HospitalInspections.org

Based on staff interview and observation during a tour of the psychiatric emergency intake department, the facility failed to post EMTALA, Patient Rights signs conspicuously in the emergency/intake and other visible areas.
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Findings were:
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On 07/16/19 a tour of the Psychiatric Emergency Department at the Pavilion, revealed no required signage concerning EMTALA, and Patient Rights any where in the patient waiting area or in any of the intake assessment rooms in the dedicated emergency department of the psychiatric unit.

Interview with the Director of Intake, Staff # 3, stated, "everything was removed from all the walls, there is nothing on any of the walls in this area."

The finding was confirmed by Staff #3 and Staff #4 on the afternoon of 07/16/2019.

Based on medical record review and facility policies and procedures, the facility failed to perform a Medical Screening Exam on the patient's second trip to the psychiatric unit emergency department.
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Findings were:
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Facility policy Title: ED010- Early Medical Screening for Low Acuity Patients (EMLA) in the ED states in part.
"The enactment of COBRA/EMTALA laws in 1985 requires Emergency Departments to evaluate any and all patients that present for an emergency medical condition. The essential provisions of the statue are as follows: Any patient who presents to the hospital must be provided with an appropriate medical screening examination" to determine if he/she is suffering from an "emergency medical condition". If they are, then the hospital is obligated to either provide them with treatment until they are stable or to transfer them to another hospital. If the patient does not have an "emergency medical condition", the statute imposes no further obligation on the hospital.
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The person who performs the medical screening exam (MSE) must be specifically determined to be a "qualified medical person" by the hospital's rules, regulations, polices and/or by-laws.
Patients Excluded from the EMLA Process:
" <12 years of age or >75 years of age
" All lacerations that may require suturing
" Any suspected fracture that may require radiologic examination
" Abdominal pain - any female of childbearing age requiring diagnostic testing to determine pregnancy
" Al patients with Chest Pain
" All Sexual Assault patients
" All suspected child abuse/neglect cases
" Any condition that requires reporting to a State or federal agency
" Mental Health - any patient presenting with suicidal/homicidal ideation/gestures/agitation
" Patients in law enforcement custody.
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The patient initially presented to the psychiatric unit emergency department at NWTHS on 5/22/2019 10:05. He returned to the psychiatric unit emergency department at NWTHS-Access on 5/22/2019 with law enforcement officer and a document titled, "Amarillo Police Department Notification of Emergency Detention" Date 5/22/19 Time: 1845 Hrs., document stated in part, "suicide attempt and psychosis." No Medical Screening Examination was available for the second visit to the ED. M.D. Staff #11 re-ordered out-patient referrals. Amarillo PD was contacted to return and pick up pt.
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The above was acknowledged by Staff #3 on the morning of 7/17/2019.