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Based on record review, observation and interview, 1. Staff failed to ensure that all areas where emergency patients are treated have EMTALA signs regarding their rights in 1 of a total sample of 1 departments observed (Emergency Department) and 2. The facility failed to define providers that are qualified medical professionals for Medical Screening Exams.


Findings include:

Facility staff failed to ensure all areas where emergency patients are treated have EMTALA signs. See tag A2402.

Facility staff failed to define who are Qualified Medical Professionals for Medical Screening Exams. See tag A2406.

Based on observation and interview, the facility failed to ensure EMTALA signs are posted in all patient waiting and emergency treatment areas in 1 of 3 patient care areas (Emergency Department Entrance, Triage, and Patient Treatment Areas).

Findings include:

On 8/6/2019 at 9:10AM during a tour of the Emergency Department area accompanied by ED Patient Care Supervisor B, EMTALA signage was observed in the main entrance, in the two waiting rooms and in the front desk triage area. No signage was noted in the two private pateint triage rooms or any of the patient treatment rooms. This includes all 31 treatment/exam rooms in the department out of a total sample of 32 (room #31 is currently a supply room). This was confirmed in interview with ED Patient Care Supervisor B at 9:25AM. ED Patient Care Supervisor B stated "we have never had signs in our rooms."

On 8/6/2019 at 1:30PM, conducted an interview with Director of Quality A who stated "I was not aware that EMTALA signage needed to be posted in the treatment areas."

Based on record review and interview the facility failed to define which individuals have been determined to be qualified to perform a medical screening exam.

Findings: Review on 8/6/2019 at 11:00AM of the facility's Medical Staff Bylaws sections titled "Governance and Organizational Manual, Rules and Regulations, and Credentialing Manual" did not find any statement regarding who was qualified to perform a medical screening exam. Director of Quality A confirmed that this designation was not located in any of the above documents. Review of facility policy EDTC (Emergency Department Trauma Center)- Medical Screening Exam effective date of 4/6/2016 reveals the statement "All persons presenting to the EDTC for emergency treatment will be provided with a Medical Screening Exam completed by a qualified provider." Interview at 11:30AM with Chief Medical Officer D confirmed that there is no such designation in any of the facility Bylaws stating "we presume all are qualified unless there are exclusions listed."