HospitalInspections.org

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Based on interview and document review, the
hospital failed to implement their policies and
procedures for evaluation, treatment, and the
transfer of patients that presented for emergency
care in accordance with the Emergency Medical
Treatment and Labor Act (EMTALA).

Failure to ensure patients receive a
comprehensive medical screening examination
by a qualified medical professional and stabilizing
treatment prior to transfer or discharge risks poor
health outcomes, injury, and death.

Findings included:

The hospital failed to ensure that 2 of 27 patients (Patients #1 and #2)
received a medical screening exam before they
left the emergency department (ED).
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Based on interview, record review, and review of hospital policies and procedures and medical staff bylaws, the hospital failed to ensure a medical screening examination (MSE) was conducted on all patients who present to the emergency department (ED).

Failure to ensure that patients receive a MSE by a qualified medical professional and stabilizing treatment prior to discharge or transfer, risks poor health outcomes, injury, and death.

Findings included:

1. Review of the hospital's policy and procedure titled "EMTALA Patient Transfer Protocol," Policy #PC.RI10 revised 11/2016, showed that all patients who presented to emergency department must receive a medical examination to identify a potential emergency medical condition (EMC).

2. Investigators #1 and #2 reviewed 27 ED patient encounters. The documents showed the hospital failed to ensure medical screening examinations (MSE) were completed in 2 of 27 patients (Patients #1 and #2).

3. Interviews regarding Patient #1's ED encounter resulted in the following:

a) On 11/13/20 at 12:54 PM, Investigator #2 interviewed the Officer (Interview #13), identified by the Registration Specialist (Staff #12) as the officer involved in the care of Patient #1. The officer confirmed that he brought Patient #1 to the hospital on the afternoon of 11/01/20 for medical clearance. The officer reports that he was asked to bring Patient #1 to Providence St. Peter's Hospital (PSPH). Patient #1 was not medically evaluated at CMC.

b) On 11/13/20 at 1:15 PM, Investigator #2 interviewed the hospital's Registration Specialist (Staff #12) present during a patient encounter (Patient #1). Staff #12 confirmed that on the afternoon of 11/01/20, an officer brought Patient #1 in for medical clearance and was told to go to PSPH, without receiving a medical screening examination (MSE).

4. Interviews regarding Patient #2's ED encounter resulted in the following:

a) On 11/13/20 at 1:50 PM, Investigators #1 and #2 interviewed the Chief Quality Officer (Staff #14) regarding Patient #2. Staff #14 confirmed a self-reported EMTALA violation occurred on 10/26/20 from 1:07 PM to 1:30 PM. The event involved an ED physician telling a patient to go to another hospital without providing a medical screening examination.

b) On 11/13/20 at 11:20 AM, Investigator #1 interviewed the Medical Director for the ED (Staff #5). Staff #5 confirmed a violation occurred that involved an ED physician (Staff #15) telling a patient in the waiting room to go to another hospital. No medical screening examination was done.
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