HospitalInspections.org

On September 25, 2012, an unannounced on-site EMTALA (Emergency Medical Treatment and Labor Act) complaint investigation survey authorized by the Centers for Medicare and Medicaid Services (CMS) was conducted at St. Peter's Hospital. One deficiency was cited as a result of this investigation. The facility is not in compliance with CFR ?489.24.

Based on record review and staff interview, the facility failed to accept an appropriate transfer of a patient when the hospital had the capacity and capability to treat the individual. Findings include:

Staff member B, the Emergency Department (ED) Health Unit Coordinator, of hospital B was interviewed by the surveyor on 9/25/12 at 11:00 a.m. He stated that a physician at hospital A called on 9/15/12 and asked if there was anyone on-call for Ear Nose and Throat (ENT) services. Staff member B further stated he called the ENT specialty provider that was on-call and the physician stated he was unavailable that weekend.

The physician on-call lists were reviewed by the surveyor on 9/25/12 at 10:00 a.m. Staff member A was listed as being on-call 24 hours from 7:00 a.m. to 7:00 a.m. on 9/10/12 to 9/19/12.

The hospital policy titled, 'Acceptance of Transfers with Emergency Medical Conditions', was reviewed on 9/25/12 at 2:00 p.m. Under Procedure it stated, "All telephonic requests for transfer received by the hospital will be referred immediately to the appropriate hospital personnel currently on duty for immediate processing. Where the decision to transfer the patient rests on the evaluation of the patient's condition, the call will be transferred to the appropriate on-call specialist or Emergency Department physician for evaluation and acceptance."

The hospital census for 9/15/12 was reviewed by the surveyor on 9/25/12 at 3:45 p.m. The total capacity of hospital B was 99 beds. The total hospital census on 9/15/12 was 60.

Staff member A was interviewed on 9/26/12 at 3:00 p.m. He stated he was on-call on 9/15/12 for ENT services. He had received a call from staff member B in the ED with a physician on the phone from hospital A with a patient to transfer. Staff member B stated, "Do you want to take the patient?" Staff member A said he thought he had a choice whether to accept the patient or not. He also stated that he had a family function that had just started and he told staff member B that he was unavailable.

In summary, a physician at hospital A called hospital B to try and transfer a patient requiring ENT services. The physician on-call for ENT services at hospital B did not accept the patient transfer and the hospital did have the capacity to accept the patient.