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Based on review of patient records, hospital policies and procedures and staff interviews, the hospital failed to comply with all requirements of 489.24.

Refer to citation and example at:

A 2406 (489.24(a)) Medical Screening Exam - Hospital staff at the North Side Free Standing Emergency Department failed to provide a medical screening exam for a patient who arrived by ambulance in their Emergency Department on November 26, 2017. The hospital was not on diversion status at the time.

Based on review of the complainant's information, review of ambulance records, review of hospital policy and procedure, and staff interview, the hospital staff at a Free Standing Emergency Department of the hospital failed to provide a medical screening exam to rule out an emergency medical condition for a patient who arrived by ambulance for 1 of 25 records reviewed of patients presenting to the Free Standing Emergency Department (Patient #1).

Failure to provide a medical screening exam risked patient health and safety, and is a violation of the federal "anti-dumping" regulations.

Findings include:

Patient #1: Per review of the complainant's information and review of the ambulance "Patient Care Report" dated 11/26/17, the Patient arrived by ambulance at the Free Standing Emergency Department on 11/26/17 at approximately 11:45 A.M. The ambulance report documented the patient presented with abdominal pain and nausea/vomiting; and had a history of assaultive behavior and suicidal ideation. In route to the Free Standing Emergency Department, the patient became agitated and assaulted ambulance staff. "On arriving at Deaconess North, the Doctor on duty states to staff he could not accept patient as there was no one to baby sit..Patient was taken to (another hospital) who had just come off divert." Per record review, the patient was diagnosed with community acquired pneumonia, and admitted for IV antibiotics, fluids and placed back on psychiatric medication.

Record review of hospital policy titled, "EMTALA Medical Screening Stabilization Policy" last dated 08/31/13, showed that all individuals presenting on Hospital property requesting emergency medical services shall receive an appropriate Medical Screening Examination.

The hospital failed to provide an appropriate medical screening exam to rule out an emergency medical condition as required.