HospitalInspections.org

Based on review of facility documents, medical records (MR) and interview of staff (EMP) it was determined the facility failed to report a patient transfer that may possibly have violated the Emergency Medical Treatment and Active Labor Act for one of two applicable MRs reviewed (MR1).

Findings include:

Review on January 13, 2015, of facility policy "EMTALA System Policy," last reviewed October 17, 2014, revealed "Patient Transfer and Emergency Medical Treatment and Labor Act (EMTALA) Purpose: To identify guidelines for providing the appropriate setting for conducting medical screening examinations; to identify providers eligible to perform emergency medical screening examinations; To comply with the Emergency Medical Treatment and Labor Act EMTALA), 42 U.S.C. 1395 and subsequent federal interpretive guidelines and state regulations. Departments that conduct medical screenings include: Emergency Departments of GMC ... Policy: Any person who comes to facility requesting assistance for a potential emergency medical condition/emergency services will receive a medical screening performed by a qualified provider to determine whether an emergency medical condition exists. Persons with emergency conditions will be treated and their condition stabilized without regard to ability to pay for services. EMTALA does not apply to inpatients. The triage process recognizes that triage and a medical screening are two separate processes. ... "

Review of the Central Log for Emergency Department (ED) for December 29, 2014, revealed 52 patients were seen in the ED on that date. Two transfers from [name of transferring facility] were listed on this log.

Review of MR1 revealed the patient was received from [name of transferring facility] at 5:53 PM on December 29, 2014. The patient was brought in by police as a 302. The patient reported they were initially brought to [transferring facility]. While in the waiting room at [the transferring facility], MR1 was reportedly told there was no room for the patient, and was transferred to Geisinger-Bloomsburg to be evaluated. Further review revealed no transfer forms were sent with the patient. MR1 was evaluated in the ED at Geisinger-Bloomsburg and admitted to the behavioral health unit for treatment.

Review of Patient Safety Reports from Geisinger-Bloomsburg Hospital revealed no report for this possible EMTALA incident.

Interview of EMP1 at 10:22 AM confirmed MR1 was received at this facility at 5:53 PM on December 29, 2014, and was admitted to the behavioral health unit for treatment. OTH1 spoke to EMP1 on December 29, 2014, and was unclear how MR1 arrived at Geisinger-Bloomsburg. OTH1 told EMP1 they were concerned because they did not receive a call requesting the patient be transferred to Geisinger-Bloomsburg from [name of transferring facility] and no transfer forms were sent with the patient. Further interview with EMP1 revealed EMP1 called [name of the transferring facility] within 30 minutes of their knowledge of this incident on December 29, 2014, and spoke to OTH2 in the ED. EMP1 told OTH2 about the patient who appeared to have been sent to the facility from [name of the transferring facility]. EMP1 told OTH2 the patient might have been seen in the waiting room. EMP1 told OTH2 the facility did not receive a transfer phone call or paperwork with the patient. OTH2 told EMP1 they would investigate the incident. EMP1 confirmed Geisinger-Bloomsburg did not report this incident to the Department of Health.