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Based on record review and interview, the hospital failed to consistently provide stabilizing care for patients who were identified to have an EMC, from 12/01/18 to 03/25/19 as evidenced by:

Two Patients (#13, and 16) of 20 did not show evidence of stabilizing treatment for patients with an EMC.

- Patient #13 was referred to the hospital ED by the family PCP with deteriorating neurological symptoms. The ED record showed the patient was discharged home, and the patient did not receive stabilizing treatment.

- Patient #16 came to the hospital ED for chest pain and shortness of breath. The ED record showed that the patient experienced persistent hypertension (213/111) during the patient's 6 hour ED stay. The ED record showed that the nurse informed the physician several times during this period. The record did not show the patient received stabilizing treatment for hypertension.

These failed practices:

1. Had the likelihood to affect the health and safety outcomes of (Patients #13, and 16), due to delayed treatment of a serious health condition.

A review of hospital policy titled, "EMTALA-Emergency Medical Screening Examination and Stabilizing Treatment (1/25/19)", states the hospital will provide stabilizing treatment within the hospital's capabilities.

Based on record review and interview, the hospital failed to consistently effect an appropriate transfer for patients who were identified to have an EMC, from 12/01/18 to 03/25/19 as evidenced by:

Three Patients (#1, 8, and 18) of 20 did not show evidence of an appropriate transfer.

- Patient #1 was treated at the hospital ED for Supraventricular Tachycardia, and transferred to a receiving hospital. The ED record does not show evidence of a signed Physician Certification.

* The record did not show that the receiving hospital agreed to accept the patient.

* The record did not show that medical records related to the patient's EMC, a written consent, or a physician certification were sent to the receiving hospital.

* The record did not show that the transfer was effected through qualified medical personnel.

- Patient #8, an 11 month old male, was brought to the hospital ED with hypoxia, and transferred to a receiving hospital.

* The ED record did not show that medical records related to the patient's EMC were sent to the receiving hospital.

- Patient #18 was seen in the Hospital ED after an outpatient CT scan showed a Dissecting Thoracic Aortic Aneurysm. The patient was transferred to a receiving hospital.

* The record did not show that the receiving hospital agreed to accept the patient.

* The record did not show that medical records related to the patient's EMC, a written consent, or a physician certification were sent to the receiving hospital.

* The record did not show that the transfer was effected through qualified medical personnel.

These failed practices:

1. Had the likelihood to delay care and affect the health and safety outcomes of (Patients #1, 8, and 18), due to inadequate transfer procedures.


A review of hospital policy titled, "EMTALA-Emergency Medical Screening Examination and Stabilizing Treatment (1/25/19)", stated that patient transfers will be effected through qualified medical personnel, the transfer request will identify the accepting facility, pertinent medical records will be sent to the receiving hospital, and that the physician certification and the consent to transfer will be duly signed and sent to the receiving hospital.