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Based on interview and record review, Elite Hospital Kingwood failed to maintain an accurate ED Central Log. Patient #1 arrived at the facility through ambulatory entrance on 3/17/24 at 8:58 pm to seek emergency treatment and exited the facility without being seen on 3/17/24 at 9:05 p.m. The facility entered the patient in the business "quick-registration" computer system but failed to record them on the ED Central Log.

TX00495006
Findings included:

Record review 4/30/2024 of the facility policy titled " EMTALA Guidelines for Emergency Services", last reviewed 07/31/2023, stated " ... The Emergency Department shall maintain a central log documenting the following information:
" Each individual presenting to the ED for assistance
" If the individual refused treatment
" If the individual was refused treatment
" If the individual was transferred, admitted and treated, stabilized and transferred or discharged
The central log shall also include whether directly or by reference patient logs from other areas of the hospital that may be considered dedicated emergency rooms, i.e., Pediatrics, Labor and Delivery."

Review of the facility's emergency department surveillance tapes dated 3/17/24 at 8:58 pm showed a silver SUV pull up quickly to the ED ambulatory lobby entrance. An adult male with a black t-shirt and black baseball cap entered carrying a toddler and approached Patient Access Representative Staff ID #64. They had a verbal conversation and Staff ID #64 was typing on the computer and placing a call on the phone. When the female adult with them approached the desk, she took over the exchange with Staff ID # 64. At 9:02 pm, Staff ID #64 handed her a registration ipad and the female adult was pulling out her wallet and scanning retrieved items which she layed on registration counter. At 9:04 pm, the adult male, female and child start to head to the exit doors. The adult female is angry and appears to be yelling at Staff ID #64.

Record review on 4/30/24 at 2:45 p.m. of the facility's central log with Patient Access Manager Staff ID #54 was performed. She confirmed there was no evidence of Patient ID #1 on the facility's central log.

During a telephone interview on 4/30/24 at 2:45 pm with Patient Access Representative Staff ID #64. She confirmed she worked 10 am to 10 pm on 3/17/24. She confirmed that she recalled Patient ID #1 arriving with their parents for care after a dog bite by their family pet. She stated she had quick registered the patient with patient's name, date of birth in the Centricity computer system. She stated that she proceeded to give them the ipad to continue registration process which they were waiting to be seen. She stated that the patient's mother noticed the sign on the counter which stated that "facility doesn't take Medicaid" and stated the mom asked her about that. She stated she told the mother "we do not participate in Medicaid but the doctor can see you." She stated that "parents became angry because the child had not been taken back immediately for care and that the facility did not participate in Medicaid", began screaming and cursing at her and left the building. She stated that the mother had started the process for registration and uploading documents on the ipad system they utilize, nut did not complete and submit it so therefore the information was not saved.

Interview on 4/30/24 at 2:45 p.m. with Patient Access Manager Staff ID #54. She stated that the facility's central log is a manually created excel spreadsheet that requires the patient access representatives to manually enter patients on the list. She stated that the patient likely was not entered in the central log because the mother failed to complete the full registration process and therefore the information did not cross over into the system where they retrieve patients. She confirmed there was no back-up system to capture patients who left without being seen, if they had not completed their registration process.