HospitalInspections.org

Based on interviews and document reviews, it was determined the hospital failed to provide a patient who presented to the Emergency Department a medical screening evaluation.

Findings:

On 08/04/2024, at approximately 2:29 AM, Patient #5 arrived at the Emergency Department in police custody.

A review of patient #5's medical record indicated the patient had been registered and no other care was completed. Patient #5's medical record contained a section titled: "Disposition Documentation" which stated that patient #5 "Patient Left Department: Left without treatment".

A written statement dated 08/30/2024, the officer who accompanied patient #5 to the hospital indicated he advised the hospital staff that patient #5 was in police custody for; "Illustrat[ing] a state of mind which made me concerned for [him/her]. I spoke to [his/her] family briefly and found that [Patient #5] had a history of mental health illness (to include schizophrenia) and was not taking [his/her] medications." "During the time at [I]nland, [Pt. #5] tried urinating in the waiting room. [He/She] also assaulted a security guard after urinating in the bathroom. At this point, the nurse stated that they were too short staffed, and that there was triage patients currently admitted; and that with [his/her] behavior, they could not handle [him/her]".

The officer's statement further indicated that patient #5 was then taken to another hospital for evaluation.

Based on document reviews and interviews, the hospital failed to provide a medical screening examination with the capability of the hospital's Emergency Department for a patient who was seeking care in one (1) of twenty (20) ED patient records reviewed (Patient #5).

Finding:

The hospitals "Emergency Treatment and Transfer Rules" policy, last revised 04/01/2024, states in part,
"HOSPITAL DUTY WITH RESPECT TO EMERGENCY MEDICAL CONDITION -
If an individual Comes to the Emergency Department, then the hospital must provide a Medical Screening Examination. If, as a result of the Medical Screening Examination, it is determined that the individual has an Emergency Medical Condition, the hospital will offer further diagnosis and treatment, if it is within its ability to do so. Northern Light Health Member Organizations will provide, without discrimination, care for Emergency Medical Conditions (within the meaning of section 1867 of the Social Security Act (42 U.S.C. § 1395dd)) to individuals regardless of their eligibility under System Policy 16-002, Financial Assistance for Northern Light Health Hospital Services.

On 08/04/2024, at approximately 2:29 AM, Patient #5 arrived at the Emergency Department in police custody. In a written statement dated 08/30/202, by the officerwho accompanied patient #5 to the hospital, stated: "He advised the hospital staff that patient #5 was in police custody for "illustrat[ing] a state of mind which made me concerned for [him/her]. I spoke to [his/her] family briefly and found that Patient #5 had a history of mental health illness (to include schizophrenia) and was not taking [his/her] medications."

When the officer asked the Registered Nurse if the ED could receive Patient #5, the Registered Nurse stated: "That they would try and admit [him/her] for a mental health evaluation."

"During the time at [I]nland, [Pt. #5] tried urinating in the waiting room. [He/She] also assaulted a security guard after urinating in the bathroom. At this point, the nurse stated that they were too short staffed, and that there was triage patients currently admitted; and that with [his/her] behavior, they could not handle [him/her]".

The officer then left the hospital with patient #5 on 08/04/2024 at approximately 2:45 AM.

Patient #5's clinical record failed to include the triage assessment or medical screening evaluation. The record contained a section titled: "Disposition Documentation" which stated that patient #5 "Patient Left Department: Left without treatment".