HospitalInspections.org

Based on interview, it was determined the facility failed to comply with 42.CFR 489.24, Special responsibilities of Medicare hospitals in emergency cases. The sending facility contacted the Psychiatrist on call at 0220, who refused to accept an emergent patient because the patient was out of the catchment area. See A 2411

Based on interview, it was determined the facility contacted the Psychiatrist on call (Physician #1) regarding a request from a referring hospital to accept a patient who required specialized Psychiatric Services. Physician #1 refused to accept the patient. Evidence follows:

A. Review of the Psychiatry On-Call Schedule for October 2010, revealed Physician #1 was on call from 10/29/10 at 1700 until 11/05/10 at 1700.

B. The patient's Emergency Room record from the referring hospital contained the following documentation.
1) The patient presented to the referring hospital Emergency Room on 10-30-10 at 0050. Patient admitted to thoughts of suicidal ideation but no attempts made. patient keeps rising and sitting in chair at nurses station.
2) Referring hospital called Jefferson Regional Medical Center at 0220, paged Physician #1. Physician #1 stated she could not accept the patient because he was out of catchment.
C. Interview with Physician #1 by telephone at 1105 on 02/03/11 revealed, "I don't remember that specific incident, but Administration has told us not to accept Emergency Room patients outside of the catchment area." When questioned what the catchment area included, she indicated from Stuttgart, Sheridan, Star City to Pine Bluff, Arkansas. When further questioned if she would accept an emergency room patient outside of the catchment area, she confirmed, "No".