HospitalInspections.org

Based on observations and interview, the hospital failed to post conspicuous in the emergency department for those patients waiting for examination, signs specifying the rights of individuals under section 1867 of the Social Security Act with respect to examination and treatment in the emergency department. Findings include:

A tour of the emergency department (ED) was conducted with registered nurse (RN)-B on 8/25/15 at 2:30 p.m. The hospital had two entrances, which included the main ED entrance leading into the waiting area and the ambulance/garage entrance. There were no visible signs specifying the rights of individuals under section 1867 of the Social Security Act with respect to examination and treatment for emergency medical conditions and women in labor (EMTALA) in the ED waiting area or in individual ED rooms for individuals to view while waiting for an examination.This was verified with RN-B on 8/25/15 at 2:35 p.m. during the ED tour. It was verified that individuals are sometimes triaged in the triage room prior to seeing a physician. There was no visible EMTALA sign in the triage room.

Based on interview and documentation review the hospital failed to maintain an accurate and complete central log on each individual who presented to the obstetrics department for a medical screening examination for 7 of 7 (P18, P19, P20, P21, P22, P23, and P24) obstetric patient records reviewed. Findings include:P18:
Review of the central log for obstetrics for 3/21/15 revealed P18 presented to the obstetrics department. The central log noted a chief complaint of "observation/evaluation" and P18's disposition was noted as "unknown". Review of the progress notes of 3/21/15 at 15:49 revealed P18 presented with a chief complaint of contractions and the progress note of 20:37 was admitted to the hospital and delivered.

P19:
Review of the central log for obstetrics for 5/4/15 revealed P19 presented to the obstetrics department. The central log noted a chief complaint of "observation/evaluation" and disposition was noted as "unknown". Review of the progress notes of 5/4/15 at 10:00 a.m. noted P19 presented with a chief complaint of irregular contractions and progress note of 5/4/15 at 12:22 noted P19 was discharged.

P20:
Review of the central log for obstetrics for 5/5/15 revealed P20 presented to the obstetrics department. The central log noted a chief complaint of "other" and disposition was noted as "unknown". Review of the progress notes for 5/5/15 at 3:51 p.m. noted P20 was admitted to the hospital.

P21:
Review of the central log for obstetrics for 7/19/15 revealed P21 presented to the obstetrics department. The central log noted the chief complaint was "other". P21's disposition was noted as "unknown". Review of the progress notes for 7/19/15 at 6:36 p.m. noted P21 presented with a chief complaint of ruptured membranes and mild cramping. Review of the progress notes of 7/19/15 at 8:25 p.m. noted P21 was transferred to another hospital by ambulance.P22:
Review of the central log for obstetrics for 5/17/15 revealed P22 presented to the obstetrics department. The central log noted P22 was admitted to the hospital. Review of P22's progress notes of 5/17/15 at 10:35 p.m. noted P22 was discharged to home.

P23:
Review of the central log for obstetrics for 6/1/15 revealed P23 presented to the obstetrics department. The central log noted P23's disposition was "other". Review of P23's progress notes on 6/1/15 at 11:10 a.m. revealed P23 was discharged to home.P24:
Review of the central log for obstetrics for 4/17/15 revealed P24 presented to the obstetrics department. The central log noted P24's chief complaint and disposition were "unknown". Review of the progress notes of 4/17/15 at 9:20 p.m. P24 presented with a chief complaint of regular contractions. Progress notes of 4/17/15 at 12:42 a.m. noted P24 discharged to home.On 8/26/15 at 3:08 p.m. an interview with Registered Nurse (RN)-H was conducted and she verified that the obstetrics central log was inaccurate and incomplete as it related to chief complaint and disposition of the individual.