HospitalInspections.org

Finding:

Based on observations, record reviews, and interviews, the facility failed to provide a medical screening examination with the capability of the hospital's Emergency Department ("ED") for a patient who came to the ED seeking care in one (1) of twenty-one (21) ED patient records reviewed (Patient #1).

The hospital's "Emergency Management and Transfer Rule" policy, last revised 04/01/2024, states in part, " ...If an Individual comes to the Emergency Department, then the hospital must provide a Medical Screening Examination..."

On 05/10/2024, Northern Light Eastern Maine Medical Center self-reported a possible EMTALA violation stating, in part, "[Patient #1] presented to Eastern Maine Medical Center's ED on Friday, May 10, 2024, at approximately 8:30 PM, and felt he/she had been turned away by ED staff due to having his/her infant with him/her."

On 05/21/2024, at 11:06 AM, the Regulatory and Licensing Compliance Officer provided a summary of the hospital's investigation of Patient #1's allegations. The summary states in part, "On May 13, 2024, [Manager of Patient Access], Manager of Patient Access, interviewed [Registration Representative], Registration Representative, who was present when the patient [Patient #1] arrived at the ED. I [Manager of Patient Access] spoke with the Registration employee on 05/13/24 to take her statement on the conversation between the patient and the Pivot nurse [Nurse #1]. Per the Registration employee, the Pivot nurse [Nurse #1] asked, "is that your baby?". The patient said, "yes." The nurse then said "then you'll need to find someone to take your baby". The patient, with a puzzled look, said "okay", and then turned around and left. The patient was not registered prior to leaving. Per [Registration Representative], the Pivot nurse never asked the patient what he/she needed to be seen for."

On 05/21/2024, at 11:13AM, the Emergency Department Nurse Manager stated, "[Patient #1] never received a medical screening exam, after he/she presented on May 10."

Northern Light Eastern Maine Medical Center identified the potential violation, self-reported the event, and put in measures to ensure staff did not pose questions that could possibly deter a patient in the future from seeking care. Such measures included a review of the facility's Emergency Medical Treatment and Active Labor Act ("EMTALA") policies, mandatory online training, and in-person training for Emergency Department and Registration staff. At the time of the on-site survey, surveyors determined, through observation, document reviews, and interviews, that Northern Light Eastern Maine Medical Center was in compliance, but previously out of compliance with 42 CFR, Part 489, Responsibilities of Medicare Participating Hospitals in Emergency Cases.