HospitalInspections.org

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Based on observation, document review and interview, the Emergency Department (ED) did not post Patient Rights signs in all areas likely to be noticed by patients arriving to the ED.

Specifically, signage for Emergency Medical Treatment and Labor Act (EMTALA), Patient Rights and Parent's Bill of Rights were not prominently posted in the ED patient care areas.

This lack of signage may lead to patients not being fully informed of their rights.

Findings include:

Observations in the facility's ED during a tour on 07/12/18 at 10:15AM, identified the following: One (1) EMTALA sign posted on the wall across from the waiting room's nurses' station, was obscured by another sign directly in front of it. No Parent's Bill of Rights signage was found. No additional signage was found in the ED waiting area, registration corridor, hallway leading to the main ED, main treatment areas or pediatric areas. EMTALA signage was posted in the ambulance entrance, but no Parent's Bill of Rights signage was posted in this area. The same lack of signage was observed in the Obstetrics Triage Area and the Psychiatric ED waiting area.

The facility Policy and Procedure (P&P) titled "Emergency Medical Treatment and Labor Act Requirements and Compliance", last revised 7/27/2017, did not contain information regarding signage requirements.

The facility P&P titled "Patients' Rights and Responsibilities", last revised 2/23/2017, stated the following: "... the Patient Bill of Rights shall be posted in clearly viewed areas ... including the emergency service waiting areas." This P&P did not include information related to the Parent's Bill of Rights.

The facility's "Patient Information Guide", given to all patients admitted to the facility, included both the Patient's Bill of Rights and the Parent's Bill of Rights; the facility could not provide a policy for the Parent's Bill of Rights.

These findings were confirmed with Staff N (Director of Nursing) and Staff D (Senior Vice President of Quality Management) at the time of the observation.
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Based on interview and document review, the Medical Staff did not establish criteria delineating the qualifications an Emergency Department (ED) Physician must possess to supervise the provision of Emergency Care Services.

This failure may lead to a non-qualified Physician supervising emergency care services.

Findings include:

The facility's Medical Staff Bylaws did not describe the qualifications, such as the necessary education, experience or specialized training, a medical staff member must possess in order to supervise emergency care services.

Review of the facility's "Nassau University Medical Center Emergency Medicine Schedule", dated July 2018, identified one (1) Physician's name, on each shift in bold type, as the Supervising Physician for the shift.

During interview of Staff I (Medical Director) on 07/16/18 at 11:30AM, Staff I stated, "generally I (myself) or one (1) of the two (2) Assistant Chairs are on duty and would be supervising the ED; if not it is the Physician in bold on the schedule".

When asked if there were specific criteria delineating the qualifications the Physician must possess in order to supervise Emergency Care Services, Staff I responded, "to my knowledge, there is no written criteria, it is the most senior Physician on duty at the time".

This was confirmed by Staff D (Senior Vice President of Quality Management) during the afternoon of 07/16/18.