HospitalInspections.org

Based on document review and interview, the facility failed to log and complete a medical screening exam for 1 of 20 medical records reviewed.

Findings Include:

1. See findings cited at 42 CFR 489.24 (1), A2406.

Based on document review and interview, the facility failed to keep a log of each individual presenting to the F1 emergency department for medical care for 1 of 20 patients (patient P1).

Findings Include:

1. Review of F1 emergency department (ED) log did not indicate P1 (patient with injured finger) was recorded seeking medical treatment on 4/2/2023.

2. On 10/23/2023 at 1145 hours, RN1, Manager, Emergency Room, confirmed that no security footage, or log was maintained to confirm P1's allegation timeline. Staff nurses on duty the at the time were interviewed regarding the alleged incident, and did not recollect the name of the patient involved. One staff nurse did remember answering the emergency room telephone line and speaking with a patient presenting with an injured finger/hand.

3. On 10/23/2023 at 1530 hours, S2, Registered Nurse, Regional Director Regulatory, confirmed that P1 was not logged or registered as presenting for care at F1's emergency room on 4/2/2023.

Based on document review and interview, the facility failed to provide P1 a medical screening examination in accordance with Emergency Medical Treatment and Labor Act," EMTALA requirements for 1 of 20 patients (patient P1).

Findings Include:

1. F1 policy for: "Emergency Medical Screening," PolicyStat: 13803313, last approved 08/2023, indicates F1 will perform without delay, an appropriate medical screening examination to all persons who come to the facility emergency room and request assistance.

2. Review of F1 emergency department (ED) log did not indicate P1 (patient with injured finger) was recorded seeking medical treatment on 4/2/2023, and no documentation of a medical screening examination (MSE) was available for review.

3. On 10/23/2023 at 1145 hours, RN1, Manager, Emergency Room, confirmed that no security footage, or log was maintained to confirm P1's allegation timeline. Staff nurses on duty the at the time were interviewed regarding the alleged incident, and did not recollect the name of the patient involved. One staff nurse did remember answering the emergency room telephone line and speaking with a patient presenting with an injured finger/hand.

4. On 10/23/2023 at 1530 hours, S2, Registered Nurse, Regional Director Regulatory, confirmed that P1 did not receive a medical screening exam before leaving the facility on 4/2/2023.