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Based on observation and interview, it was determined the facility failed to post a sign specifying the rights of the individual with respect to examination and treatment of emergency medical conditions and women in labor for non-English speaking individuals. The failed practice did not ensure non-English speaking individuals were aware of their rights for treatment of emergency medical conditions and treatment of women in labor. The failed practice had the potential to affect all non-English speaking individuals seen in the Emergency Department. The findings follow:

A. Observation of the Emergency Department on 07/05/13 at 1050 revealed there was no evidence of a sign indicating the rights of individuals with respect to examination and treatment of emergency medical conditions and women in labor for non-English speaking individuals. In an interview with the Emergency Room Director on 07/05/13 at 1050, she confirmed the Emergency Department treated Hispanic patients who do not speak or read English. She confirmed there was no sign present for non-English speaking individuals.

B. In an interview with the Chief Executive Officer on 07/05/13 at 1310, he confirmed the Emergency Department treated Hispanic patients who do not speak or read English.

Based on clinical record review and interview, it was determined the facility failed to inform seven (#7, #9, #11, #16, #17, #20 and #21) of eight (#7, #9, #11, #16, #17, #20, #21 and #22) patients of the risks and benefits of being transferred to another facility. The failed practice did not ensure the patients were aware of/or accepted the risks or benefits of the transfer. The failed practice had the potential to affect all patients being transferred to another facility from the Emergency Department. The findings follow:

A. Review of Patient #7, #9, #11, #16, #17, #20 and #21's clinical records on 07/05/13 revealed the patients were transferred to other acute care facilities. There was no evidence the patients or guardians were informed of the risks and benefits of the transfer.

B. Review of the Policy "Transfer (EMTALA)" provided on 07/05/13 revealed, "No patient shall be transferred from (named facility) without a physician personally examining and evaluating the patient's condition and medical needs and assuring that proper transfer procedures are used. Once the physician and patient and/or their designee have made the decision to transfer to another facility, the physician will: The transferring physician must document the reasons for transfer and the specific risks and benefits on the transfer record under the Certification of Risks and Benefits section. Informed consent must be obtained from the patient or their legal representatives."
C. The findings were confirmed in an interview with the Chief Nursing Officer on 07/05/13 at 1315.

Based on observation and interview, it was determined the facility failed to post a sign specifying the rights of the individual with respect to examination and treatment of emergency medical conditions and women in labor for non-English speaking individuals. The failed practice did not ensure non-English speaking individuals were aware of their rights for treatment of emergency medical conditions and treatment of women in labor. The failed practice had the potential to affect all non-English speaking individuals seen in the Emergency Department. The findings follow:

A. Observation of the Emergency Department on 07/05/13 at 1050 revealed there was no evidence of a sign indicating the rights of individuals with respect to examination and treatment of emergency medical conditions and women in labor for non-English speaking individuals. In an interview with the Emergency Room Director on 07/05/13 at 1050, she confirmed the Emergency Department treated Hispanic patients who do not speak or read English. She confirmed there was no sign present for non-English speaking individuals.

B. In an interview with the Chief Executive Officer on 07/05/13 at 1310, he confirmed the Emergency Department treated Hispanic patients who do not speak or read English.

Based on clinical record review and interview, it was determined the facility failed to inform seven (#7, #9, #11, #16, #17, #20 and #21) of eight (#7, #9, #11, #16, #17, #20, #21 and #22) patients of the risks and benefits of being transferred to another facility. The failed practice did not ensure the patients were aware of/or accepted the risks or benefits of the transfer. The failed practice had the potential to affect all patients being transferred to another facility from the Emergency Department. The findings follow:

A. Review of Patient #7, #9, #11, #16, #17, #20 and #21's clinical records on 07/05/13 revealed the patients were transferred to other acute care facilities. There was no evidence the patients or guardians were informed of the risks and benefits of the transfer.

B. Review of the Policy "Transfer (EMTALA)" provided on 07/05/13 revealed, "No patient shall be transferred from (named facility) without a physician personally examining and evaluating the patient's condition and medical needs and assuring that proper transfer procedures are used. Once the physician and patient and/or their designee have made the decision to transfer to another facility, the physician will: The transferring physician must document the reasons for transfer and the specific risks and benefits on the transfer record under the Certification of Risks and Benefits section. Informed consent must be obtained from the patient or their legal representatives."
C. The findings were confirmed in an interview with the Chief Nursing Officer on 07/05/13 at 1315.