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Based on a review of facility policy, observations, and staff interview (EMP), it was determined the facility failed to ensure conspicuous signage was posted in all required areas specifying the rights of individuals under section 1876 of the Act with respect to examination and treatment for emergency medical conditions and women in labor, as well as information indicating whether or not the hospital participates in the Medicaid program.

Findings include:

Review on December 15, 2021, of the facility policy "Subject: Emergency Medical Treatment and Active Labor Act (EMTALA) Date: March 25, 2021, revealed "I. Policy UPMC seeks to comply with all applicable laws and regulations relating to the provision of emergency services, including the Emergency Medical Treatment and Active Labor act (EMTALA), 42 U.S.C.1395dd. ... V. Procedure: 1. If an individual seeking emergency medical care comes to the hospital ' s Dedicated Emergency Department a QMP [Qualified Medical Person] shall offer a Medical Screening Exam. If an individual seeking emergency medical care comes to any other portion of the hospital campus, including on-campus clinics, sidewalks, driveways, and parking lots, and requests emergency medical care, a QMP will offer a Medical Screening Exam to that person. Hospital property is the hospital ' s campus, defined as an area that is 250 yards around the main hospital building, but it does not include other areas or structures of the main hospital building that are not a part of the hospital, such as physician offices, rural health centers, skilled nursing facilities, or other entities that participate separately in Medicare or restaurants, shops or other nonmedical facilities. In the absence of a request for emergency medical care made by the patient or their representative, a QMP medical screening exam will be offered if the Prudent Layperson Observer standard is met. ... 10. The facility shall post clear and visible signage that identifies the rights of the individual under EMTALA with respect to examination and treatment for Emergency Conditions and indicates the hospital ' s participation in the Medicare and Medicaid programs. ..."

On December 15, 2021, a tour of the Emergency Department (ED) was conducted at 10:05 AM. Observations at this time revealed EMTALA signage posted in the admitting area, the ambulance entrance, and the waiting room. There was no signage posted in the pedestrian entrance to the ED or any of the 23 ED treatment rooms.

On December 15, 2021, at 10:13 AM, the above observations were confirmed by EMP4.

Based on a review of facility documentation and staff interview (EMP), it was determined the facility failed to ensure a medical screening exam was provided to one of one patient (PT1) who came to facility for emergency services.

Findings include:

Review on December 15, 2021, of the facility policy "Subject: Emergency Medical Treatment and Active Labor Act (EMTALA) Date: March 25, 2021, revealed "I. Policy UPMC seeks to comply with all applicable laws and regulations relating to the provision of emergency services, including the Emergency Medical Treatment and Active Labor act (EMTALA), 42 U.S.C.1395dd. ... V. Procedure: 1. If an individual seeking emergency medical care comes to the hospital ' s Dedicated Emergency Department a QMP [Qualified Medical Person] shall offer a Medical Screening Exam. If an individual seeking emergency medical care comes to any other portion of the hospital campus, including on-campus clinics, sidewalks, driveways, and parking lots, and requests emergency medical care, a QMP will offer a Medical Screening Exam to that person. Hospital property is the hospital ' s campus, defined as an area that is 250 yards around the main hospital building, but it does not include other areas or structures of the main hospital building that are not a part of the hospital, such as physician offices, rural health centers, skilled nursing facilities, or other entities that participate separately in Medicare or restaurants, shops or other nonmedical facilities. In the absence of a request for emergency medical care made by the patient or their representative, a QMP medical screening exam will be offered if the Prudent Layperson Observer standard is met. ... "

A review of the facility documentation revealed on November 4, 2021, at approximately 9:30-10:00 AM, a patient (PT1) presented to the UPMC McKeesport D level Outpatient registration/Valet and requested directions to the ED. The patient was met by an APCT [Associate Patient Care Technician]. The patient asked about the wait time for the Emergency Department (ED). The APCT suggested that since the wait was long in the ED to try an Urgent Care. The APCT provided the patient with directions to the Urgent Care. The patient left UPMC McKeesport and presented to an Urgent Care. The patient was found to be bradycardic [an abnormally slow heart action] on the electrocardiogram, and was taken to another hospital's ED via ambulance.

During an interview on December 15, 2021, at 2:00 PM, EMP1 confirmed PT1 was not provided a medical screening exam as required when they presented to the facility on November 4, 2021.