HospitalInspections.org

Based on record review and interviews, facility staff failed to accept the transfer of 1 of 21 patients (Patient #21) with an emergency medical condition.

Findings Include:

Facility staff failed to accept the transfer of a patient with an emergency medical condition. See tag A-2411.

Based on record review and interview, facility staff failed to accept the transfer of 1 of 21 patients (Patient #21) with an emergency medical condition.

Findings Include:

A review of the facility's policy "EMTALA (Emergency Medical Treatment and Labor Act)" last revised on 12/16/2022 revealed, "... If the Recipient Hospital has specialized Capabilities that are not available at the transferring hospital, the Recipient Hospital will not refuse to accept the transfer of an individual needing those Capabilities if the hospital has the Capacity to treat the individual..."

A review of Patient #21's medical record from the transferring facility revealed, "... The patient is presenting with left arm pain and that is relatively sudden onset... It is worsened since that time and [s/he] notes discoloration... [S/he] has a history of severe peripheral vascular disease (a circulation disorder) and my concern is that [s/he] has a degree of ischemia (stopped blood flow) causing [his/her] pain... [Receiving facility] contacted for recommendations. Spoke with [House Supervisor G]... I am attempting to facilitate transfer by discussion with a vascular surgeon regarding acute ischemic limb. I was told to contact [other facility]... I did ask if [receiving facility] had availability and vascular surgery. [House Supervisor G] refused to answer whether or not they had beds... I was also being told that patient requests are not a reason for transfer. I was not able to speak with a vascular surgeon..."

During an interview on 05/22/2023 at 11:10 AM with Risk Manager J, s/he stated that House Supervisor G never "flat out refused" to accept Patient #21 for transfer, but s/he would not directly answer ED (Emergency Department) MD (Medical Doctor) K's question as to if the facility could accept Patient #21 for transfer.

During an interview on 05/22/2023 at 11:21 AM with Chief Medical Officer (CMO) B, s/he stated the hospital had both capacity and capability to accept this patient for transfer.

An interview was conducted on 05/22/2023 at 1:07 PM with DON (Director Of Nursing) C who stated that s/he was aware of the EMTALA violation related to Patient #21 not being accepted for transfer. DON C stated that the next day s/he held a meeting with the house supervisors to discuss EMTALA regulations. S/he also sent an email and PowerPoint for all 10 house supervisors to review regarding EMTALA regulations, which an email confirmation that this EMTALA PowerPoint was read and reviewed is required by 05/26/2023. DON C stated that annual EMTALA education has been added to house supervisor education. No further instances of transfer refusal were identified in patient records since 05/09/2023.