an English and a Spanish version of EMTALA signage was noted at one entrance, the entrance used for patients who arrive from the main hospital entrance. A sign was also posted inside the ED in front of the L&D nursing station, which is located across from two of the five LDRs (Labor, Delivery, Recovery rooms). The L&D observation revealed a second ED entrance was used by patients when escorted to L&D from the ED. EMTALA signage was not posted at the second entrance to the ED nor was any signage posted in the corridor to the right of the ED entrance. That corridor led to the other LDR rooms, two of which were reported as most frequently used for initial triage of patients to L&D prior to determination of admission. Patients transported to L&D from the ED and placed directly into one of the two identified LDRs would not pass by conspicuously posted EMTALA signage at the L&D entrance, on the corridor housing those two LDR rooms or inside the room. Further, there was no designated waiting room/area for L&D.

Interview with Manager #8, the L&D Manager, on 09/12/2023 at 1045 hours, revealed there were no signs at the L&D entrance from the ED or in the corridor to the right. Manager #8 stated two of the LDR rooms on this hallway were the primary rooms used for triaging patients. Interview confirmed no signage was posted in that corridor or inside the LDRs. Further interview revealed there was not a L&D waiting room.