HospitalInspections.org

Based on facility records, observation, and staff interviews, the Department determined the administrator failed to ensure that Patient # 1 and Patient # 2 received a Medical Screening Exam before signing the financial consent. This deficient practice poses a risk to the health and safety of patients if emergency care is delayed.

Findings Include:

Policy titled "Conditions of Admission" revealed: " ...POLICY: It is the policy of Dignity Health that every acute care facility and dedicated emergency department utilize a Conditions of Admission (COA) form that has been reviewed by the Dignity Health Legal Department and is consistent with applicable state and federal laws and regulation ...PURPOSE: The primary intent of the COA form is to establish the conditions under which a patient is admitted to the hospital for inpatient or outpatient services and under which an outpatient receives care in emergency departments. Conditions of Admission form for use in the emergency departments consisting of two parts ...Emergency department patients should sign Part 1 of the COA upon admission or as soon thereafter as possible, given the patient's condition. Patients seeking Emergency Services shall not be asked to sign Part II of the COA until after the emergency medical screening examination and stabilizing services ...."

Hospital document titled "Conditions of Admissions Two Part Form"
2 out of 5 patient medical records reviewed revealed the patient's signature was timed before the MSE was provided.

A medical record review of the following revealed
Patient # 1 signed Part Two of the Consent for Admission before MSE was provided
Arrival 1805 Triage 1802 MSE 1912 Financial Consent signed 1854
Patient # 2 signed Part Two of the Consent for Admission before MSE was provided
Arrival 0613 Triage 0627 MSE 0645 Financial Consent signed 0627
Patient # 3 signed Part Two of the Consent for Admission after the MSE was provided
Arrival 0025 Triage 0030 MSE 028 Financial Consent signed 0043
Patient # 4 signed Part Two of the Consent for Admission after the MSE was provided
Arrival 1015 Triage 1015 MSE 1015 Financial Consent signed 1042
Patient # 5 signed Part Two of the Consent for Admission after the MSE was provided
Arrival 0955 Triage 1001 MSE 1011 Financial Consent signed 1038

Interview and Observation with employee # 7.
While employee #7 was demonstrating how the patient signs the Consent for Admission Forms on the IPAD, it was revealed that the form is time-stamped when the patient signs.

Employee # 2 and employee # 3 both confirmed during an interview dated 02/26/2025 that patient # 1 and patient # 2 signed Part Two of the Consent for Admission before receiving an MSE.