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Based on record review and interview, the hospital failed to ensure a medical screening examination was conducted for one (Pt #21) of 21 patients.

This failed practice has the likelihood for an emergency medical condition to go unidentified and untreated thereby, increasing the risk of undesirable health outcomes and result in no identification of patients requiring immediate care.

Findings:

The "Radio Log" from Murray County Sheriff Office for 11/06/20 showed:
1) EMS was dispatched to a local nursing home at 1:10 pm;
2) at 1:12 pm EMS was on scene;
3) at 1:25 pm EMS was enroute to the Hospital;
4) at 1:29 pm EMS was at the Hospital;
5) at 1:34 pm EMS was enroute to another hospital.

EMS "Prehospital Care Report" dated 11/06/20 showed that EMS Staff #1 and #2 were:
1) dispatched to a local nursing home to transport Pt #21 to the Hospital for weakness, diaphoresis, clammy and pain to all four extremities. EMS was enroute to the local nursing home at 1:10 pm;
2) at 1:12 pm EMS arrived at the nursing home;
3) at 1:14 pm EMS Staff #1 and #2 were with Pt #21 for assessment and transport to Hospital ER;
4) at 1:29 pm EMS arrived at the Hospital and EMS Staff #1 and #2 unloaded Pt #21 on the gurney in the garage bay of the ED; and
5) at 1:34 pm EMS departed the hospital with patient #1 enroute to another hospital.

A review of the Murray County Prehospital Care Report written by Staff #2 on 11/06/20 stated at 1:25 pm while enroute to the Hospital EMS Staff #2 called the hospital to give report on the patient's condition. ED physician #1 answered the call and reported "we (the hospital) are on divert" and the patient should go somewhere else. At 1:29 pm after arriving at the hospital and unloading Pt #21 from the ambulance, ED physician #1 came out to the bay (ambulance emergency entrance) and stated "I told you, we (the hospital) are on divert, take her somewhere else" and refused to see the patient and told EMS staff #1 and #2 once again to "take her somewhere else."

A review of the State EMResource report dated 11/06/20 showed no notification of divert status was reported for the day.

No documentation was provided by the hospital that showed Pt #21 was logged in or assessed at the hospital on 11/06/20 at or around 1:29 pm or that the hospital was on divert.

On 11/23/20 at 11:00 am Staff A stated, the Hospital had only been on divert one day (11/16/20).

On 11/23/20 at 11:30 am Staff D stated, anyone who came to the ED for treatment should be recorded in the ED log.

On 07/29/21 at 10:30 am EMS Staff #2 stated, on 11/06/20 Pt #21 was in the Hospital ED bay and the attending ED physician #1 came out to the bay and spoke with EMS staff #2 and never assessed the patient and told the EMS crew to take Pt #21 to another hospital.