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Based upon document review and interview the facility did not comply with all of the provisions for conducting a medical screening exam. Please reference findings under Tag A2406.

Based upon interview, medical record review and document review, the hospital did not provide a medical screening exam, following a suggestion by staff that the patient go elsewhere, for 1 of 30 patients who presented to the Emergency Department (ED) (Patient #1). A lack of a medical screening exam could result in an emergency medical condition not being identified and treated.

Findings include:

Review of Policy " Emergency Medical Treatment and Active Labor Act (EMTALA) " #LE.900, last revised 7/14 revealed, all individuals presenting to the hospital requesting examination or treatment shall be offered a medical screening examination to determine if the individual has an emergency medical condition. An appropriate medical screening examination shall be provided by a physician or dentist or a qualified member of the Medical Staff.

Review of the ED record dated 3-15-16 revealed the patient arrived at 3:28am and was triaged at 3:30am as a level 4 non-urgent visit.

Interview with Staff #2 on 4-25-16 at 11:35am revealed that the patient presented to the ED with complaints of post-surgical shoulder pain rated as a 10 on a scale of 1-10 with 10 being the worse possible pain. Staff #2 indicated that after speaking with the provider, it was noted that it would be a couple of hours before the patient would be seen. Staff #2 returned to the patient and stated "I am not trying to turn away business but it will be at least two hours before you are seen by a physician and treated. If you do not want to wait, you may want to seek treatment elsewhere to control your pain". The patient became upset and left the ED.

Review of the ED record dated 3-15-16 the patient left without being seen at 3:35am.